Bg. Wang et al., EFFECT OF THE INTENSITY OF TRANSCUTANEOUS ACUPOINT ELECTRICAL-STIMULATION ON THE POSTOPERATIVE ANALGESIC REQUIREMENT, Anesthesia and analgesia, 85(2), 1997, pp. 406-413
Given the inherent side effects associated with both opioid and nonopi
oid analgesic drugs, a nonpharmacologic therapy that could decrease th
e need for analgesic medication would be valuable. We designed a sham-
controlled study to assess the effect of the intensity of transcutaneo
us acupoint electrical stimulation (TAES) on postoperative patient-con
trolled analgesia (PCA) requirement for hydromorphone (HM), the incide
nce of opioid-related side effects, and the recovery profile after low
er abdominal surgery. One hundred one healthy consenting women undergo
ing lower abdominal procedures with a standardized general anesthetic
technique were randomly assigned to one of four postoperative analgesi
c treatment regimens: Group I (n = 26) PCA only; Group II (n = 25), PC
A + sham-TAES (no electrical stimulation): Group III (n = 25), PCA + l
ow-TAES (4-5 mA of electrical stimulation): Group IV (n = 25), PCA + h
igh-TAES (9-12 mA of electrical stimulation). The PCA device was progr
ammed to deliver HM, 0.2-0.4 mg intravenously boluses ''on demand,'' w
ith a minimum lockout interval of 10 min. The TAES skin electrodes wer
e placed at the Hegu acupoint on the nondominant hand and on both side
s of the surgical incision. The TAES frequency was set in the dense-an
d-disperse mode, alternating at 2 Hz and 100 Hz every 3 s, with stimul
ation of the hand and incision alternated every 6 s, The patients in G
roups II-IV were instructed to use TAES every 2 h for 30 min while awa
ke. After discontinuation of PCA, oral pain medications were administe
red on demand. The postoperative PCA-HM requirement, pain scores, opio
id-related side effects, and requirements for antiemetic and antipruri
tic medication were recorded. High-TAES decreased the HM requirement b
y 65% and reduced the duration of PCA therapy, as well as the incidenc
e of nausea, dizziness, and pruritus. Low-TAES produced a 34% decrease
in the HM requirement compared with only 23% in the ''sham'' TAES gro
up. We conclude that high-TAES produced a significant decrease in the
PCA opioid requirement and opioid-related side effects after low intra
abdominal surgery.