The International Peace Maternity and Child Health Hospital, The China Welfare Institute
Since 1964, over 8,000 cases of abdominal tubal sterilization operations have been performed under acupuncture anesthesia with preoperative pethidine 50 mg given intravenously as an adjuvant. The effective rate was 97.15%. In search for a simple and safe anesthetic method for abdominal tubal sterilization and to evaluate its effectiveness, 60 patients were selected and divided at random into 3 groups of 20 cases each, namely, Group A, ear acupuncture plus pethidine 50 mg; Group B, ear acupuncture only; Group C, pethidine 50 mg. The effectiveness of the 3 groups was compared.
Preliminary "needling test": The tolerance and adaptability of the patient was observed by preoperative needling of point Hegu, while the pain threshold and the threshold of pain tolerance was determined by the amount of pressure directed to point Neiguan by means of a metal spring gauge.
The auricular points selected were: Shenmen and Uterus, Lung and Brain. Subcutaneously and horizontally, one needle was inserted into point Shenmen and travelled to point Uterus, and another needle was inserted into point Brain and travelled to point Lung either on the right or the left ear. Cases in Group A were given 50 mg pethidine intravenously 5 minutes before operation in addition to ear acupuncture, while cases in Group B received ear acupuncture only and those in Group C, 50 mg of pethidine only.
Results: In Group A, 90% of the cases rated grade I (excellent and good). The corresponding figures for Groups B and C were 85% and 65% respectively.
Analgesic effect: In Group A, 95% of the cases were observed to have complete analgesic effect or slight pain, the rate in Groups B and C were 90% and 80% respectively.
Reaction to visceral traction: In Group A, 75% had no or slight reaction to visceral traction, while in Groups B and C, the rates were 50% and 65% respectively.
Muscle relaxation: Adequate muscular relaxation was observed in 55% of the cases in Group A; the corresponding figures in Groups B and C were 35% and 30% respectively.
There was a definite correlation between preliminary pain threshold values and the effectiveness during the operation. Cases with high pain threshold and pain tolerance threshold values had better acupunctural anesthetic effect, indicating that there existed a positive correlation.
From a clinical appraisal of the 3 groups, taking into consideration of all the factors involved, the effective rate, the rate of grade I and II results, analgesic effect, response to visceral traction and muscular relaxation, the effective rate was highest in Group A. It seemed that acupuncture induced an analgesic effect while pethidine exerted an analgesic and relaxing effect. When administered simultaneously, their coordinating analgesic effect was enhanced, leading to abatement of pain perception and response to visceral traction, and to relaxation of the muscles. The operation could thus be performed smoothly with satisfactory anesthetic effect.
Since 1964, over 8,000 cases of abdominal tubal sterilization operations have been performed under acupuncture anesthesia with preoperative pethidine 50 mg given intravenously as an adjuvant. The effective rate was 97.15%. In search for a simple and safe anesthetic method for abdominal tubal sterilization and to evaluate its effectiveness, 60 patients were selected and divided at random into 3 groups of 20 cases each, namely, Group A, ear acupuncture plus pethidine 50 mg; Group B, ear acupuncture only; Group C, pethidine 50 mg. The effectiveness of the 3 groups was compared.
Preliminary "needling test": The tolerance and adaptability of the patient was observed by preoperative needling of point Hegu, while the pain threshold and the threshold of pain tolerance was determined by the amount of pressure directed to point Neiguan by means of a metal spring gauge.
The auricular points selected were: Shenmen and Uterus, Lung and Brain. Subcutaneously and horizontally, one needle was inserted into point Shenmen and travelled to point Uterus, and another needle was inserted into point Brain and travelled to point Lung either on the right or the left ear. Cases in Group A were given 50 mg pethidine intravenously 5 minutes before operation in addition to ear acupuncture, while cases in Group B received ear acupuncture only and those in Group C, 50 mg of pethidine only.
Results: In Group A, 90% of the cases rated grade I (excellent and good). The corresponding figures for Groups B and C were 85% and 65% respectively.
Analgesic effect: In Group A, 95% of the cases were observed to have complete analgesic effect or slight pain, the rate in Groups B and C were 90% and 80% respectively.
Reaction to visceral traction: In Group A, 75% had no or slight reaction to visceral traction, while in Groups B and C, the rates were 50% and 65% respectively.
Muscle relaxation: Adequate muscular relaxation was observed in 55% of the cases in Group A; the corresponding figures in Groups B and C were 35% and 30% respectively.
There was a definite correlation between preliminary pain threshold values and the effectiveness during the operation. Cases with high pain threshold and pain tolerance threshold values had better acupunctural anesthetic effect, indicating that there existed a positive correlation.
From a clinical appraisal of the 3 groups, taking into consideration of all the factors involved, the effective rate, the rate of grade I and II results, analgesic effect, response to visceral traction and muscular relaxation, the effective rate was highest in Group A. It seemed that acupuncture induced an analgesic effect while pethidine exerted an analgesic and relaxing effect. When administered simultaneously, their coordinating analgesic effect was enhanced, leading to abatement of pain perception and response to visceral traction, and to relaxation of the muscles. The operation could thus be performed smoothly with satisfactory anesthetic effect.
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