电针对老年脆弱脑功能病人髋关节置换术中脑氧饱和度及术后谵妄的影响

doi:10.3969/j.issn.1003-9198.2021.07.004

Abstract

Abstract: Objective To investigate the effect of electroacupuncture on intraoperative cerebral oxygen saturation and postoperative delirium in the elderly patients with fragile brain function undergoing hip replacement. Methods A total of 60 elderly patients with fragile brain function receiving hip repalcement surgery under general anesthesia were randomly divided into electroacupuncture group (EA group) and non-electroacupuncture group (C group),with 30 cases in each group. EA group received electroacupuncture from 30 min before induction of anesthesia to 30 min before the end of surgery, while no intervention was performed on the C group. Regional cerebral oxygen saturation (rSO₂) was recorded before anesthesia induction (T₀), after tracheal intubation (T₁), at the beginning of operation (T₂), 30 min and 1 h after beginning(T₃, T₄), and at the end of operation (T₅). The mean rSO₂(rSO_2mean), minimum rSO₂ (rSO_2min) and maximum declining percentage compared with baseline values (rSO₂_%_max) was calculated.The extubation time, Ricker sedation-agitation scale (RSAS) score and the residence time of postanesthesia care unit (PACU) were recorded. Postoperative delirium and postoperative recovery quality questionnaire (QoR-15) were evaluated 1 d, 2 d and 3 d after surgery. Results Compared with C group, rSO₂ at T₁-T₅, rSO_2mean and rSO_2min was significantly increased in EA group (P＜0.05), while rSO_2%max was significantly decreased (P < 0.05); The incidence of delirium in EA group was significantly decreased 1 d after surgery (P<0.05); The extubation time as well as the residence time of PACU was significantly shortened (P<0.05), and RSAS score was significantly reduced in EA group (P<0.05); QoR-15 score was significantly increased on 1 d, 2 d and 3 d after surgery in EA group(P<0.05). Conclusions Electroacupuncture can improve intraoperative rSO₂ in the elderly patients with fragile brain function undergoing hip replacement, reduce the incidence of postoperative delirium, improve the quality of recovery, and accelerate the quality of postoperative recovery, which may be due to the improvement of cerebral oxygen metabolism.

Key words: electroacupuncture, aged, fragile brain function, cerebral oxygen saturation, postoperative delirium

CLC Number:

R 619

LI Xue-fei, ZHENG Man, ZHAN Wei-fang, WANG Wei, ZOU Rong. Effect of electroacupuncture on intraoperative cerebral oxygen saturation and postoperative delirium in elderly patients with fragile brain function undergoing hip replacement[J]. Practical Geriatrics, 2021, 35(7): 676-679.

References

[1] 中华医学会麻醉学分会老年人麻醉学组. 中国老年患者围术期麻醉管理指导意见[J].国际麻醉学与复苏杂志, 2014, 35(11): 1057-1069.
[2] 王丽,王浩,孟扬. 右美托咪定对胃癌行外科治疗脆弱脑功能患者的术后影响[J]. 检验医学与临床, 2017,14(19): 2965-2966.
[3] CHANG Q Y, LIN Y W, HSIEH C L, et al. Acupuncture and neuroregeneration in ischemic stroke[J]. Neural Regen Res, 2018, 13(4):573-583.
[4] CARSON J L, ALTMAN D G, DUFF A, et al. Risk of bacterial infection associated with allogeneic blood transfusion among patient undergoing hip fracture repair[J]. Transfusion,1999, 39(7):694-700.
[5] STARK P A,MYLES P S,BURKE J A. Development and psychometric evaluation of a postoperative quality of recovery score: the QoR-15[J]. Anesthesiology, 2013, 118(6):1332-1340.
[6] JO Y Y, SHIM J K, SOH S, et al. Association between cerebral oxygen saturation with outcome in cardiac surgery: brain as an index organ[J]. J Clin Med, 2020, 9(3):840-851.
[7] LEI L, KR F L, CARROLL J, et al. Cerebral oximetry and postoperative delirium after cardiac surgery: a randomized, controlled trial[J]. Anesthesia, 2017, 72(12):1456-1466.
[8] EVERED L A, VITUG S, SCOTT D A, et al. Preoperative frailty predicts postoperative neurocognitive disorders after total hip joint replacement surgery[J]. Anesth Analg, 2020, 131(5):1582-1588.
[9] YUAN W, WANG Q. Perioperative acupuncture medicine: a novel concept instead of acupuncture anesthesia[J]. Chin Med J,2019,132(6):707-715.
[10] ZHENG H Z, JIANG W, ZHAO X F, et al. Electroacupuncture induces acute changes in cerebral cortical mi RNA profile, improves cerebral blood flow and alleviates neurological deficits in a rat model of stroke[J]. Neural Regen Res, 2016, 11(12):1940-1950.
[11] TAN F, WANG J, LIU J X, et al. Electroacupuncture stimulates the proliferation and differentiation of endogenous neural stem cells in a rat model of ischemic stroke[J]. Exp Ther Med, 2018, 16(6): 4943-4950.
[12] 吴艳春, 陈俭, 方强. 电针对心脏瓣膜置换术后患者镇静作用的初步研究[J]. 中国中西医结合杂志, 2007, 27(12):1070-1073.

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Effect of electroacupuncture on intraoperative cerebral oxygen saturation and postoperative delirium in elderly patients with fragile brain function undergoing hip replacement

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