Wang Xuewei, Tsao Daxin, Zhang Zhongming, Sun Yonghua (Department of Burns)
Shi Guang (Unit of Acupuncture Anesthesia, Department of Anesthesia, Jishuitan Hospital, Beijing)
From April 1970 to October 1975, acupuncture anesthesia was adopted 243 times for operations of burn cases. We are going to discuss 12 of these cases in which scalp acupuncture anesthesia was used 23 times, as this type of anesthesia is especially desirable in severe burn cases when drug anesthesia or ordinary acupuncture anesthesia is neither suitable nor possible.
Three of the 12 cases were severe electric burns (with more than 10% 3rd-4th degree burn) and the other 9 were all heat burns with 40-96% of total burnt area and 15-90% of 3rd degree burn (the most severe one had 96% total burnt area and 90% 3rd degree burn). These 9 cases were all complicated by burns of the respiratory tract of different severity. Operations of tangential excision of eschar of the trunk or extremities, debridement, skin grafting and amputation were performed respectively during a period of 3-22 days after injury. Anesthesia was scalp acupuncture plus synchronous stimulation with local synchronous stimulation as an adjunct; in individual cases, ordinary acupuncture, ear acupuncture or stimulation of nerve trunks was also used. Electric pulse for stimulation at acupuncture points was put out through 57-6 type acupuncture anesthesia appartus produced by Beijing Aviation Academy. The frequency was 200 c./min.-1200 c./min. The intensity of stimulation was decided by adaptation and tolerance of the patient. Preoperative medication generally included dolantin, phenergan, fluphenazine and fentanyl. The usual operating time was 1-2 hours, 3 hours in individual cases.
Patients might assume any posture during operation, for example, excision or tangential excision of eschar was performed with the patient lying prone. Tourniquet was used in limb operations and most of the cases tolerated well if not exceeding one hour. All operations were completed uneventfully. Most of the patients did not fast before operation. Small amount of fluid was given orally during operation and food was given immediately after operation. Fluid infusion during operation was given according to the amount lost from operative hemorrhage, metabolism and wound exudation at the time. No vasopressor was used in the operating theatre.
In 2 of the 12 cases, which were the severest in burnt area and 3rd degree burn (96/90 and 94/60), most part of the eschar was safely excised in several sessions within 5-7 days after injury under scalp acupuncture anesthesia and the wound surface eliminated. The uneventful course of recovery of these 2 cases, we believe, is more or less related with the application of scalp acupuncture anesthesia.
About the effect of scalp acupuncture anesthesia in the 23 operations of the 12 cases, excellent-good grade in 13 operations and failed in 4. There was no death.
Shi Guang (Unit of Acupuncture Anesthesia, Department of Anesthesia, Jishuitan Hospital, Beijing)
From April 1970 to October 1975, acupuncture anesthesia was adopted 243 times for operations of burn cases. We are going to discuss 12 of these cases in which scalp acupuncture anesthesia was used 23 times, as this type of anesthesia is especially desirable in severe burn cases when drug anesthesia or ordinary acupuncture anesthesia is neither suitable nor possible.
Three of the 12 cases were severe electric burns (with more than 10% 3rd-4th degree burn) and the other 9 were all heat burns with 40-96% of total burnt area and 15-90% of 3rd degree burn (the most severe one had 96% total burnt area and 90% 3rd degree burn). These 9 cases were all complicated by burns of the respiratory tract of different severity. Operations of tangential excision of eschar of the trunk or extremities, debridement, skin grafting and amputation were performed respectively during a period of 3-22 days after injury. Anesthesia was scalp acupuncture plus synchronous stimulation with local synchronous stimulation as an adjunct; in individual cases, ordinary acupuncture, ear acupuncture or stimulation of nerve trunks was also used. Electric pulse for stimulation at acupuncture points was put out through 57-6 type acupuncture anesthesia appartus produced by Beijing Aviation Academy. The frequency was 200 c./min.-1200 c./min. The intensity of stimulation was decided by adaptation and tolerance of the patient. Preoperative medication generally included dolantin, phenergan, fluphenazine and fentanyl. The usual operating time was 1-2 hours, 3 hours in individual cases.
Patients might assume any posture during operation, for example, excision or tangential excision of eschar was performed with the patient lying prone. Tourniquet was used in limb operations and most of the cases tolerated well if not exceeding one hour. All operations were completed uneventfully. Most of the patients did not fast before operation. Small amount of fluid was given orally during operation and food was given immediately after operation. Fluid infusion during operation was given according to the amount lost from operative hemorrhage, metabolism and wound exudation at the time. No vasopressor was used in the operating theatre.
In 2 of the 12 cases, which were the severest in burnt area and 3rd degree burn (96/90 and 94/60), most part of the eschar was safely excised in several sessions within 5-7 days after injury under scalp acupuncture anesthesia and the wound surface eliminated. The uneventful course of recovery of these 2 cases, we believe, is more or less related with the application of scalp acupuncture anesthesia.
About the effect of scalp acupuncture anesthesia in the 23 operations of the 12 cases, excellent-good grade in 13 operations and failed in 4. There was no death.
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