研究疾病:
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低氧血症和呃逆
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研究疾病代码:
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Target disease:
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hyoxemia and hiccup Singultation
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Target disease code:
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研究类型:
Study type:
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观察性研究
Observational study
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研究设计:
Study design:
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病例对照研究
Case-Control study
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研究所处阶段:
Study phase:
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其它
Others
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研究目的:
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通过经皮电刺激翳风穴,观察其在无痛胃镜检查中的作用
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Objectives of Study:
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Effect of transcutaneous electrical stimulation of Yifeng acupoint on painless gastroscopy
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药物成份或治疗方案详述:
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两组患者麻醉诱导前半小时由同一医生进行取穴,取穴部位:双侧翳风穴(耳垂后方,乳突与下颌角之间的凹陷处)。皮肤消毒后,穴位处粘贴电极片并连接电针治疗仪。观察组给予频率为2/100 Hz的疏密波,刺激强度以患者能够接受的最大强度为宜,从检查前30min开始持续刺激至胃镜检查结束;对照组仅连接刺激仪并给予阈下电刺激。
术前常规禁食禁饮,检查前30min口服达克罗宁胶浆10ml,建立右上肢静脉通道,左侧前屈卧位,监测 ECG,HR,SPO2,RR及 NIBP(袖带置于左上臂)。两组均经鼻导管4L/ min 吸氧1min。吸氧1min 后行麻醉诱导,静注舒芬太0.1-0.2ug/kg 和丙泊酚1.5-2.5mg/kg(注射速度10mg/s),维持剂量1-2mg/(kg*h),两组患者均给药至无睫毛反射,呼喊无应答,且脑电双频指数(bispectral index,BIS)为46~55,开始胃镜检查,出现体动时追加丙泊酚。所有麻醉操作由同一麻醉医生(对分组情况不知情)完成,胃镜检查也由同一位内镜医师完成。检查过程中出现血压下降(MAP<20%术前血压),给予静脉滴注麻黄素3 mg纠正;检查中出现心动过缓(HR<50次/分),给予阿托品0.5 mg纠正;检查中出现呼吸抑制(Spo2<90%),立即停止继续输注药物,并抬高下
颌,开放气道;无改善时拔出胃镜,行面罩辅助通气,仍无明显好转则紧急气管插管行呼吸机辅助通气。
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Description for medicine or protocol of treatment in detail:
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Two groups of patients were selected by the same doctor half an hour before anesthesia induction, and the acupoints were located at bilateral Yifeng ( behind earlobe, the concave place between mastoid and mandibular angle ). After skin disinfection, paste electrodes at acupoints and connect electroacupuncture apparatus. The observation group was given 2 / 100 Hz sparse and dense waves, and the stimulation intensity was appropriate to the maximum intensity that the patient could accept. The stimulation continued from 30 minutes before the examination to the end of gastroscopy. The control group was only connected to the stimulator and given subliminal electrical stimulation.
Routine fasting and fasting before operation, oral administration of dacronin 10 ml 30 min before examination, establish right upper limb venous channel, left flexion position, ECG, HR, SPO2, RR and NIBP ( cuff placed in the left upper arm ). Both groups were inhaled oxygen by nasal catheter 4 L / min for 1 min. After 1 min of oxygen inhalation, anesthesia induction was performed, and sufentanil 0.1 – 0.2 ug / kg and propofol 1.5 – 2.5 mg / kg ( injection rate 10 mg / s ) were intravenously injected, with the maintenance dose of 1 – 2 mg / ( kg * h ). Both groups of patients were administered until no eyelash reflex and no response to shouting. The bispectral index ( BIS ) was 46 – 55. Gastroscopy was started, and propofol was added when there was movement. All anesthesia operations were performed by the same anesthetist ( unaware of the grouping ), and gastroscopy was performed by the same endoscopic physician. Blood pressure decreased during the examination ( MAP < 20 % preoperative blood pressure ) and was corrected by intravenous infusion of ephedrine 3 mg ; heart appeared in the examination
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纳入标准:
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①获取知情同意书;
②年龄 20- 64 岁;
③BMI16- 30kg /m2 ;
④美国麻醉医师协会(ASA)分级I~III级;
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Inclusion criteria
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(1) Obtain informed consent;
(2) Age 20-64 years;
(3)BMI16- 30kg /m2
(4) American Association of Anesthesiologists (ASA) grades I to III;
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排除标准:
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1. 严重心血管疾病、主要脏器功能障碍者
2.胸廓畸形、存在支气管炎和哮喘病史、近期上呼吸道感染、基础血氧饱和度<95%
3.BMI<16或<30kg /m2者
4.口腔颌面部畸形、颌面部手术史、颞下颌关节功能异常、胃食管反流性疾病、凝血功能障碍、达克罗宁或丙泊酚过敏者。
5.存在重度睡眠呼吸暂停综合征或困难气管插管麻醉史者;
6.长期服用抗抑郁或镇痛药物者;
7.肺功能障碍者;
8.妊娠期、哺乳期或计划妊娠者;
9.认知功能障碍或严重精神疾病者;
10.听力异常,中耳炎等耳道疾病史者;
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Exclusion criteria:
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1. Severe cardiovascular disease, major organ dysfunction
2. Thoracic malformations, history of bronchitis and asthma, recent upper respiratory tract infections, basal oxygen saturation < 95%
3. BMI<16 or <30kg/m2
4. Oral and maxillofacial deformities, history of maxillofacial surgery, temporomandibular joint dysfunction, gastroesophageal reflux disease, coagulation dysfunction, dacronin or propofol allergy.
5. There is a history of severe sleep apnea syndrome or difficult endotracheal intubation anesthesia;
6. Long-term use of antidepressant or analgesic drugs;
7. People with pulmonary dysfunction;
8. Pregnant, nursing or planning to become pregnant;
9. Cognitive dysfunction or serious mental illness;
10. Hearing abnormalities, otitis media and other ear canal diseases history;
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研究实施时间:
Study execute time:
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从From
2022-07-01
至To
2023-07-01
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征募观察对象时间:
Recruiting time:
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从From
2022-09-26
至To
2023-03-31
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