The Clinical Analysis Of 282 Cases Of Appendectomy Under Acupuncture Anesthesia

Yu Beijian, Yang Tou (Department of Anesthesia, The First Municipal Hospital, Wuhan)

Since September 1975, we have carried out 282 cases of appendectomy under acupuncture anesthesia and the success rate was 92.08% and the score for Grade I & II combined were 68.44%.

Clinical reports revealed that the effect of the acupuncture anesthesia with various groups of points were approximately the same. In order to observe the relationship between the principle of selection of points, stimulating parameters and the effect of acupuncture anesthesia we have used 3 different groups of points for appendectomy in our hospital. This is the report of our preliminary analysis.


I. General materials.

1. Of 282 cases, 156 cases were male and 126 cases were female, the average age was 29 years with a range of 14-46 years.

2. No preanesthetics were used. The dose of adjuvant drugs used and dividing of the Grade were according to the general rules determined in our country in 1975.

3. Mode of incision (for appendectomy).

Incision along linea semilunaris.

4. Acupuncture anesthesia manipulator.

C.D.M. 1-2 model (wave: double phases spiked pulsations.)


II. Method of acupuncture stimulation.

1. Selection of points.

The first group: along the channels, Zusanli (both sides), Sanyinjiao (both sides), the second group: according to segmental distribution of the spinal cord. Pishu, Weishu, Wushu (all right side), the third group: combination of the above two.

2. Parameters:

Zusanli, Sanyinjiao, 120-600c./min. Pishu, Weishu, Zhangmen, Wushu 3000-6000c./min, or 30,000-60,000c./min.

III. Results

IV. Discussion.


1. The present principle of selection of points are usually divided into: a. Along the course of channels. b. According to the segmental distribution of the spinal cord. c. Combination of the above two. All of these points will cause the same effect, if the intensity of stimulation is reached to a sufficient degree.

2. In the course of appendectomy, we have observed the effect of the 3 different groups of points on the 5 main operative steps; it was found that the third group was more effective in reducing the traction reaction (in handling the appendix and mesoappendix) than other groups (P<0.01).


During operation, we have blocked the root of mesoappendix with 0.5% procaine in 108 cases, the number of patient blocked and the amount of procaine used in the third group were less than other two groups. (The numbers of patient blocked in the first, second and third groups were 55/97, 33/59 and 46/126; the amount of procaine used was 2.56 cc. 3.06 cc. and 2.21 cc. respectively). However, the rate of Grade I and II. effect did not elavate accordingly.

3. Some authors suggested that the use of high frequency on the local points will increase the pain tolerance threshold. We have analysed the result of 153 cases in whom local points of Zhangmen and Wuchu were used with different stimulating frequency; it was found that if the frequency was more than 10,000c./min., the effect was better than those under 10,000c./min. Whether it is due to transient nerve blocking resulting from peripheral nervous fatigue or inhibition of transmission after the use of electric current stimulation remains to be solved.


On the ground of the clinical observation of 282 cases, we believed that except the patient's mental state, the pathologic changes of appendix, the position of appendix, the duration of operation and the skillfulness of the surgeon and anesthetist, the effect of acupuncture anesthesia is also related to the frequency of local stimulation. There was no relation to the points selected.