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Research: Open-heart Surgery

January 2010
Postoperative Pain and Respiratory Function in Patients Treated with Electroacupuncture Following Coronary Surgery
Neurosciences, January 2010, Volume 15, Issue 1, pages 7-10
OBJECTIVES: To evaluate respiratory function and pain score in patients undergoing coronary bypass procedures during the first 7 postoperative days.
METHODS: The study was carried out as a case-control study between April 2008 and April 2009 in the Department of Cardiovascular Surgery, Firat University Faculty of Medicine, Elazig, Turkey. Thirty patients, who had undergone a median sternotomy (MS) for coronary artery bypass graft, were randomized to either the electroacupuncture and pharmacologic analgesia (acupuncture) group, or the pharmacologic analgesia alone (control) group. In each group, severity of pain, analgesic intake, respiratory function, and pulmonary complications were recorded. Pethidine hydrochloride and metamizole sodium were administered.
RESULTS: Of the 30 subjects, 15 were in the control group and 15 in the acupuncture group. There were no statistically significant differences between the 2 groups in terms of age and gender. Statistically significant differences in metamizole, pethidine, days 3, 5, 6, and 7 visual analogue scale scores were observed between the acupuncture and control groups. Postoperative complications (atelectasia) were observed in 2 (13.3%) patients, one (6.6%) in each group. The postoperative forced expiratory volume in one second/forced vital capacity value was higher than the preoperative value in the acupuncture group.
CONCLUSIONS: Electroacupuncture was more effective than control treatments in decreasing pain and limiting opioid and non-opioid medication intake during the first 7 postoperative days following MS.

March 2010
Cardioprotective Effects of Electroacupuncture Pretreatment on Patients Undergoing Heart Valve Replacement Surgery: A Randomized Controlled Trial
Journal: The Annals of Thoracic Surgery, Volume 89, Issue 3, pages 781-786
Abstract: BACKGROUND: Cardiac ischemia-reperfusion injury after cardiopulmonary bypass contributes to postoperative morbidity and mortality in patients with open-heart surgery. This randomized controlled trial was designed to address the protective effects of electroacupuncture (EA) pretreatment on myocardial injury in patients undergoing heart valve replacement surgery. METHODS: Sixty patients with acquired heart valve disease were randomly allocated to the EA pretreatment group or the control group. Patients in the EA group received EA stimulus at bilateral Neiguan (PC 6), Lieque (LU 7), and Yunmen (LU 2) for 30 minutes each day for five consecutive days before surgery. Hemodynamic data, mechanical ventilation time, inotropic drug use in the intensive care unit, serum cardiac troponin I concentrations, morbidities, and mortalities were compared between the two groups. This trial is registered with ClinicalTrials.gov, number NCT00732459. RESULTS: At 6 hours, 12 hours, and 24 hours after reperfusion, levels of serum cardiac troponin I were significantly decreased in the EA group (5.74 +/- 0.67, 6.22 +/- 0.66, and 5.21 +/- 0.58) compared with that in the control group (7.89 +/- 0.74, 8.34 +/- 1.08, and 7.57 +/- 0.89, p < 0.05). The EA pretreatment significantly reduced overall serum troponin I release at 6 hours, 12 hours, and 24 hours after aortic cross-clamp removal. Meanwhile, EA pretreatment also reduced the inotrope score at 12 hours, 24 hours, and 48 hours after the intensive care unit arrival and shortened intensive care unit stay time (p < 0.05). CONCLUSIONS: The present study demonstrated that EA pretreatment may alleviate cardiac ischemia-reperfusion injury in adult patients undergoing heart valve replacements. This simple and convenient treatment has the potential to be used in the clinic for reducing myocardial injury in patients with heart valve replacement surgery.

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