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| The protective effect of transcutaneous electrical stimulation on vital organ function in neurosurgery doing controlled hypotension |
| MO Yunchang, CHEN Linbi, Wang Xixi, PAN Yuanyuan, LUO Shan, HUANG Luping, |
Department of Anesthesiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015
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Abstract Objective: To study the protective effect of transcutaneous electrical acupoint stimulation (TEAS) combined with controlled hypotension on brain, liver and kidney in neurosurgery. Methods: Fifty elective surgery patients with brain tumor were randomly divided into control group and treatment group, each was 25 cases. The treatment group (TEAS group) with TEAS plus controlled hypotension, stimulation frenquecy was 2/ 100 Hz, density wave, the intensity of 8-12 mA, electrical stimulation of bilateral Hegu, Sanyinjiao, Qu Chi and Zusanli, and reduced the mean arterial pressure (MAP) to the target and maintained 40-50 minutes. In the control group (Sham group): only electrodes attached to the same points, no stimulation, as other treatments with the TEAS group. Then we extracted internal jugular vein in these time points, including 5 minutes before lowering blood pressure (T1), to maintain blood pressure 60 minutes (T2), after elevated blood pressure 60 minutes (T3), 24 hours and 48 hours after surgery (T4 and T5), detected cerebral protection factor and damage factor: SOD, CGRP, ET, MDA, IL-6 and S100β protein; the function indicators of heart: LDH, cTnI, MYO, CK and CK-MB; indexes of liver function: prealbumin, glutathione, ALT, AST, ALP, γ-transglutaminase; renal function parameters: Cystatin C, BUN, Cr, uric acid. Results: ①The cerebral protection factor and damage factor: Compared with T1, the level of SOD decreased obviously in the patients of control group at T2, T3 and T5 time points (P<0.05), however the level of CGRP, ET, MDA, IL-6 increased in T3, T4 and T5 (P<0.05). Compared with the control group, the TEAS group respectively reduced IL-6 and S100β in T2, reducing the level of ET in T3, increasing the SOD in T4, and lowering the MDA in T5 (P<0.05). ②The function indicators of cardiac: there was no difference between these two groups in the function indicators of cardiac (P>0.05). ③The indexes of renal function: the level of cystatin C of sham group was significantly higher in the T2 and T3 compared with the T1 time point (P<0.05). Compared with the control group, the treatment group could reduce the level of cystatin C in the T2 and T3 (P<0.05). ④The indicators of liver function: compared with T1, the level of AST, ALT and α-GST respectively increased in the T2, T3, T4 and T5 (P<0.05), while the prealbumin level significantly decreased in two points, including T2 and T3 (P<0.05). The patients of TEAS group was observed the level of α-GST could be reduced in T2 and T3 and the level of AST and ALT also reduced in the T4 and T5 in these two points (P<0.05). Conclusion: The neurosurgery combines with controlled hypotension can cause a certain impact on the function of brain, liver and renal. However the transcutaneous electrical acupoint stimulation (TEAS) can play a role in organ protection.
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Received: 22 December 2015
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