EFFECT OF SURAZEPINE ON ACUPUNCTURE ANALGESIA

Ma Lihua, Hu shulan, Wang Suling, Wang Kuan

(The Third Hospital, Beijing Medical College, Beijing)

Surazepine is a new weak sedative with relatively strong tranquilizing, hypnotic, anti-convulsive and antidepressive effect. It is used in our clinical practice as an agent supplementing acupuncture analgesia and observation was carried out to clarify whether it may have synergistic effect on acupuncture analgesia or whether it may be used to improve efficacy of acupuncture analgesia.

Our clinical observation included 47 male and 93 female patients, total 140. The age ranged from 17 to 65, Operations performed were thyroid surgery, cervical spine surgery, ovarian resection, lower segmental caesarian section, tubal ligation and appendectomy.

The effect of surazepine on the pain and pain tolerance thresholds of the skin were analyzed in patients receiving thyroid operation who were given 5 mg of the drug an hour prior to surgery. The acupoints chosen were bilateral Futu. Prior to the incision of the skin, 0.1 mg of fentanyl was given intravenously. Potassium ion stimulation test was used to measure the severity of pain; 45 patients were divided into 5 groups: Group I received surazepine alone (N=-6); Group II acupuncture alone was used (N= 11); Group III acupuncture was used in combination with surazepine (N=10); Group IV fentanyl was given in combination with acupuncture (N=12) and in Group V Surazepine as well as acupuncture and fentanyl were used (N=12).

Results; There was no noticeable changes in painful and pain tolerance thresholds in group I which indicated that surazepine alone did not have analgesic effect. There was significant difference between Group II and III in painful and pain tolerance thresholds (p<0.05). The difference was very significant between Groups III and IV (P<0.01) and between Groups IV and V as well (P<0.05). These results showed that surazepine added analgesic effect to acupunctural analgesia, and this effect was even more prominent if surazepine was used in combination with both acupuncture and Fentany

Two groups of patients totaling 18, undergoing thyroid surgery were analyzed. In one group 5 mg of surazepine was given and in the other no medication was used. The acupoints and analgesics used were identical in two groups. The clinical conditions were similar in both groups. The reactions and responses to pain were observed during main steps of the operation. The response to skin incision under minor local anesthesia was not included in the project. The incidence of no pain or negligible pain during retraction of the thyroid gland was 61.6% in the group with medication, 33.3% in the group without medication (p<0.05). In 5.6% of cases in the group of medication additional local anaesthesia was needed during closing of the skin because of pain and 33.3% in the group without medication (p<0.05).

Surazepine itself did not have analgesic effect, but it would increase the analgesic effect of acupuncture. When acupuncture and fentanyl were used in combination the analgesic effect was even more evident. During this combination, the blood pressure and pulse rate remained stable and the patient was quiet; the tranquilizing effect was seen in 85% of cases. Very few or mild side effects occurred. Only in 10% of cases there was some dizziness, nausea and feeling of weakness in the extremities which disappeared in an hour.