Abstract:

Objective To investigate the effects of intraoperative electroacupuncture analgesia on the stress response to tracheal intubation in patients undergoing general anesthesia for thyroid surgery. Methods A total of 60 patients scheduled for elective combined general anesthesia and thyroid surgery at the Affiliated TCM Hospital of Guangzhou Medical University from June 2022 to June 2023 were randomly assigned to either the control group （Ctr group） or the electroacupuncture group （EA group）. Both groups underwent tracheal intubation under general anesthesia. In the EA group， electroacupuncture was applied at bilateral Neiguan （PC6）， Quchi （LI11）， and Lieque （LU7） acupoints for 15 minutes before tracheal intubation and before extubation， in addition to routine general anesthesia and analgesia. Hemodynamic parameters including systolic blood pressure （SBP）， mean arterial pressure （MAP）， diastolic blood pressure （DBP）， and heart rate （HR） were observed at different time points in both groups （before intubation： T₀； 1， 5， 10， 15， and 30 minutes after intubation： T₁， T₅， T₁₀， T₁₅， T₃₀； 1 minute before extubation： EXBT1； 1 and 5 minutes after extubation： EXAT₁， EXAT₅）. The total amount of opioid analgesics used intraoperatively and any adverse reactions were recorded. Results Significant statistical differences were observed between the EA group and Ctr group in SBP at T₁-T₁₅， EXAT₁， and EXAT₅； MAP at T₅-T₁₅ and EXAT₁； DBP at T₁₅ and EXAT₁； HR at T₁， T₅， EXAT₁， and EXAT₅ （P < 0.05）. During T₁-T₁₅， the SBP， MAP， DBP， and HR in the EA group showed a decreasing trend and were lower compared to the Ctr group. The SBP， MAP， and DBP fluctuations were smaller in the EA group compared to the Ctr group， while the HR fluctuations were larger in the EA group after intubation but smaller after extubation. There was no significant difference in the total amount of opioid analgesics used intraoperatively between the two groups （P > 0.05）. The incidence of adverse reactions such as nausea and vomiting differed significantly （P < 0.05）， while the incidence of rash and hypertension did not differ significantly between the two groups （P > 0.05）. Conclusion Intraoperative electroacupuncture analgesia can effectively attenuate the vascular stress response induced by tracheal intubation and extubation in patients undergoing thyroid surgery and reduce the occurrence of opioid-related adverse reactions.

Key words: electroacupuncture analgesia, thyroid surgery, tracheal intubation, stress reaction, haemodynamics