COMPARISON OF COMPLICATIONS OF THYROIDECTOMY UNDER ACUPUNCTURE ANESTHESIA 

Wan Denin, Liu Yingtao, Zhu Yumei, Zeng Qingda, Li Hangui,

(Department of Anesthesia, 2nd Hospital, Hubei Medical College, Wuchang)

Comparison was made among 1024 cases of thyroidectomy under acupuncture anesthesia, 149 cases under epidural anesthesia and 67 cases under general anesthesia (endotracheal intubation and compound intravenous anesthesia) during the period of 1963 to 1982,

i The rate of success in the group of acupuncture anesthesia was 93.07% (I and II grade rates being 72.66%). During anesthesia, the incidence of decrease of blood pressure of about 10~-40 mmHg was 12.79% in the group of acupuncture anesthesia, 47.65% in the group of epidural anesthesia and 79.10% in the group of general anesthesia. The incidence in the group of acupuncture anesthesia is remarkably lower than that in the other two groups (P<0.01).

There were 4 cases with complications in 1024 cases of thyroidectomy under acupuncture anesthesia including 1 case of laryngismus and 1 case of phrenospasm caused by needling on Futu (neck), 1 case of postoperative pain and 1 case of numbness and transient myasthenia at right forearm caused by needing on Hegu and Neiguan points. After appropriate treatment, all the above mentioned complications were relieved without sequelae.

The complications in the group using cervical epidural anesthesia included 6 cases of the damage of spinal nerve roots, 1 case of incomplete hemiplegia caused by the damage of spinal cord leaving sequelae of decreased muscular contractility of the left upper limb, 5 cases of respiratory depression and 1 case of postoperative death due to progressive muscular paralysis leading to paralysis of respiratory muscles.

The post-operative complications in general anesthesia included 1 case of laryngeal edema, 1 case of severe laryngalgia and 2 cases of severe thyroid crisis including 1 death.

The results showed that the incidence of complications observed in medicinal anesthesia (8.72% in epidural anesthesia group, 5.97% in general anesthesia group) was far higher than that seen in acupuncture anesthesia (0.39%) and the nature of complication in medicinal anesthesia even more severe resulting in some cases in disability or death. On the contrary, the complications observed in acupuncture anesthesia were not severe. They showed less untoward effect on circulation and respiration and there was not a single death seen with acupuncture anesthesia in 1024 cases of thyroidectomy. This review clearly indicates that for thyroidectomy acupuncture anesthesia is a safe and effective anesthesia.