Abstract：
BACKGROUND: Dizziness often occurs after microvascular decompression (MVD), and therapeutic options are limited. The aim of this trial was to determine the potential efficacy of transcutaneous electrical acupoint stimulation (TEAS), against dizziness and its safety in patients undergoing MVD.
METHODS: Adult patients scheduled to undergo MVD for hemifacial spasm under total intravenous anesthesia were randomized at a 1:1 ratio to receive, after extubation, 30-min TEAS in the mastoid region as well as Fengchi acupoints (GB20) and Neiguan acupoints (PC6) or 30-min sham stimulation. The primary outcome was the incidence of dizziness at 2 h after surgery. Secondary outcomes included dizziness, postoperative nausea and vomiting (PONV) or headache severity, rescue medication, changes in intraocular pressure before and after surgery, length of stay, dizziness symptoms 4 weeks after discharge, and surgical complications.
RESULTS: A total of 86 patients (51.9 ± 9.4 years of age; 67 women) were enrolled. One patient (in the TEAS arm) was excluded from analysis due to conversion to sevoflurane anesthesia. The rate of dizziness at 2 h after surgery was 31.0 % (13/42) in the TEAS arm vs. 53.5 % (23/43) in the sham control arm (P = 0.036). TEAS was also associated with significantly lower severity of dizziness, based on a 10-point scale, during the first 24 h after surgery. None of the other secondary efficacy outcomes differed significantly between the two arms. All postoperative complications were Clavien-Dindo grade I or II. The rate of postoperative complications was 21.4 % (9/42) in the TEAS arm vs. 16.3 % (7/43) in the sham control arm (P = 0.544).
CONCLUSIONS: Compared with sham control, TEAS was associated with a lower incidence of dizziness within 2 h and lower severity of dizziness within 24 h post-operatively, but no improvement in other outcomes, in adult patients undergoing MVD for hemifacial spasm.
METHODS: Adult patients scheduled to undergo MVD for hemifacial spasm under total intravenous anesthesia were randomized at a 1:1 ratio to receive, after extubation, 30-min TEAS in the mastoid region as well as Fengchi acupoints (GB20) and Neiguan acupoints (PC6) or 30-min sham stimulation. The primary outcome was the incidence of dizziness at 2 h after surgery. Secondary outcomes included dizziness, postoperative nausea and vomiting (PONV) or headache severity, rescue medication, changes in intraocular pressure before and after surgery, length of stay, dizziness symptoms 4 weeks after discharge, and surgical complications.
RESULTS: A total of 86 patients (51.9 ± 9.4 years of age; 67 women) were enrolled. One patient (in the TEAS arm) was excluded from analysis due to conversion to sevoflurane anesthesia. The rate of dizziness at 2 h after surgery was 31.0 % (13/42) in the TEAS arm vs. 53.5 % (23/43) in the sham control arm (P = 0.036). TEAS was also associated with significantly lower severity of dizziness, based on a 10-point scale, during the first 24 h after surgery. None of the other secondary efficacy outcomes differed significantly between the two arms. All postoperative complications were Clavien-Dindo grade I or II. The rate of postoperative complications was 21.4 % (9/42) in the TEAS arm vs. 16.3 % (7/43) in the sham control arm (P = 0.544).
CONCLUSIONS: Compared with sham control, TEAS was associated with a lower incidence of dizziness within 2 h and lower severity of dizziness within 24 h post-operatively, but no improvement in other outcomes, in adult patients undergoing MVD for hemifacial spasm.
摘要：
背景：微血管减压术（MVD）后常常出现头晕，和治疗选择是有限的。本试验的目的是确定经皮穴位电刺激（TEAS）的潜在疗效，MVD患者的头晕及其安全性。
方法：计划在全静脉麻醉下接受面肌痉挛MVD的成年患者以1：1的比例随机接受，拔管后,乳突区30分钟TEAS以及风池穴（GB20）和内关穴（PC6）或30分钟假刺激。主要结果是手术后2h头晕的发生率。次要结果包括头晕，术后恶心和呕吐（PONV）或头痛的严重程度，救护药物,手术前后眼压的变化，逗留时间,出院后4周出现头晕症状,和手术并发症。
结果：共纳入86名患者（51.9±9.4岁；67名女性）。一名患者（TEAS组）由于转换为七氟醚麻醉而被排除在分析之外。TEAS臂术后2h头晕的发生率为31.0%(13/42)。假对照组为53.5%(23/43)(P=0.036)。TEAS还与头晕的严重程度显着降低有关，根据10分制，在手术后的第一个24h。两组之间的其他次要疗效结果均无明显差异。所有术后并发症均为Clavien-DindoI级或II级。TEAS组术后并发症发生率为21.4%(9/42)。假对照组为16.3%(7/43)(P=0.544)。
结论：与假手术对照相比，TEAS与术后2小时内头晕的发生率较低和术后24小时内头晕的严重程度较低有关，但其他结果没有改善，在接受面肌痉挛MVD的成年患者中。
方法：计划在全静脉麻醉下接受面肌痉挛MVD的成年患者以1：1的比例随机接受，拔管后,乳突区30分钟TEAS以及风池穴（GB20）和内关穴（PC6）或30分钟假刺激。主要结果是手术后2h头晕的发生率。次要结果包括头晕，术后恶心和呕吐（PONV）或头痛的严重程度，救护药物,手术前后眼压的变化，逗留时间,出院后4周出现头晕症状,和手术并发症。
结果：共纳入86名患者（51.9±9.4岁；67名女性）。一名患者（TEAS组）由于转换为七氟醚麻醉而被排除在分析之外。TEAS臂术后2h头晕的发生率为31.0%(13/42)。假对照组为53.5%(23/43)(P=0.036)。TEAS还与头晕的严重程度显着降低有关，根据10分制，在手术后的第一个24h。两组之间的其他次要疗效结果均无明显差异。所有术后并发症均为Clavien-DindoI级或II级。TEAS组术后并发症发生率为21.4%(9/42)。假对照组为16.3%(7/43)(P=0.544)。
结论：与假手术对照相比，TEAS与术后2小时内头晕的发生率较低和术后24小时内头晕的严重程度较低有关，但其他结果没有改善，在接受面肌痉挛MVD的成年患者中。
