Transcutaneous electrical nerve stimulation on ST36 and SP6 acupoints prevents hyperglycaemic response during anaesthesia: a randomised controlled trial.
OBJECTIVE
Hyperglycaemia is a common result of stress signals caused by pain and surgical procedure. Volatile anaesthetics also directly manipulate glucose homeostasis by affecting pancreatic insulin release and induce hyperglycaemia without surgical stress. We determined the preoperative application of transcutaneous electrical nerve stimulation (TENS) to the Chinese acupoints ST36 (Zusanli) and SP6 (Sanyinjiao) as a complementary therapy for controlling plasma glucose and improving insulin resistance during anaesthesia.


METHODS
We designed a single-blind, randomised controlled clinical study of female patients, scheduled for elective hysterectomy. The 52 patients consented to enrolment and were assigned to receive either TENS (n = 26) on bilateral ST36 and SP6 acupoints with continuous mode at a frequency of 15 Hz and the intensity of 10 mA synchronously for 30 min or non-stimulation (placebo group, n = 26) preoperatively. Haemodynamics, blood glucose and plasma insulin were measured during general anaesthesia.


RESULTS
At baseline, there was no significant difference between the TENS group and the placebo group in plasma glucose and insulin levels as well as homeostasis model assessment (HOMA) index. In the placebo group, plasma glucose, insulin and HOMA index increased during induction of general anaesthesia, surgical incision, and throughout the operation. Plasma glucose and insulin levels as well as HOMA index were significantly lower in the TENS group as compared to the placebo group at different time points after discontinuation of TENS application. These results indicate the positive effect of prevention of hyperglycaemia and the increased sensitivity of plasma insulin in the TENS group.


CONCLUSIONS
We found TENS at bilateral ST36 and SP6 acupoints to be an alternative means of managing the plasma glucose level and improving insulin resistance perioperatively.
Department of Anesthesiology, Department of Gynecology and Obstetrics, Department of Clinical Laboratory, Department of Surgery, Tungs' Taichung Metroharbor Hospital, Taichung Taipei, Taiwan.
Kee-Ming
KM
Man
Samantha S
SS
Man
Jui-Lung
JL
Shen
Kim-Seng
KS
Law
Shun-Liang
SL
Chen
Wen-Jinn
WJ
Liaw
Chao-Te
CT
Lee
Yuan-Ju
YJ
Lee
Wen-Ling
WL
Liao
Tzu-Ming
TM
Chang
De-Xin
DX
Yu
Der-Cherng
DC
Chen
Yung-Hsiang
YH
Chen
Wen-Chi
WC
Chen
Shih-Liang
SL
Chang
D015669:Acupuncture Points; D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000379:methods*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007044:Hysterectomy / Q000379:methods; D007328:Insulin / Q000097:blood / Q000378:metabolism; D008516:Medicine, Chinese Traditional / Q000379:methods; D008875:Middle Aged; D010179:Pancreas / Q000378:metabolism; D016037:Single-Blind Method; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D016896:Treatment Outcome
D007328:Insulin