Perioperative acupuncture in asthma patients under general anesthesia

الملخص EN

Background and objective The incidence of asthma has increased in the last few years.

Acupuncture was found to have a bronchodilating effect in asthmatic patients.

The aim of this study was to evaluate the perioperative bronchodilator effect of acupuncture in comparison with regular inhalation asthma treatment.

Patients and methods The study was conducted at Kasr AL Ainy Teaching Hospital.

Forty patients of both sexes, aged 20–40 years, classifi ed as ASA 2, with mild partially controlled asthma [determined from forced expiratory volume in the fi rst second (FEV1), forced expiratory volume/forced vital capacity (FEV1/FVC), peak expiratory fl ow rate (PEFR) ranging from 70 to 79%] were allocated to two groups.

Group A (n = 20) received preoperative acupuncture for 30 min, and if there was clinical improvement on the basis of spirometer tests patients were allowed to proceed with their operation, followed by intraoperative acupuncture until fully awake.

Group B (n = 20) received a 30 min preoperative treatment with 10 drops of nebulized salbutamol (1 mg, 1 ml) and 500 mg ipratropium bromide diluted in 2 ml normal saline inhaled through a nebulizer.

FEV1, FEV1/FVC, PEFR, SPO2, and hemodynamic data were collected before treatment T(0) and 30 min after the end of treatment T(30).

The onset of bronchodilation as marked by the disappearance of wheezing and improvement in patient symptomatology, the success rate of treatment (improved pulmonary function tests >12%, disappearance of wheezing) recorded at T(30), intraoperative hemodynamic changes, peripheral oxygen saturation, end tidal CO2 levels, peak airway pressure, and any complications related to the different treatments used were also recorded.

Results Wheezing disappeared after 9.5 ± 1.67 min, recorded from T(0), in group A compared with 14.4 ± 2.80 min in group B.

At T(30), pulmonary function tests improved by more than 12% and wheezing disappeared in 16 (80%) patients in group A and in 18 (90%) patients in group B.

This was statistically signifi cant (P < 0.001).

There was a statistically signifi cant increase in FEV1, FEV1/FVC, and PEFR peripheral oxygen saturation (SpO2) within each group compared with T(0).

Intraoperatively, the peak airway pressure was clinically comparable in both groups, although it was statistically signifi cant (P = 0.04).

In group A there were no complications related to the use of acupuncture.

Two (10%) patients in group A and 14 (70%) patients in group B experienced an increase in heart rate by more than 10%.

Conclusion Perioperative acupuncture seemed to improve respiratory functions without serious side effects.