Journal of Surgery Concepts & Practice >

2021 , Vol. 26 >Issue 06: 537 - 542

DOI: https://doi.org/10.16139/j.1007-9610.2021.06.016

Original article

Study on acupuncture with thoracic paravertebral block for patients with intercostal nerve transfer and general anesthesia

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  • Department of Anesthesiology, Jing’an District Central Hospital, Shanghai 200040, China

Received date: 2021-03-15

  Online published: 2022-07-27

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Abstract

Objective To analyze the clinical effect of acupuncture combined with thoracic paravertebral block (TPVB) in the treatment of pain and complications of the patients with intercostal nerve transfer and general anesthesia. Methods Eighty-eight patients with intercostal nerve transfer were randomized into three groups: 34 cases with patient controlled intravenous analgesia (PCIA) just after operation in group A, 28 cases with TPVB given when entering the operation and(PCIA) at the end of operation in group B, and 26 cases with TPVB and(PCIA) combined with acupuncture in group C. Acupuncture analgesia was used in group C with electroacupuncture stimulated for 20 minutes on points of Zhigou, Houxi, Hegu and bilateral Neiguan just the day before operation. Incidence of postoperative nausea and vomiting and the postoperative dosage of analgesic fentanyl were recorded. The indices related with analgesia including β-endorphin (β-EP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), 5-hydroxytryptamine (5-HT) and cortisol were detected using ELISA method before and after operation and compared among 3 groups. Results The dosage of fentanyl was lower in group C than those in group A and B significantly (P<0.05) and the incidence of nausea and vomiting lower than those in group A and B (P<0.05). Only serum IL-6 concentration 2 hours after operation in group B decreased significantly compared with that in group A (P<0.05). When compared those in group A, β-EP increased and IL-6, TNF-α and cortisol decreased in group C significantly (P<0.05). The concentration of β-EP increased and cortisol decreased significantly in C group(P<0.05) compared with those in B group. Comparing with that of 1 day before operation, The concentrations of serum β-EP, 5-HT and cortisol decreased and IL-6 increased in C group significantly (P<0.05) after acupuncture intervention. The concentration of β-EP, 5-HT and TNF-α in serum decreased significantly 2 hours after operation than before, while the concentrations of IL-6 in serum increased significantly (P<0.05). The concentration of TNF-α in patients 2 hours after operation decreased significantly (P<0.05). Conclusions Acupuncture combined with TPVB and general anesthesia could have good analgesic effect, which increases the concentration of β-EP and inhibits the release of pro-inflammatory factors such as IL-6, TNF-α and cortisol.

Key words： Acupuncture; Thoracic paravertebral block; Postoperative analgesia

Cite this article

YU Shijian, WANG Xuehu, ZHANG Lin, LIN Weiwei, CUI Wei . Study on acupuncture with thoracic paravertebral block for patients with intercostal nerve transfer and general anesthesia[J]. Journal of Surgery Concepts & Practice, 2021 , 26(06) : 537 -542 . DOI: 10.16139/j.1007-9610.2021.06.016

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