Meta-Analysis of Electroacupuncture in Cardiac Anesthesia and Intensive Care
Meta-Analysis of Electroacupuncture in Cardiac Anesthesia and Intensive Care
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DOI：
10.1177/0885066617708558
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发表时间：
2019-08-01
影响因子：
3.1
通讯作者：
Maybauer, Marc O.
中科院分区：
文献类型：
--
作者：
Asmussen, Sven;Przkora, Rene;Maybauer, Marc O.
背景：针灸治疗在中国已有2500多年的历史，在世界范围内被用于急性和慢性疼痛的镇痛。针灸也用于全身麻醉（GA）。本系统综述和荟萃分析的目的是评估电针（EA）和GA在心脏手术患者中的疗效。方法:我们检索了3个数据库（Pubmed、Cochrane Library和Web of science，从1965年到2017年1月31日），检索了随机对照试验（rct），包括接受心脏手术的患者，单独接受GA或GA + EA。作为主要结局，我们研究了GA + EA入路与术中麻醉药物剂量、机械通气时间（MV）、术后血管活性药物剂量、重症监护病房（ICU）和住院时间的长短以及肌钙蛋白I和细胞因子的水平。结果：最初的检索产生了477条引用，但仅纳入了7项前瞻性随机对照试验，共纳入321例患者。GA + EA的使用减少了术中麻醉药物的用量（P < 0.05），缩短了MV时间（P < 0.01）和ICU住院时间（P < 0.05），减少了术后血管活性药物的剂量（P < 0.001）。此外，肌钙蛋白I （P < 0.01）和肿瘤坏死因子α (P < 0.01)水平显著降低。结论：在心内直视手术中配合使用EA可缩短心内直视手术和ICU住院时间，减轻炎症反应，可能对心脏有保护作用。我们的发现刺激了未来的随机对照试验提供明确的建议。
Background: Acupuncture treatment has been employed in China for over 2500 years and it is used worldwide as analgesia in acute and chronic pain. Acupuncture is also used in general anesthesia (GA). The aim of this systematic review and meta-analysis was to assess the efficacy of electroacupuncture (EA) in addition to GA in patients undergoing cardiac surgery. Methods: We searched 3 databases (Pubmed, Cochrane Library, and Web of Science-from 1965 until January 31, 2017) for randomized controlled trials (RCTs) including patients undergoing cardiac surgery and receiving GA alone or GA + EA. As primary outcomes, we investigated the association between GA + EA approach and the dosage of intraoperative anesthetic drugs administered, the duration of mechanical ventilation (MV), the postoperative dose of vasoactive drugs, the length of intensive care unit (ICU) and hospital stay, and the levels of troponin I and cytokines. Results: The initial search yielded 477 citations, but only 7 prospective RCTs enrolling a total of 321 patients were included. The use of GA + EA reduced the dosage of intraoperative anesthetic drugs (P < .05), leading to shorter MV time (P < .01) and ICU stay (P < .05) as well as reduced postoperative dose of vasoactive drugs (P < .001). In addition, significantly lower levels of troponin I (P < .01) and tumor necrosis factor alpha (P < .01) were observed. Conclusion: The complementary use of EA for open-heart surgery reduces the duration of MV and ICU stay, blunts the inflammatory response, and might have protective effects on the heart. Our findings stimulate future RCT to provide definitive recommendations.