HERNIORRHAPHY UNDER LOCAL AND ACUPOINT ELECTRO ACUPUNCTURE ANESTHESIA

Sun Zhifeng, Wang Xiuwen, Bian Xueping

(Rongcheng County Hospital, Shandong)

Herniorrhaphy of 121 cases under local and acupoint electro-acupuncture anesthesia was investigated clinically. Sex; Male, 109 cases; female, 12 cases. Age: 3 to 77 years old. Basal anesthesia by Sodium Luminal was also adopted. Among 121 cases, indirect hernia, 83 cases; femoral hernia, 14 cases; direct hernia, 9 cases; communicating funicular hydrocele, 15 cases (2 cases complicated by undescended testis and orchidectomy were performed simultaneously; in other 2 cases, replacing orchiopexy was performed); amony 121 cases, 10 cases of incarcerated hernia operated immediately. Relationship between age and effectiveness was explored. Fluctuation of blood pressure was monitored during these surgical operations.

Acupoint Selection: Incision area; bilateral Shenmen-Sympathetic penetration.

Needling at incision area: 5 inch long needles were used. One penetrated from Wushu to Weidao, paralleling the incision and being close to the femoral artery. The second penetrated at Daju into the muscular layer, paralleling the incision and reached the linea me-diana. Obvious muscular tremor could be ob served during electric stimulation. A third one was inserted at a point 0.5 cm above Wushu and penetrated towards the umbilicus through the muscular layer. Besides, a 2 inch long needle was inserted towards perineum at Qugu with an oblique angle of 45°. When electric stimulation started, the abdominal muscles quivered. In male patients, the tremor of penis appeared at times.

Results: Grade I, 31 cases (25.6%); Grade II, 86 cases (71.1%). Successful case number, 117; successful rate, 96.7%.

Relationship between age and effectiveness: In elder patients (>41 years), the effect was better Than the younger (P<0.005,) But the age factor did not correlate with the ineffectiveness (0.05> P>0.1).

During surgical operation, the amplitude of blood pressure fluctuation was within 10 mm Hg. Blood pressure elevated to some extent in a part of patients mostly with low systolic pressure before the operation, while blood pressure lowered to some extent in patients mostly with high systolic pressure before the operation (3 of them had been involved with the stimulation of surgical maneuver). In the rest, blood pressure lowered slowly without adverse effects and no management was adopted.

Results showed that local and acupoint electro-acupuncture improved the analgesic effect of herniorrhaphy and met the needs of surgical operation. There were little interferences in the physiological states of the patient, the dynamics of blood flow was regulated. It had no special claim on surgeon's manoeuvre and was easy to be accepted and popularized. A definite clinical usefulness was evaluated, some experiences for successful electro-acupuncture anesthesia were discussed.