Anestéziológia a intenzívna medicína 1/2016

TENS effect on hemodynamic stability of patients during surgery

The aim of this trial was to compare transcutaneous electrical nervous stimulation anaesthesia (TENS) and conventional opioid-anaesthesia (OA) with regard to the haemodynamic stability following open heart surgery. In prospective blinded control trail we randomly assigned 34 patients (TENS = 16; OA = 18) undergoing elective coronary artery bypass graft or valve surgery operation to receive either TENS or OA. The TENS group received electrostimulation bilateral at 3 international standardized acupuncture points until closure of thorax with no additional analgesia. In contrast, the OA group received continuous sufentanil infusion. Haemodynamic parameters (heart rate, mean arterial and venous pressure, cardiac output) measured at the beginning, after the sternotomy and at the end of the surgery as well as amounts of needed catecholamines (norepinephrine, epinephrine) were compared using non-parametric Mann-Whitney test. There was no significant difference in any of measured haemodynamic parameters between the groups. Except of that, the TENS group showed significantly lower demand on norepinephrine at the end of the surgery (p = 0.02; median 0 mcg/h in TENS versus 100 mcg/h in OA). TENS seems to be a reliable method in regard to haemodynamic stability in open heart surgery.

Keywords: TENS, opioid anaesthesia, haemodynamic parameters