PATIENTS COMPLICATED WITH CARDIOVASCULAR DISEASES UNDER ACUPUNCTURE ANESTHESIA AND EPIDURAL ANESTHESIA 

Qu Xiaoxin, Zhang Tanren, Sun Guizhen, Hou Li

(Xi'an Fourth Hospital, Shanxi)

It is well known, anesthetics and the operative stimulus may influence the function of the cardiovascular system, therefore, certain risk would be taken to give operations on patients with cardiovascular disease. The application of acupuncture anesthesia might avoid these disadvantages, and give help to adjust the functions of the circulation of the body. In order to further study of the safety of acupuncture anesthesia, the authors have observed the change of the function of the left ventricle under acupuncture and epidural anesthesia during an operation of abdominal hysterectomy, based on 57 cases of acupuncture anesthesia and 30 cases of epidural anesthesia, of the 57 cases, 5 cases of hypertension, 4 cases of coronary heart disease, 4 cases of rheumatic heart disease, 18 cases of hypertensive heart disease, 14 cases of myocardial disease, 2 cases of congenital heart disease; of the 30 cases, 19 cases of hypertension, 2 cases of rheumatic heart disease, 3 cases of myocardial disease, 5 cases of hypertensive heart disease, 1 case of coronary heart disease. All of the cases, systolic time intervals, pump function parameters, and peripheral vascular parameters were determined and analysed. The systolic time intervals include 1) Heart rate, (HR); 2) Electromechanical systole (QS2); 3) Left ventricular ejection time (LVET); 4) Pre-eJection period (PEP;

5) Pre-ejection period/Left ventricular ejection time (PEP/LVET); 6) Mechanical systole (MS); 7) Isovolumic contraction time (IVCT); 8) Isovolumic contraction time/Left ventricular ejection time (IVCT/LVET); the pump function parameters include 1) Stroke volume <SV); 2) Stroke volume index (SVI); 3) Cardiac output (CO); 4) Cardiac index (CI); 5) The ratio of SVI of pre- and postoperation; 6) The ratio of CI of pre- and post-operation;

7) Left ventricle stroke proportion (LVSP); 8) Left ventricle work (LVW); 9) Tension time index (TTI); 10) Heart index (HI); and peripheral vascular parameters include 1) Total' peripheral resistance (TPR); 2) Mean blood pressure (MBP); 5) Aorta conpliance (CA).

Result: there was no apparent change in systolic time intervals before and after an operation under the acupuncture anesthesia (P<0.05), nor was there any apparent change in pump function parameter and peripheral vascular parameter before and after an operation under acupuncture anesthesia in Grade I and II cases (P<0,05). Yet SV (P<0.01), SVI (P<0.01), CO (P<0.05), CI (P<0.05), LVSP (P<0.02), apparently decreased after an operation under acupuncture anesthesia in Grade III and IV, while TPR increased (P<0.05). This shows the function of the left ventricle is comparatively stable under the acupuncture anesthesia, and acupuncture can weaken the influence of operation on the cardiovascular, and keep the balance and stability of the circulation function during an operation. PEP became longer (P<0.01), PEP/LVET (P<0.01) increased. SV (P<0.01), SVI (P<0.01), CO (P<0.001), CI (P<0.001), LVW (P<0.05), LVSP (P<0.01) all decreased, TPR (P<0.01) increased, indicate that the function of left ventricle became weaker in patients with cardiovascular disease after an operation under epidural anesthesia. This may imply that an operation under epidural anesthesia may increase the risk of a cardiovascular disease patient.

In the light of the above parameters, we believe that acupuncture anesthesia is a relatively safe means for patients with heart disease.