title: [Effects of electro-acupuncture combined general anesthesia on myocardial injury of high blood sugar patients with coronary heart disease in the perioperative phase].
abstract: OBJECTIVE
  To investigate the effects of electro-acupuncture (EA) combined general anesthesia on myocardial injury of high blood sugar patients with coronary heart disease (CHD) in the perioperative phase.
  
  
  METHODS
  Recruited were 40 senile patients with glycosylated hemoglobin (HbA1c) more than 6.5%. They were more than 60 years old. They received post-traumatic fracture reduction surgery of four limbs. They were randomly assigned to two groups, Group N (treated by general intravenous anesthesia) and Group D (treated by EA combined with general intravenous anesthesia), 20 in each group. All patients were maintained anesthesia by propofol, fentanyl, and vecuronium. Prior to the induction of anesthesia, patients in Group D received induction of EA at Neiguan (PC6) and Baihui (DU20) for 20 min, which lasted to the end of the surgery. At before intubation (T0), immediately after intubation (T1), 5 min (T2), immediately after extubation (T3), 5 min (T4), 60 min (T5), 180 min (T6), the fast blood glucose (FBG), plasma vasoactive substance TXB2 and 6-K-prostacycline (6-K-PGF1alpha) were detected in the two groups. The glucose coefficient of variation (GluCV) and the ratio of TXB2/6-K-PGF1alpha were calculated. The changes of ST-segment elevation (mV, sampling 1 min after each time point, and the mean calculated) was recorded.
  
  
  RESULTS
  There was no statistical difference in all the tested values between the two groups at T0 (P>0.05). The FBG, ST elevation, and the ratio of TXB2/6-K-PGF1alpha were significantly higher at each time point than at T0 in Group N (P<0.05), while there was no statistical difference in Group D (P>0.05). The ratio of TXB2/6-K-PGF1alpha and ST elevation were significantly higher in Group N than in Group D (P<0.01). The TXB2 and 6-K-PGF1alpha were significantly higher at each time point than at T0 in the two groups (P<0.05). The increment of TXB2 was obviously lower in Group D than in Group N (P<0.05), but the increment of 6-K-PGF1alpha was obviously higher in Group D than in Group N (P<0.05).
  
  
  CONCLUSIONS
  EA could reduce the perioperative stress response to the injury of coronary vascular endothelial cells, and improve myocardial ischemia and CHD patients' prognosis by regulating the central nervous system, the cardiovascular active substances, and anti-oxygen free radicals.
authors.affiliation: Department of Anesthesiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437. shenhuans699@sina.com
authors.forename: Hua
authors.initials: H
authors.lastname: Shen
authors.forename: Yi-jing
authors.initials: YJ
authors.lastname: Chen
mesh_terms: D015667:Acupuncture Analgesia; D000368:Aged; D000768:Anesthesia, General; D001786:Blood Glucose / Q000032:analysis; D003327:Coronary Disease / Q000378:metabolism* / Q000601:surgery*; D015671:Electroacupuncture; D011464:Epoprostenol / Q000378:metabolism; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia; D009206:Myocardium / Q000378:metabolism; D013928:Thromboxane A2 / Q000378:metabolism
chemical_list: D001786:Blood Glucose; D011464:Epoprostenol; D006442:Glycated Hemoglobin; D013928:Thromboxane A2