Huang Heniang, Yu Rongzhen, Zhou Aiju (Eye, Ear, Nose and Throat Hospital of Shanghai First Medical College)
From June 1970 to December 1978, 430 cases of carcinoma of larynx, relatively late and inapplicable for radiotherapy, had been treated by total laryngectomy under acupuncture anesthesia. Regarding to anesthesia 73.5% cases got success. Owing to the fact that the results of acupuncture anesthesia was quite stable, we were thereby encouraged to use this kind of anesthesia persistently during the past eight years. Occasionally the imcomplete analgesia, the violent response to the traction of the larynx and the production of irritating cough were however the three main problems which hadn't yet been completely resolved during the course of acupuncture anesthesia.
Acupuncture points, including the body points Hegu, Lieque, Neiguan, ear poits ("Lung", Shenmen through to "sympathetic") and points around the skin incision (Futu, Tianding, Qishe) were used in combination during each procedure. Clinical results of acupuncture anesthesia were classified into four grades. Among these 430 cases, 174 cases were excellent (40.5%), 142 cases merely satisfactory (33%), 66 cases fair (15.3%) and 48 cases failure (11.2%).
According to the principle that operative maneuvers, performed on a conscious patient, should be modified and different from those of unconciousness. Patients under acupuncture anesthesia were certainly conscious at most of the time, in order to get well success, our experiences proposed the following improvements namely: (1) early resection of the hyoid bone so as to relax the structures of the upper part of the neck, (2) early resection of the ishmus of the thyroid gland so as to avoid suffocation, (3) to suture the cutting surface of the trachea as soon as possible so as to prevent the coughing induced by blood inhaled into the lower respiratory tract, (4) dissecting the larynx from below upwards from the surrounding tissue, and (5) following the mucous membrane of the pharynx and the upper part of the esophagus had been sutured together, patient was asked for to make a swallow, leakages whenever noticed were repaired immediately.
Through the course of acupuncture anesthesia, plethysmogram, respiratory pneumogram, cutaneous and muscular galvanic currents were recorded and closely compared with those obtained under the general anesthesia. During the prominent surgical steps, essentially in 10, those patients excellent during the acupuncture anesthesia, had no apparent difference with those under the general. In addition, patients under acupuncture anesthesia had the advantages of smooth post-operative course, less broncheo-tracheal secretion, mild coughing and early healing of the wound.
From June 1970 to December 1978, 430 cases of carcinoma of larynx, relatively late and inapplicable for radiotherapy, had been treated by total laryngectomy under acupuncture anesthesia. Regarding to anesthesia 73.5% cases got success. Owing to the fact that the results of acupuncture anesthesia was quite stable, we were thereby encouraged to use this kind of anesthesia persistently during the past eight years. Occasionally the imcomplete analgesia, the violent response to the traction of the larynx and the production of irritating cough were however the three main problems which hadn't yet been completely resolved during the course of acupuncture anesthesia.
Acupuncture points, including the body points Hegu, Lieque, Neiguan, ear poits ("Lung", Shenmen through to "sympathetic") and points around the skin incision (Futu, Tianding, Qishe) were used in combination during each procedure. Clinical results of acupuncture anesthesia were classified into four grades. Among these 430 cases, 174 cases were excellent (40.5%), 142 cases merely satisfactory (33%), 66 cases fair (15.3%) and 48 cases failure (11.2%).
According to the principle that operative maneuvers, performed on a conscious patient, should be modified and different from those of unconciousness. Patients under acupuncture anesthesia were certainly conscious at most of the time, in order to get well success, our experiences proposed the following improvements namely: (1) early resection of the hyoid bone so as to relax the structures of the upper part of the neck, (2) early resection of the ishmus of the thyroid gland so as to avoid suffocation, (3) to suture the cutting surface of the trachea as soon as possible so as to prevent the coughing induced by blood inhaled into the lower respiratory tract, (4) dissecting the larynx from below upwards from the surrounding tissue, and (5) following the mucous membrane of the pharynx and the upper part of the esophagus had been sutured together, patient was asked for to make a swallow, leakages whenever noticed were repaired immediately.
Through the course of acupuncture anesthesia, plethysmogram, respiratory pneumogram, cutaneous and muscular galvanic currents were recorded and closely compared with those obtained under the general anesthesia. During the prominent surgical steps, essentially in 10, those patients excellent during the acupuncture anesthesia, had no apparent difference with those under the general. In addition, patients under acupuncture anesthesia had the advantages of smooth post-operative course, less broncheo-tracheal secretion, mild coughing and early healing of the wound.
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