Research Group of Acupuncture Anesthesia, Hospital of Wuhan Iron and Steel Complex, Wuhan
In 1973, we initially applied acupuncture anesthesia by electric needling of the Juliao point to infraorbital foramen. A total of 268 cases of thyroidectomy has been performed since then. It was found that this new approach appeared quite good for relieving pain perception during the course of operation. The successful, excellent and good rates were 99%, 60% and 30.5% respectively. A control study of 107 cases of thyroidectomy was allocated at random. They consisted of 3 groups according to the distribution of acupuncture points as follows: the Futu point group 25 cases, Hegu point group 57 cases and Hegu-Neiguan points group 25 cases. Comparing the rates of excellent and good effects, it was significantly higher in Juliao group (92.5%) than in Futu group (80%) (P<0.05), and even more so than either Hegu point group (77%) or Hegu-Neiguan points group (72%) (P<0.01). It seems to show that the Juliao point to infraorbital foramen is the point of choice in thyroidectomy. As regards the rate of success, however, there was no significant difference between Juliao point to infraorbital foramen group and control groups. In order to ascertain the response of patient to operative manipulation during procedure, clinical data on 180 cases of acupuncture anesthesia by Juliao point to infraorbital foramen were used for statistical analysis. The results of painless response to 7 operative manipulations were as follows: to incise skin, 68.8%, to dissect muscle, 55.5%, to handle upper pole, 42.2%, to handle lower pole, 45.5%, to suture muscle, 65.5%, and to suture skin, 55%.
Method: The patient is put in supine position with eyes looking upward. The Juliao point is the across point that is determined by extending a line from the pupilar center downward perpendicularly, another line drawn from alae nasi laterally and horizontally. The needle is inserted into the skin of this point with right hand, then direct the tip of the needle upwards, outwards and backwards to reach the infraorbital foramen, when the anesthetist experiences the feeling of free of resistance suddenly, and the patient feels paresthesia over the innervated area of infraorbital nerve. It must put a firm pressure upon the lower margin of the orbit with fingers of left hand so as to prevent the needle from entering into the eye orbit of the patient. The depth of needling is 3-4 cm in adult.
Pain threshold was determined by potassium iontophoresis to evaluate the analgesic effect of this mode of acupuncture anesthesia. The threshold of the pain was measured in milliamperes in 4 subjects of young healthy women every 10 minutes for 60 minutes during electric needling of the Juliao point to infraorbital formen. It was shown that the pain threshold of skin was elevated gradually. The highest area of elevation of pain threshold is located over the skin of the cervical region, the mean elevation is 75% in 10 minutes after needling, and marked elevation of 150% in 40 minutes. The amplitude of elevation of pain threshold of cervical skin by Juliao point to infraorbital formen was significantly higher than that of Hegu point.
The mechanism of anesthetic action of electric needling with Juliao point to infraorbital formen is still unknown. We presume that the analgesic effect was due to inhibition of afferent impulse of pain stimulation transmitted from the surgery site by prolonged and intense stimulation of infraorbital nerve of the maxillary branch of trigeminal nerve.
In 1973, we initially applied acupuncture anesthesia by electric needling of the Juliao point to infraorbital foramen. A total of 268 cases of thyroidectomy has been performed since then. It was found that this new approach appeared quite good for relieving pain perception during the course of operation. The successful, excellent and good rates were 99%, 60% and 30.5% respectively. A control study of 107 cases of thyroidectomy was allocated at random. They consisted of 3 groups according to the distribution of acupuncture points as follows: the Futu point group 25 cases, Hegu point group 57 cases and Hegu-Neiguan points group 25 cases. Comparing the rates of excellent and good effects, it was significantly higher in Juliao group (92.5%) than in Futu group (80%) (P<0.05), and even more so than either Hegu point group (77%) or Hegu-Neiguan points group (72%) (P<0.01). It seems to show that the Juliao point to infraorbital foramen is the point of choice in thyroidectomy. As regards the rate of success, however, there was no significant difference between Juliao point to infraorbital foramen group and control groups. In order to ascertain the response of patient to operative manipulation during procedure, clinical data on 180 cases of acupuncture anesthesia by Juliao point to infraorbital foramen were used for statistical analysis. The results of painless response to 7 operative manipulations were as follows: to incise skin, 68.8%, to dissect muscle, 55.5%, to handle upper pole, 42.2%, to handle lower pole, 45.5%, to suture muscle, 65.5%, and to suture skin, 55%.
Method: The patient is put in supine position with eyes looking upward. The Juliao point is the across point that is determined by extending a line from the pupilar center downward perpendicularly, another line drawn from alae nasi laterally and horizontally. The needle is inserted into the skin of this point with right hand, then direct the tip of the needle upwards, outwards and backwards to reach the infraorbital foramen, when the anesthetist experiences the feeling of free of resistance suddenly, and the patient feels paresthesia over the innervated area of infraorbital nerve. It must put a firm pressure upon the lower margin of the orbit with fingers of left hand so as to prevent the needle from entering into the eye orbit of the patient. The depth of needling is 3-4 cm in adult.
Pain threshold was determined by potassium iontophoresis to evaluate the analgesic effect of this mode of acupuncture anesthesia. The threshold of the pain was measured in milliamperes in 4 subjects of young healthy women every 10 minutes for 60 minutes during electric needling of the Juliao point to infraorbital formen. It was shown that the pain threshold of skin was elevated gradually. The highest area of elevation of pain threshold is located over the skin of the cervical region, the mean elevation is 75% in 10 minutes after needling, and marked elevation of 150% in 40 minutes. The amplitude of elevation of pain threshold of cervical skin by Juliao point to infraorbital formen was significantly higher than that of Hegu point.
The mechanism of anesthetic action of electric needling with Juliao point to infraorbital formen is still unknown. We presume that the analgesic effect was due to inhibition of afferent impulse of pain stimulation transmitted from the surgery site by prolonged and intense stimulation of infraorbital nerve of the maxillary branch of trigeminal nerve.
No comments:
Post a Comment