[Effect of acupuncture--general anesthesia on hemodynamics in perioperative period of patients undergoing cholecystectomy].
OBJECTIVE
To observe the effect of acupuncture-general anesthesia on hemodynamics in the perioperative period of patients undergoing laparoscopic cholecystectomy.


METHODS
Sixty patients of ASA class I-II scheduled to receive laparoscopic cholecystectomy were randomly assigned to two groups equally, Group A, the control group, and Group B, the compound anesthesia group. The general anesthesia applied on them during operation was induced by combined midazolam, fentanyl, propofol and vecuronium bromide, but for those in Group B, 15 min of electric stimulation at bilateral Neiguan (PC6), Hegu (LI4) and Quchi (LI11) was given with an acupuncture anesthesia apparatus before the drug induction as acupuncture anesthesia induction, then the general anesthesia started and maintained the same as that in Group A. Changes of cardiac function and hemodynamics were monitored using thoracic electrical bio-impedance method at different time points of operation, i.e. the baseline before induction (T0), after induction when loss of consciousness (T1), during intubation (T2), beginning of operation (T3), ending of operation (T4), during extubation (T5) and 10 min after extubation (T6).


RESULTS
No significant difference between the two groups was found in operation lasting time and anesthesia maintaining time (P > 0.05). The amount of vecuronium bromide consumed in an unit of time in Group B was significantly lower than that in Group A (P < 0.05). The mean arterial pressure (MAP), heart rate (HR), rate pressure product (RPP), cardiac output (CO), systemic vascular resistance (SVR), and blood flow acceleration index (ACI) in Group A at T1 were all significantly lower (P < 0.05 or P < 0.01), but became significantly higher at T2 and T5 as compared with those of baseline (P < 0.05 or P < 0.01), while no significant change of them was found in Group B. Moreover, MAP, RPP, SVR and ACI were significantly higher in Group A than those in Group B at T2 and T5 (P < 0.05 or P < 0.01).


CONCLUSIONS
The acupuncture-general anesthesia shows a bi-directional effect for diminishing the fluctuation of hemodynamics and stabilizing the blood circulation, and also can reduce the consumption of narcotics during operation, so it has an extensive value in clinical practice.
Ding
Yi-Hong
YH
Department of Anesthesiology, Shanghai Yueyang Hospital Integrative Chinese and Western Medicine, Shanghai.
Gu
Chen-Yi
CY
D015667:Acupuncture Analgesia; D000328:Adult; D000768:Anesthesia, General; D001794:Blood Pressure / Q000502:physiology; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D015671:Electroacupuncture; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D055815:Young Adult