Objective To observe the effect of transcutaneous acupoint electrical stimulation (TAES) on au-tonomic nerve especially on vagus nerve activity during general anesthesia. Methods Fifty patients for oral and maxillofacial surgery were enrolled and randomized divided into the following 2 groups: group T and group C with 25 patients in each group. Patients in group T received electrical stimulation at the points of P6 (Nei-guan) and LI4 (Hegu). Patients in the controlled group received electrode plate at the same acupoints without any electrical stimulation. The hemodynamic index (HR、MAP) and electrocardiogram were collected periopera-tively and the signals were recorded by the methods of time domain (SDNN、RMSSD), Poincare plot (SD1、SD2) and deceleration capacity of rate (DC) for 5 minutes at each of the following time points : Before anesthesia in-duction (T0), intubation (T1), during surgical (T2) and at the end of operation (T3). Results SDNN、RMSSD、SD1、SD2、DC in the patients of group T[(70.18 ± 29.14) ms、(12.28 ± 6.03) ms、(8.68 ± 4.26) ms、(98.83 ± 41.06) ms、(4.73 ± 3.29) ms, respectively] were larger significantly than those in group C[(50.56 ± 18.55) ms、(8.06 ± 3.49) ms、(5.7 ± 2.47) ms、(71.23 ± 26.27) ms、(2.72 ± 1.74) ms, respectively] at T1,(P<0.05). SDNN、RMSSD、SD1、SD2、DC in the patients of group T[(17.07±6.57)ms、(12.91±5.24)ms、(9.13±3.71)ms、(22.17± 8.97)ms、(4.72±2.18)ms, respectively] were also larger significantly than those in group C[(12.59±5.22)ms、(9.93 ± 2.95) ms、(7.02 ± 2.08) ms、(16.17 ± 7.52) ms、(3.06 ± 1.17) ms, respectively] at T2, (P<0.05). There was no significant difference in HR and MAP between the two groups. Conclusion TAES can improve the au-tonomic nerve especially the vagus nerve activity during general anesthesia. HRV is more sensitive in reflecting autonomic nerve activity than hemodynamic index.%目的:观察"穴位""电刺激"(TAES)对全麻术中迷走神经活动的影响.方法:选择期行口腔颌面手术患者50例,随机分为TEAS组(T组)和对照组(C组),T组入室后即给予双侧"内关"、"合谷"穴电刺激,对照组仅将电极片贴附在相同穴位上,不给予电刺激.记录两组麻醉诱导前(T0)、诱导插管(T1)、术中(T2)和术毕苏醒期(T3)的血流动力学指标(HR、MAP)及心率变异性(HRV)的时域指标(SDNN、RMSSD)、散点图指标(SD1、SD2)及心率减速力(DC)变化.结果:T1时T组SDNN、RMSSD、SD1、SD2、DC[分别为(70.18±29.14)ms、(12.28±6.03)ms、(8.68±4.26)ms、(98.83±41.06)ms、(4.73±3.29)ms]明显大于C组[分别为(50.56±18.55)ms、(8.06±3.49)ms、(5.7±2.47)ms、(71.23±26.27)ms、(2.72±1.74)ms],(P<0.05);T2时T组SDNN、RMSSD、SD1、SD2、DC[分别为(17.07±6.57)ms、(12.91±5.24)ms、(9.13±3.71)ms、(22.17±8.97)ms、(4.72±2.18)ms]明显大于C组[分别为(12.59±5.22)ms、(9.93±2.95)ms、(7.02±2.08)ms、(16.17±7.52)ms、(3.06±1.17)ms],(P<0.05);但两组间HR、MAP未见统计学差异(P>0.05).结论:TEAS可提高全麻术中患者的自主神经特别是迷走神经活动性,HRV反映自主神经活动性改变要比血流动力学指标更敏感.
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