[Mechanism of acupoint transcutaneous electric stimulation on analgesic anesthesia in the patients undergoing general anesthesia anorectal operation].

OBJECTIVE: To observe the regulatory effects of acupoint electric stimulation on the analgesic substances and the relevant indices of nerve-immunity-endocrine system in the patients undergoing general anesthesia anorectal operation.

METHODS: One hundred and fifty-six patients undergoing hemorrhoids and anal fistula operation were randomized into three groups, 146 cases were included in the analysis. In the No.1 group (48 cases), the conventional intravenous general anesthesia was applied. In the No.2 group (50 cases), besides the conventional intravenous general anesthesia, the acupoint transcutaneous electric stimulation was combined at Neiguan (PC 6), Shenmen (HT 7), Shangliao (BL 31) and Ciliao (BL 32). operation in the No.2 and No.3 groups were lower apparently than that in the No.1 group ( P <0.05, P <0.01).

CONCLUSIONS: During the general anesthesia anorectal operation, the acupoint transcutaneous electric stimulation achieves analgesic anesthesia through effectively promoting the release of body analgesic substance and reducing the stress level in the operation. With the comprehensive acupoint selection as Neiguan (PC 6) and Shenmen (HT 7) and the local acupoints, the therapeutic effects are better in comparison with the simple selection of local acupoints. In the No.3 group (48 cases), besides the conventional intravenous general anesthesia, the acupoint transcutaneous electric stimulation was combined at Shangliao (BL 31) and Ciliao (BL 32). The electric stimulation was maintained till the end of operation. The patients' saliva was collected 0.5 h before operation and 1 h after operation separately. The indices that reflect the body pain regulation and nerve-immune-endocrine secretion were detected, such as opiophin protein (OPI), secretory immunoglobulin A (SIgA), saliva amylase (sAA), cortisol (Cor) and tumor necrosis factor α (TNF-α). The pain degree was observed 1 h after operation.

RESULTS: In the No.2 group, OPI after operation was higher than that before operation ( P <0.05). The difference value of OPI in the No.2 group was higher apparently than that in the No.1 group and the No.3 group (both P <0.05). SIgA after operation was higher than that before operation in the No.1 group ( P <0.05). The difference values of SIgA, sAA, Cor in the No.2 group were lower apparently than those in the No.1 group ( P <0.05, P <0.01). TNF-αbefore and after operation and its difference value among the groups were not significant statistically (all P >0.05). The pain degrees in 1 h after.