The Effect of Auricular Acupuncture on Fentanyl Requirement During Hip Arthroplasty A Randomized Controlled Trial
The Effect of Auricular Acupuncture on Fentanyl Requirement During Hip Arthroplasty A Randomized Controlled Trial
复制标题
DOI：
10.1097/ajp.0b013e3181fd516c
复制
发表时间：
2011-03-01
影响因子：
2.9
通讯作者：
Usichenko, Taras I.
中科院分区：
文献类型：
--
作者：
Wetzel, Bert;Pavlovic, Dragan;Usichenko, Taras I.
目的：虽然耳针（AA）被认为是有效的治疗疼痛，但尚未被用于术中镇痛。因此，我们研究了AA是否能减少全髋关节置换术（THA）术中镇痛需求。方法：120例计划行全髋关节置换术的患者被纳入这项患者-麻醉师-盲法研究。患者被随机分配接受针刺特定的AA点或假手术（针刺耳螺旋上的3个非穴位）同侧的手术部位。固定AA留置针于THA术前晚上置入，术后第二天取出。患者采用地氟醚全麻，使地氟醚潮末浓度保持在3.5 ~ 5.5体积%，使双谱指数保持在40% ~ 55%。麻醉师被要求滴定芬太尼以保持心率和血压在基线值的20%以内。主要观察指标为术中芬太尼用量。次要观察指标为恶心和呕吐的发生率以及在恢复室首次要求使用镇痛药的时间。患者和麻醉师盲法的成功也被记录下来。结果：获得116例患者芬太尼需要量数据进行最终分析。AA组患者术中芬太尼用量比对照组减少15% （4.6 +/- 1.1 μ g/kg vs 5.2 +/- 1.3 μ g/kg；平均值+/- SD； P = 0.008）。两组的人口统计数据和次要结局指标具有可比性。讨论：临床效果一般，AA在术中辅助镇痛的临床应用有待进一步研究。
Objectives: Although auricular acupuncture (AA) is suggested to be effective in treatment of pain, it has not yet been used for intraoperative analgesia. Therefore, we studied whether the AA reduces intraoperative analgesic requirement during total hip arthroplasty (THA).Methods: One hundred and twenty patients scheduled for THA were enrolled in this patient-anesthesiologist-blinded study. The patients were randomly assigned to receive needling of specific AA points or a sham procedure (needling of 3 nonacupoints on the ear helix) ipsilateral to the surgery site. Fixed indwelling AA needles were placed in the evening before THA and withdrawn on the day after surgery. The patients received general anesthesia with desflurane, which end-tidal concentration was kept within 3.5 volume % to 5.5 volume% to maintain the Bispectral Index within 40% to 55%. The anesthesiologists were asked to titrate fentanyl to keep the heart rate and blood pressure within 20% of baseline values. The primary outcome was fentanyl amount given during surgery. The secondary outcome measures were incidence of nausea and vomiting and time to first request of analgesics in the recovery room. The success of patients' and anesthesiologist blinding was also documented.Results: The data of fentanyl requirement of 116 patients were available for the final analysis. Patients from AA group required 15% less fentanyl during surgery than the controls (4.6 +/- 1.1 mu g/kg vs. 5.2 +/- 1.3 mu g/kg; mean +/- SD; P = 0.008). Demographic data and secondary outcome measures were comparable in both groups.Discussion: Regarding the modest clinical effect, AA should be further investigated for its clinical usefulness for complementary analgesia during the surgery.