Research Group of Acupuncture Anesthesia, Zhongshan Medical College, Guangzhou
In the 197 cases of subtotal gastrectomy, the finger plethysmography of stroke volume, blood pressure and heart rate were continuously made with the 4-guide recorder, and at the same time, nausea and vomiting were observed so as to analyse the rule of the reaction of visceral dragging pain.
1. The indication of the reaction of visceral dragging pain
During the operation, this reaction was very complex. According to the changes of physiological indices, it was divided into two types, the sympathetic exciting reaction and the sympathetic depression reaction. In the sympathetic exciting reaction, the plethysmogram and the pulse wave were decreased, but the blood pressure and the heart rate increased. The duration of the reaction was short, the patient felt pain, which was mainly due to visceral pain reaction. In sympathetic depression reaction, these four physiological indexes were opposite to those of the former case. The duration was longer. The patient felt nausea and vomiting, which were mainly due to visceral dragging reaction. During the process of gastrectomy, these two types of reaction often mixed up together, however, sometimes strong sympathetic exciting reaction was induced by some steps of operation, and manifest sympathetic depression reaction appeared in some other steps of the operation.
2. The occurance of the reaction of visceral dragging pain
The sympathetic exciting reaction appeared frequently during the stretching of the gastrointestinal wall, it was possibly induced by stimulation of the receptors of the gastrointestinal wall. In the epidural anesthesia, the T[4]--T[10] were blocked, the sympathetic exciting reaction was obviously reduced, showing that the great splanchnic nerve may be the main afferent path of this reaction. The sympathetic depression reaction occured frequently during separating the greater curvature omentum, and was possibly induced by the stimulation of the receptors (omentum) arround the stomach. In epidural anesthesia, this reaction did not decrease. Therefore, it is possible that the splanchnic nerve is not the main afferent path of this reaction, and afferent impulses would pass through the vagus into the medulla oblongata.
3. The influence of acupuncture on the reaction of visceral dragging pain:
Stimulation of the "Back-shu" points can inhibit the sympathetic exciting reaction, while stimulation of the "Ear-radix" points inhibit nausea and vomiting.
In the 197 cases of subtotal gastrectomy, the finger plethysmography of stroke volume, blood pressure and heart rate were continuously made with the 4-guide recorder, and at the same time, nausea and vomiting were observed so as to analyse the rule of the reaction of visceral dragging pain.
1. The indication of the reaction of visceral dragging pain
During the operation, this reaction was very complex. According to the changes of physiological indices, it was divided into two types, the sympathetic exciting reaction and the sympathetic depression reaction. In the sympathetic exciting reaction, the plethysmogram and the pulse wave were decreased, but the blood pressure and the heart rate increased. The duration of the reaction was short, the patient felt pain, which was mainly due to visceral pain reaction. In sympathetic depression reaction, these four physiological indexes were opposite to those of the former case. The duration was longer. The patient felt nausea and vomiting, which were mainly due to visceral dragging reaction. During the process of gastrectomy, these two types of reaction often mixed up together, however, sometimes strong sympathetic exciting reaction was induced by some steps of operation, and manifest sympathetic depression reaction appeared in some other steps of the operation.
2. The occurance of the reaction of visceral dragging pain
The sympathetic exciting reaction appeared frequently during the stretching of the gastrointestinal wall, it was possibly induced by stimulation of the receptors of the gastrointestinal wall. In the epidural anesthesia, the T[4]--T[10] were blocked, the sympathetic exciting reaction was obviously reduced, showing that the great splanchnic nerve may be the main afferent path of this reaction. The sympathetic depression reaction occured frequently during separating the greater curvature omentum, and was possibly induced by the stimulation of the receptors (omentum) arround the stomach. In epidural anesthesia, this reaction did not decrease. Therefore, it is possible that the splanchnic nerve is not the main afferent path of this reaction, and afferent impulses would pass through the vagus into the medulla oblongata.
3. The influence of acupuncture on the reaction of visceral dragging pain:
Stimulation of the "Back-shu" points can inhibit the sympathetic exciting reaction, while stimulation of the "Ear-radix" points inhibit nausea and vomiting.
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