HYSTERECTOMY UNDER ACUPUNCTURE ANESTHESIA AND COMBINED ACUPUNCTURE ANESTHESIA

Anesthesia Group, Xi'an Fourth Hospital, Shanxi

In recent two years (1981 to 1982), 169 cases of transabdominal total hysterectomy were performed, 62 cases of them under acupuncture anesthesia, 86 cases under combined acupuncture anesthesia and 21 cases under extradural anesthesia as control.

1. Method

In all patients a dosage of sedative was given the night before operation, sod. luminal 0.1 g im 50 minutes before operation, and hyoscine 30 mg iv gtt after induction.

1) The acupuncture anesthesia group:

The acupoints used were as following:

a) Cephalic acupoints: Zhongjiao through to Xiajiao (both sides) and XiaJiao through to Zhongjiao (both sides).

b) Corporal acupoints: Modified needling method of Ciliao (both sides) and Wushu through to Weidao (both sides).

Electrical stimulation was generated from Bei-Hang 57-6D electrostimulator with a frequency of 100/sec. Electric current strength is limited according to the tolerance of the patients. Adjuvants were administered according to the rule designed by the collaborating group.

2) The combined acupuncture anesthesia group:

The acupoints of this group were the same kind as mentioned above, and the extradural puncture site was made at L 1-2 or L 2-3 .After induction, 10 to 15 minutes before incision of the skin, we gave xylocaine 5 ml, and dolantin 50 mg or 1 mg/kg IV gtt. Dosage may be added properly if the patient needs during the operation.

3. The extradural anesthesia group:

The extradural puncture site is L 1-2 or L 2-3 • Xylocaine and other adjuvants were given as routine.

2. Results

1) The excellent rate of acupuncture anesthesia group was 82.26%.

2) Combined acupuncture anesthesia group: According to the different dosage of xylocaine added, we divided them as following:

2% xylocaine 5 ml used: 27 cases, the excellent rate was 96.30%. 2% xylocaine 10 ml used: 35 cases, the excellent rate was 91.43%. More than 10 ml used: 24 cases, the excellent rate was 70.83%. These data showed that the less xylocaine used the better effects obtained. The excellent rates of analgesia in 2% xylocaine 5 ml, 10 ml, and more than 10 ml .group were 59.26%, 34.29% and 29.17% respectively, P<0.05. The excellent rates of reaction of viscera traction were 81.48%, 60.00%and 8.35% respectively, P<0.01. The excellent rates of muscular relaxation were 81,48%, 60.00%, and 12.50% respectively, P<0,01. The •excellent rates of physiological indices were 51.85%, 34.29%, 4.17% respectively, P<0,01.

3) Total dose of xylocaine used in combined acupuncture anesthesia group is less than that used in extradural anesthesia group, P<0.01. It means that acupuncture is playing an important role in regulating factor of the body,

4) According to the results mentioned above, it is suggested that combined acupuncture anesthesia is an effective method of anesthesia. The merits were those as following:

It is more pronounced that acupuncture is effective and safe. It promotes the regulation of the body and the recovery of the patients.

Combined acupuncture anesthesia may produce pain relief, muscular relaxation. It may reduce the reaction of viscera traction, and reduce the dosage of xylocaine used during operation. So it may keep the patients from the physiological interference of the drug anesthesia.

The indications may be expanded, such as weak patient or forecast for acupuncture anesthesia unsatisfied one may also be operated under combined acupuncture anesthesia.

Compiled by Hu Yingqi