title: Transcutaneous electric acupoint stimulation alleviates remifentanil-induced hyperalgesia in patients undergoing thyroidectomy: a randomized controlled trial.
abstract: BACKGROUND
  In this prospective, randomized, double-blind study, we verified the hypothesis that TEAS can alleviate remifentanil-induced hyperalgesia in patients undergoing thyroidectomy.
  
  
  METHODS
  60 American Society of Anesthesiologists physical status (ASA) I-IIpatients, aged 18-60 year, scheduled for thyroidectomy were randomly allocated to TEAS or sham groups. TEAS consisted of 30 min of stimulation (6-9 mA, 2/10 Hz) on the Hegu (LI4) and Neiguan (PC6) before anesthesia. Anesthesia was maintained with sevoflurane adjusted to bispectral index (40-60) and target remifentanil 5.0 ng/ml. Mechanical pain thresholds were assessed using electronic von Frey. The primary outcome was mechanical pain thresholds. Secondary outcomes included postoperative pain scores, the time to first rescue analgesic, cumulative number of rescue analgesia, and side effects, including postoperative nausea and vomiting (PONV), dizziness and shivering in 24 h postoperatively.
  
  
  RESULTS
  Baseline mechanical pain thresholds were similar between the groups. The analysis revealed the decrease in mechanical threshold was greater in the sham group than the TEAS group (P < 0.001). Postoperative pain scores and cumulative number of rescue analgesia were lower in the TEAS group (P < 0.05). In addition, TEAS group patients reduced the incidence of PONV and shivering.
  
  
  CONCLUSIONS
  Preoperative TEAS can attenuate remifentanil-induced hyperalgesia in patients undergoing thyroidectomy.
authors.affiliation: Department of Anesthesiology, The Shengli Clinical Medical College of Fujian Medical University & Fujian Provincial Hospital Fuzhou 350001, China.
authors.forename: Yanqing
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, The Shengli Clinical Medical College of Fujian Medical University & Fujian Provincial Hospital Fuzhou 350001, China.
authors.forename: Yusheng
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Department of Anesthesiology, The Shengli Clinical Medical College of Fujian Medical University & Fujian Provincial Hospital Fuzhou 350001, China.
authors.forename: Yihuan
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Anesthesiology, The Shengli Clinical Medical College of Fujian Medical University & Fujian Provincial Hospital Fuzhou 350001, China.
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Dai
authors.affiliation: Department of Anesthesiology, The Shengli Clinical Medical College of Fujian Medical University & Fujian Provincial Hospital Fuzhou 350001, China.
authors.forename: Qiuyan
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: Department of Anesthesiology, The Shengli Clinical Medical College of Fujian Medical University & Fujian Provincial Hospital Fuzhou 350001, China.
authors.forename: Liangcheng
authors.initials: L
authors.lastname: Qiu
keywords: Transcutaneous electric acupoint stimulation; hyperalgesia; remifentanil; thyroidectomy