Zhuang Xinliang, Qu Guilian, Chen Shoulin, Zhang Lingdi (Shanghai First People's Hospital)
As most of prostate hypertrophy patients belong to old age and patients undergoing prostatectomy are comparatively advanced in age with frequent association of cardio-vascular diseases and impaired functions of important organs, the anesthesia for the operation of these patients is essentially one for the aged. In this study we summarized the clinical data of 300 cases of prostatectomy using different methods of anesthesia, and a comparison of advantages and disadvantages of the acupuncture, the epidural and the general anesthesia is presented.
Operations were performed under acupuncture anesthesia in 150 cases under epidural anesthesia in 100 cases and under general anesthesia in 50 cases. Acupuncture anesthesia was performed according to the principle of combining the selection of points according to the course of Channels and those along the nerve. The basic points were Ciliao, Yaoshu and paraincisional needling, additional points being Mingmen, Jizhong, Zusanli, Sanyinjiao, etc. to be selected accordingly. The total grade I and II effectiveness rate exceeded 70%.
Analysis of Clinical Data. 1, The average age for patients undergoing operations were 69.36 (54-88) in the acupuncture anesthesia group, 66.45(52-76) in the epidural anesthesia group and 55.16 (45-85) in the general anesthesia group. Abnormal electrocardiographic findings were found in 55 cases (36.6%) in the acupuncture anesthesia group, in 22 cases (22.0%) in the epidural anesthesia group and in 14 cases (28.0%) in the general anesthesia group.
2, Blood Pressure Changes during Operations. An elevation of blood pressure was observed in 75.23% of the acupuncture anesthesia cases while a fall in 74.0% of the epidural anesthesia cases, whereas an elevation in 38.0% and a fall in 44.0% were found in the general anesthesia cases. The percentage of cases necessitating the usage of hypertensors was 55.0% for epidural anesthesia, 24.3% for general anesthesia and only 6% for acupuncture anesthesia.
Post-operative Conditions. Cases requiring the administration of analgesic within 24 hours after the operation were 22.0% for acupuncture anesthesia, 66.0% for epidural anesthesia and 40.0% for general anesthesia. The percentage of post-operative complications was 10% for acupuncture anesthesia, 15% for epidural anesthesia and 20.0% for general anesthesia.
Changes in Physiological Indices. Plethysmogram, the first derivative thoracic impedance cardiogram and rheoencephalogram were measured in some of our patients, showing a decreased cardiac output and vasodilation within the blocking range in the epidural anesthesia cases, while in the acupuncture anesthesia group was shown an increased cardiac output instead. Based on these data, it is clear that the application of acupuncture for prostatectomy is a fairly good choice of anesthesia.
As most of prostate hypertrophy patients belong to old age and patients undergoing prostatectomy are comparatively advanced in age with frequent association of cardio-vascular diseases and impaired functions of important organs, the anesthesia for the operation of these patients is essentially one for the aged. In this study we summarized the clinical data of 300 cases of prostatectomy using different methods of anesthesia, and a comparison of advantages and disadvantages of the acupuncture, the epidural and the general anesthesia is presented.
Operations were performed under acupuncture anesthesia in 150 cases under epidural anesthesia in 100 cases and under general anesthesia in 50 cases. Acupuncture anesthesia was performed according to the principle of combining the selection of points according to the course of Channels and those along the nerve. The basic points were Ciliao, Yaoshu and paraincisional needling, additional points being Mingmen, Jizhong, Zusanli, Sanyinjiao, etc. to be selected accordingly. The total grade I and II effectiveness rate exceeded 70%.
Analysis of Clinical Data. 1, The average age for patients undergoing operations were 69.36 (54-88) in the acupuncture anesthesia group, 66.45(52-76) in the epidural anesthesia group and 55.16 (45-85) in the general anesthesia group. Abnormal electrocardiographic findings were found in 55 cases (36.6%) in the acupuncture anesthesia group, in 22 cases (22.0%) in the epidural anesthesia group and in 14 cases (28.0%) in the general anesthesia group.
2, Blood Pressure Changes during Operations. An elevation of blood pressure was observed in 75.23% of the acupuncture anesthesia cases while a fall in 74.0% of the epidural anesthesia cases, whereas an elevation in 38.0% and a fall in 44.0% were found in the general anesthesia cases. The percentage of cases necessitating the usage of hypertensors was 55.0% for epidural anesthesia, 24.3% for general anesthesia and only 6% for acupuncture anesthesia.
Post-operative Conditions. Cases requiring the administration of analgesic within 24 hours after the operation were 22.0% for acupuncture anesthesia, 66.0% for epidural anesthesia and 40.0% for general anesthesia. The percentage of post-operative complications was 10% for acupuncture anesthesia, 15% for epidural anesthesia and 20.0% for general anesthesia.
Changes in Physiological Indices. Plethysmogram, the first derivative thoracic impedance cardiogram and rheoencephalogram were measured in some of our patients, showing a decreased cardiac output and vasodilation within the blocking range in the epidural anesthesia cases, while in the acupuncture anesthesia group was shown an increased cardiac output instead. Based on these data, it is clear that the application of acupuncture for prostatectomy is a fairly good choice of anesthesia.
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