Transcutaneous electric acupoint stimulation reduces intra-operative remifentanil consumption and alleviates postoperative side-effects in patients undergoing sinusotomy: a prospective, randomized, placebo-controlled trial

Wang, H.; Xie, Yaning; Zhang, Q.; Xu, Ning; Zhong, Haixing; Dong, Hailong; Liu, L.; Jiang, Tao; Wang, Q.; Xiong, Lize

doi:10.1093/bja/aeu001

Cited by 108 publications

(103 citation statements)

References 36 publications

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“…Remifentanil is rapidly metabolized to a non-analgesic compound, and hence, it is administered as a continuous infusion throughout surgery. Furthermore, the infusion rate of remifentanil has been used as a measure of intraoperative nociception in previous studies [23, 24]. Therefore, we assumed that the infusion rate of remifentanil reflected the nociception induced by TXA.…”

Section: Discussionmentioning

confidence: 99%

“…Remifentanil was continuously infused throughout the surgery because it is a short-acting opioid analgesic. Its infusion rate was changed based on the patient’s vital signs, such as HR and BP, which reflect the level of intraoperative nociception being experienced by the patient [23, 24]. We considered that the infusion rate of remifentanil during the surgery reflected the degree of intraoperative nociception.…”

Section: Methodsmentioning

confidence: 99%

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Administration of tranexamic acid to patients undergoing surgery for adolescent idiopathic scoliosis evokes pain and increases the infusion rate of remifentanil during the surgery

Ohashi

Endo

et al. 2017

PLoS ONE

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BackgroundWe recently reported that tranexamic acid (TXA) evokes pain in rats by inhibiting γ-aminobutyric acid and glycine receptors on neurons in the spinal dorsal horn. Although TXA is commonly used to reduce perioperative blood loss during various surgeries, its potential to induce intraoperative nociception, thereby increasing the need for more analgesics during surgery, has not been investigated. Therefore, this study aimed to investigate whether TXA evokes pain and increases the need for a higher infusion rate of remifentanil in patients undergoing surgery for adolescent idiopathic scoliosis (AIS).MethodsData were collected from patients with AIS who underwent posterior spinal fusion surgery from January 2008 to December 2015. All surgical procedures were performed under total intravenous anesthesia with propofol and remifentanil, by the same team of orthopedic surgeons and anesthesiologists at a single institution. Patients in the TXA group were administered TXA (loading and maintenance doses, 1000 mg and 100 mg/h) whereas those in the control group were not. Our primary outcome was the infusion rate of the intraoperative opioid analgesic remifentanil.ResultsThe final analysis was based on data collected from 33 and 30 patients in the control and TXA groups, respectively. No differences were observed in the demographic data or the hemodynamic parameters between the two groups of patients. In the TXA group, the durations of surgery and anesthesia were shorter, intravascular fluid volume and total blood loss were lower, and the doses of fentanyl and ketamine administered were higher than they were in the control group (P < 0.05 for all). The mean infusion rate of intraoperative remifentanil was significantly higher in the TXA group than in the control group (control group: 0.23 ± 0.04 μg/kg/min; TXA group: 0.28 ± 0.12 μg/kg/min; P = 0.014).ConclusionsPatients who received TXA during the AIS surgery required a higher infusion rate of remifentanil, indicating that TXA evoked pain during the surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Administration of tranexamic acid to patients undergoing surgery for adolescent idiopathic scoliosis evokes pain and increases the infusion rate of remifentanil during the surgery

Ohashi

Endo

et al. 2017

PLoS ONE

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“…Acupuncture treatment has the effect of controlling pain by stimulating the CNS through an intrinsic mechanism that mediates endogenous opioids [39]. Additionally, according to several reports, acupuncture treatment stimulates the vagus nerve and the nucleus of the tractus solitarius, which subsequently modulate the opioid receptors and project rostrally to the hypothalamus, amygdala, dorsal raphe nucleus, nucleus ambiguus, parabrachial nucleus, and thalamus in the amygdala, thus modulating any imbalance in the autonomic nervous system and making acupuncture effective for treating disorders of the autonomic nervous system, such as insomnia [40].…”

Section: Discussionmentioning

confidence: 99%

Deqi Induction by HT7 Acupuncture Alters Theta and Alpha Band Coherence in Human Healthy Subjects

Lee

Yun

Yang

et al. 2017

Evidence-Based Complementary and Alternative Medicine

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The aim of this preliminary study is to investigate the changes in phase synchronization in the theta and alpha bands before and during the performance of classical acupuncture on the Sinmun (HT7). The electroencephalogram (EEG) signals from nine healthy young subjects were recorded before and during acupuncture in the “closed-eye” state. The EEG signals were acquired from 19 surface scalp electrodes (FP1, FP2, F7, F3, Fz F4, F8, T3, C3, Cz, C4, T4, T5, P3, Pz, P4, T6, O1, and O2). Needles were inserted into the HT7 bilaterally and were then manipulated to induce deqi and retained for 15 minutes. Phase synchronization was measured by phase coherence. In the theta band, coherence significantly increased between the temporal (T5, T6) and occipital areas (O1, O2) during the acupuncture stimulation. In the alpha band, coherence significantly increased between the left temporal area (T5) and other areas (frontal, parietal, and occipital). Phase coherence in the theta and alpha bands tended to increase during the retention of the acupuncture needles after deqi. Therefore, it can be concluded that acupuncture stimulation with deqi is clinically effective via the central nervous system (CNS).

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“…Compared with conventional anesthesia, anesthesia with acupoint stimulation together made the amount of narcotic drugs, extubation and recovery time had a significantly reduction (1,22), which helped anesthetists to optimize management of patients' perioperative blood pressure (23). In another research, a conclusion can be inferred that because of the perioperative acupoint stimulation, concentrations of markers of brain injury S-100β protein in serum are also declined (24).…”

Section: The Effect Of Perioperative Acupoint Stimulationmentioning

confidence: 99%

The Role of Perioperative Acupoint Stimulation in the Prevention of Postoperative Cognitive Dysfunction

Yuan¹,

Yu²

2016

J Anesth Perioper Med

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Transcutaneous electric acupoint stimulation reduces intra-operative remifentanil consumption and alleviates postoperative side-effects in patients undergoing sinusotomy: a prospective, randomized, placebo-controlled trial

Abstract: The trial was registered at clinicaltrials.gov (NCT01700855).

Cited by 108 publications

References 36 publications

Administration of tranexamic acid to patients undergoing surgery for adolescent idiopathic scoliosis evokes pain and increases the infusion rate of remifentanil during the surgery

Administration of tranexamic acid to patients undergoing surgery for adolescent idiopathic scoliosis evokes pain and increases the infusion rate of remifentanil during the surgery

Deqi Induction by HT7 Acupuncture Alters Theta and Alpha Band Coherence in Human Healthy Subjects

The Role of Perioperative Acupoint Stimulation in the Prevention of Postoperative Cognitive Dysfunction

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