Randomized Controlled Trial
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2022; 10(12): 3764-3772
Published online Apr 26, 2022. doi: 10.12998/wjcc.v10.i12.3764
Effect of wrist-ankle acupuncture on propofol dosage during painless colonoscopy: A randomized controlled prospective study
Tao He, Chan Liu, Zhi-Xia Lu, Li-Li Kong, Yan Li, Zhe Xu, Ya-Jing Dong, Wei Hao
Tao He, Chan Liu, Zhi-Xia Lu, Li-Li Kong, Yan Li, Zhe Xu, Ya-Jing Dong, Wei Hao, Department of Anesthesiology, Hebei Provincial Hospital of Traditional Chinese Medicine, Shijiazhuang 050000, Hebei Province, China
Wei Hao, Key Laboratory of Integrated Chinese and Western Medicine for Gastroenterology Research (Hebei), Key Laboratory of Integrated Chinese and Western Medicine for Gastroenterology Research (Hebei), Shijiazhuang 050000, Hebei Province, China
Author contributions: Hao W and Dong YJ conceived the study; Dong YJ, He T and Liu C recruited the patients; Dong YJ performed the wrist-ankle acupuncture; He T, Li Y, Liu C, Xu Z and Lu ZX collected the data; Hao W analyzed the data; Hao W, Kong LL interpreted the data; He T and C Liu contributed equally; All authors read and approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Hebei Provincial Hospital of Traditional Chinese Medicine Medical Ethics Committee (2019-KY-003-02).
Clinical trial registration statement: This study has been registered in China Clinical Trial Registration Center (registration code: ChiCTR1900022177, http://www.chictr.org.cn/).
Informed consent statement: Written informed consent was obtained from the participants for publication of this article and any accompanying tables/images.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
Data sharing statement: No additional data are available.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Hao, MD, Doctor, Professor, Department of Anesthesiology, Hebei Provincial Hospital of Traditional Chinese Medicine, No. 389 Zhongshan East Road, Chang'an District, Shijiazhuang 050000, Hebei Province, China. keyan_66666@126.com
Received: June 26, 2021
Peer-review started: June 26, 2021
First decision: September 1, 2021
Revised: October 14, 2021
Accepted: March 4, 2022
Article in press: March 4, 2022
Published online: April 26, 2022
Processing time: 298 Days and 22 Hours
Abstract
BACKGROUND

The clinical advantages of painless colonoscopy can reduce the fear and discomfort of patients and increase the detection rate of diseases. Propofol has the characteristics of fast effect and short action time. It is a common choice for painless endoscopic sedation and anesthetics. However, propofol can cause severe respiratory and circulatory depression. Therefore, it is important to find a way to reduce the dose of propofol.

AIM

To explore the effect of wrist-ankle acupuncture on propofol dose during colonoscopy.

METHODS

Two hundred patients who were going to receive selective painless colonoscopy in Hebei Hospital of Traditional Chinese Medicine were selected and divided into wrist-ankle acupuncture group (WAA group, n = 100) and control group (CON group, n = 100). After entering the operation room, patients were given 0.025 mg/kg nabufine intravenously and propofol at the initial dose of 0.5 mg/kg. In patients who did not fall asleep, propofol (10 mg/time) was given until loss of consciousness. Prior to anesthesia, patients in WAA group were punctured by specialist in the inferior 1, 2 and 3 regions according to the zoning principle of wrist-ankle acupuncture. The primary endpoint was required dose of propofol, and the secondary endpoints were the incidence of hypoxemia and hypotension. Furthermore, the following data were recorded: The operation time, wake-up time, incidence of nausea and vomiting, incidence of abdominal distention, post-colonoscopy pain, examiners' satisfaction, patients' satisfaction and Borg fatigue index. This study has been registered in the Chinese Clinical Trial Registry (Registration Code: ChiCTR1900022177).

RESULTS

The induced dose of propofol and the total dose of propofol in WAA group were 80 mg and 110 mg, respectively, which were significantly lower than those in CON group (P < 0.05). The incidences of hypoxemia and hypotension in the WAA group were 2.2% and 3.3%, respectively, significantly lower than those in the CON group (P < 0.05). The incidence of abdominal distension in the WAA group was 8.8%, which was significantly lower than that in the CON group (P < 0.05, 28.9%). The waking time of WAA group was 3.26 ± 0.87 min, which was significantly lower than that of CON group (6.06 ± 0.88 min, P < 0.05).

CONCLUSION

Wrist-ankle acupuncture can reduce the induction dose and total dose of propofol as well as the incidence of adverse reactions in painless colonoscopy without affecting the satisfaction of examiners and patients. This procedure is simple in operation and easy to promote in clinical practice.

Keywords: Wrist-ankle acupuncture; Ankle; Painless colonoscopy; Analgesia

Core Tip: Two hundred patients scheduled for painless colonoscopy were selected and divided into wrist-ankle acupuncture group (n = 100) and control group ( n = 100). The operation time, recovery time, incidence of nausea and vomiting, incidence of abdominal distension, pain after colonoscopy, satisfaction of examiners, satisfaction of patients and Borg fatigue index were recorded. The results showed that ankle acupuncture can reduce the induction dose and total dose of propofol, reduce the occurrence of adverse reactions of painless colonoscopy and does not affect the satisfaction of examiners and patients.