ACUPUNCTURE ANESTHESIA FOR THYROIDECTOMY

Yan Xiangmo, Li Yongman, Lian Zheshun

(Department of Anesthesia, Yanbian Mebical College, Yanji)

Zhang Hongyu, Li Zeshan

(Department of anesthesia. The First Hospital, Bethune Mebical University) Changchun)

This essay containing: 1, Clinical analysis of Hegu-Neiguan, auriculo-acupuncture, Fu-tu acupuncture anesthesia for thyroidectomy; 2. Study of Renzhong, ChengJiang acupuncture anesthesia for thyroidectomy; 3. Study conclusion of supplementary drugs in acupuncture anesthesia for thyroidectomy.

The effect of acupuncture anesthesia was divided into four grades, I+II+III grade was the rate of success; I-II grade was the rate of better results; IV grade of failure,

1. Clinical analysis of 646 cases under acupuncture anesthesia for thyroidectomy. Among 646 patients, 150 were male and 496 female. Their ages ranged from 14 to 72 years. Three groups of points were selected in this series of cases, group one was on the points of both sides of Hegu, Neiguan; group two was on the points of both sides of Futu; and group three was on the points of Jing, shenmen, Fei, Jiaogan only on the side of the left ear. Stainless steel acupuncture needles were used. Then G-6805 type apparatus electric acupuncture was used to stimulate them, induction time was about 30 minutes, frequency of stimulus, in Hegu and Neiguan was 2-6 Hz, and in Futu was 40-80 Hz. Intensity of stimulus continued until the patient felt too strong to tolerate. Sodium Luminal and Atropine or Copolamine were given intramuscular before operation, and Dolantin 1 mk/kg was administered intravenously 10-15 minutes before operation.

Effect of acupuncture anesthesia: 375 cases were included in Grade I, 177 cases in Grade II, 69 cases in Grade III, 25 cases in Grade IV, the rate of success was 91.13%, that of better results was 85.45%, the rate of failure was 3.86%. There was no evident difference in sex, age, profession, induction time (P>0.05). There was no evident difference in the effect of the three groups of points (P>0.05).

It has proved that all the points of the three groups could give good effect.

There was evident discrepancy between the method of operation and effect (P<0.01). The size of mass and the effect of acupuncture anesthesia: The effect was good in the size below 5 X 5 cm and above 10 X10 cm, and the effect was nearly the same as in size 5 x 5 cm- 10X10 cm (p<0.05).

For the analysis of physiologic change, the effect of acupuncture anesthesia was good and in most cases blood pressure and pulse were rather stable.

2. The study of acupuncture anesthesia by Renzhong, Chengjiang points for thyroidectomy. Compared with others in the same condition the rate of success in RenZhong, chengjiang was 95.83%, the rate of better results was 81.94%; and the rate of success in auriculo-acupuncture was 94.44%, the rate of better results was 77.22%; but no evident difference (p>0.05).

3. The study of supplementary drugs in acupuncture anesthesia for thyroidectomy. All the 104 cases were divided into three groups: no drugs supplied group, Coffein group and Dolantin group. The rate of success in no drugs supplied group was 83.30%, the rate of better results was 69.40%; and the rate of success in coffein group was 90.90%, the rate of better results was 75.80%; the rate of success in Dolantin group was 100%, the rate of better results was 91.40%.

The rates of success in all the three groups were all over 83%, this proved that the analgesic function of acupuncture anesthesia itself was certainly good. The rate of better results in the group administered drugs was higher than that with no supply of drugs. This also proved that the analgesic function of acupuncture anesthesia was not enough, so supplementary drugs were necessary. Dolantin group was good in releasing dragging pain.