Effect of electroacupuncture at Zusanli (ST36) and Sanyinjiao (SP6) acupoints on adrenocortical function in etomidate anesthesia patients

Abstract

Background:We aimed to investigate the effect of electroacupuncture at Zusanli (ST36) and Sanyinjiao (SP6) on adrenocortical function in patients with etomidate anesthesia. Material/Methods:We randomly divided 80 patients who underwent elective surgery into 4 groups: group etomidate (ETO), group etomidate + electroacupuncture (ETO+EA), group etomidate + sham acupuncture (ETO+SEA), and group propofol (PRO). The patients in group ETO, ETO+EA, and ETO+SEA were induced with etomidate and sufentanil and maintained with intravenous infusion of etomidate and remifentanil. Group PRO was induced with propofol and sufentanil and maintained with propofol and remifentanil. Group ETO+EA received electro-acupuncture stimulation at Zusanli and Sanyinjiao throughout the operation, while group ETO+SEA received electro-acupuncture stimulation at non-acupoints. We recorded the values of MAP, HR, BIS, CVP, cortisol, ACTH, epinephrine, norepinephrine, and arterial blood gas during the perioperative period. Results:Cortisol concentrations were significantly higher at all times except T0 in group ETO+EA compared with group ETO. The ACTH concentrations were lower in group ETO+EA than that in group ETO at point T3. Conclusions:Electroacupuncture at ST 36 and SP 6 can mitigate the adrenal cortical inhibition induced by etomidate and can reduce the secretion of catecholamines during surgery.

Sham Electroacupuncture Methods in Randomized Controlled Trials

“…Among them, 5 studies29549095107 were published between 1992 and 1999; 33 studies22242527303138454752535657586768717273747778818384929397104105106110111 were published between 2000 and 2010; the remaining 56 studies1819202123262832333435363739404142434446484950515559606162636465666970757679808285868788899194969899100101102103108109 were reported from 2010 to 2015 (Fig. 2).…”

“…2). Indications for EA included pain (32 studies)1819212426273133363740424547515256606667727682848890929697103110111, anesthesia (8 studies)46507374868994102, stroke (7 studies)2528293462105106, depression (6 studies)235359656880, obesity (4 studies)32495470, primary dysmenorrheal/menstrual pain (4 studies)619899101, substance abuse (heroin or smoking) (3 studies)6495107, osteoarthritis (2 studies)22104, migraine (2 studies)3978, nausea and vomiting (2 studies)3857, postoperative ileus (2 studies)3591, insomnia (2 studies)6381, benign prostate hyperplasia (2 studies)7987, diabetic mellitus related diseases (2 studies)83109, carpal tunnel syndrome (1 study)100, rheumatoid arthritis (1 study)93, whiplash-associated disorders (1 study)69, constipation (1 study)48, multiple sclerosis (1 study)41, tinnitus (1 study)20, auditory hallucination (1 study)30, attention deficit hyperactivity disorder (1 study)…”

“…Eight studies26495476959697110 identified acupoints by using a point detector. The “ deqi ” sensation was required in 65 real EA groups181920212223242526293031333435363940414344474850515657585960616263646667697175777879808182838586879091939899100101102104105106109111 and 3 sham EA groups selected nonspecific acupoints6178101. Eight studies utilized pricking sensation to mimic needle sensation and blind participants in control group2021235260636781.…”

“…Eight studies utilized pricking sensation to mimic needle sensation and blind participants in control group2021235260636781. Forty-two studies1920212226272831323334353739404243444647505158606162646566707177787983858992100104105106 applied EA at high intensity with maximum tolerance, and seventeen studies24295456598082868790959899102107108111 applied EA with low intensity below pain threshold or at a comfortable level with presence or absence of muscle contractions. The other trials were lacking in details on the intensity of stimulation.…”

“…The other trials were lacking in details on the intensity of stimulation. The duration of each session ranged from 5 minutes100 to 72 hours96; the total number of treatment sessions varied from 1333738394647505152727377828486888994959697100101102109 to 7244; the total duration of treatment ranged from 5 minutes100 to 6 months111. Ten studies274672767779899097102 did not report the duration of each session.…”