[Clinical study of electroacupuncture on perioperative analgesia in patients with thyroid surgery under cervical plexus block]

Abstract

Objective: To investigate the change trend and correlation between the perioperative pain degree and neuroendocrine hormone levels in the perioperative period on patients with thyroid surgery by electroacupuncture combined with cervical plexus block.

Methods: Forty patients with elective thyroidectomy were enrolled and divided into a control group and an observation group according to the random number table method, 20 cases in each group. In the control group, cervical plexus block was performed. In the observation group, the cervical plexus block combined with electroacupuncture (EA) were given. After the cervical plexus block was completed, the EA was applied at the bilateral Hegu (LI 4) and Neiguan (PC 6) for 30 min. The visual analog scale (VAS) was used to assess the pain level before anesthesia (T₀), 2 h after operation (T₁), 12 h after operation (T₂), 24 h after operation (T₃) and 48 h after operation (T₄). Blood samples such as adrenocorticotropic hormone (ACTH), C-reactive protein (CRP) and β-endorphin (β-EP) were collected to measure the level of neuroendocrine hormones, and to analyze the correlation between ACTH, CRP, β-EP and VAS scores.

Results: The VAS scores at T₁, T₂, T₃ were higher than those at T₀ in the two groups (all P<0.05). The VAS scores T₁, T₂ and T₃ in the observation group were lower than those in the control group (all P<0.05). The ACTH and CRP in the control group at T₁, T₂ and T₃ were significantly higher than those at T₀ (all P<0.05). The β-EP in the observation group at T₁, T₂ and T₃ was significantly higher than that at T₀ (all P<0.05). The ACTH and CRP in the observation group at T₁, T₂ and T₃ were lower than those in the control group,and the β-EP level was higher than that in the control group (all P<0.05).The VAS score was significantly positively correlated with ACTH and CRP levels, and negatively correlated with β-EP.

Conclusion: EA stimulation can inhibit the secretion of ACTH and CRP, promote the release of β-EP, reduce the perioperative pain score, and inhibit the body's stress response.

Keywords: cervical plexus block; electroacupuncture; neuroendocrine hormone; pain; perioperative period; thyroid surgery.