Department of Anesthesiology and Neurosurgery, Xuanwu Hospital, Beijing
Acupuncture anesthesia was successfully applied to the craniotomies of various cranio-cerebral regions for 1500 patients admitted to our hospital from 1965 to 1978. Through clinical practice, it was deeply appreciated that acupuncture anesthesia has many advantages, such as less physiological disturbance, consciousness of patient during operation, allowing timely checking of operation effects, prompt recovery from operation, easy to observe and to nurse patients, and less complications of other organs. In 1972, we performed cranitomy for 474 patients with intracranial tumors of various regions under acupuncture anesthesia. It was observed that the effectiveness of acupuncture anesthesia applied to craniotomy using the retroauricular approach to cerebellopontine angle (81.3%) was much better than that applied to the craniotomies of frontal, temporal or parietal regions. Among the various operations in the cerebellopontine angle, the removal of large acoustic nerve tumor which is difficult to manipulate and involves higher risks showed the best results under acup uncture anesthesia (86%).
This paper mainly analyses the changes of vital signs and their corresponding treatment during operation on 100 patients with acoustic nerve tumors under acupuncture anesthesia in our hospital for several years, and compares the effectiveness of acupuncture anesthesia for the same operation in 50 cases (group I) with other 50 cases under drug anesthesia (group II). Our findings are as follows:
1. Vital signs: (1) There was no marked difference of blood pressure fluctuation between the two groups; (2) The changes of pulse pressure and pulse rate in group II were greater than that in group I; (3) The change of respiration in group II was more apparent than that in group I, even stoppage of respiration occurred.
2. Recovery after operation: approximately half the number of the patients in group II needed special nursing for more than 24 hours.
3. Complications: 5% of the patient in group II were associated with lung infections and injuries of brain stem, and 2% of them died of these severe complications, which did not occur in group I.
Based on our experiences described above, it is certain that craniotomy under acupuncture anesthesia was definitely superior to drug anesthesia, especially the adoption of acupuncture anesthesia in acoustic nerve tumor resection could not only let the old and feeble patients with cardio vascular dysfunction safely pass through the operation, but also greatly lighten the threat of respiratory and circulatory complications which usually result from choking due to invasion of cranial nerve groups by adhesion between acoustic nerve tumor and brain stem.
The authors pointed out that the appearance of acupuncture anesthesia opened a new page of the development in operative surgery, but it could not substitute all the other methods of anesthesia. Acupuncture anesthesia has its own indications and special effects, and therefore, the combined acupuncture anesthesia should generally be recommended. We also emphasize that before the removal of acoustic nerve tumor under acupuncture anesthesia, instruments of intratracheal intubation for artificial respiration should be ready to meet any contingency that may arise during the operation.
Acupuncture anesthesia was successfully applied to the craniotomies of various cranio-cerebral regions for 1500 patients admitted to our hospital from 1965 to 1978. Through clinical practice, it was deeply appreciated that acupuncture anesthesia has many advantages, such as less physiological disturbance, consciousness of patient during operation, allowing timely checking of operation effects, prompt recovery from operation, easy to observe and to nurse patients, and less complications of other organs. In 1972, we performed cranitomy for 474 patients with intracranial tumors of various regions under acupuncture anesthesia. It was observed that the effectiveness of acupuncture anesthesia applied to craniotomy using the retroauricular approach to cerebellopontine angle (81.3%) was much better than that applied to the craniotomies of frontal, temporal or parietal regions. Among the various operations in the cerebellopontine angle, the removal of large acoustic nerve tumor which is difficult to manipulate and involves higher risks showed the best results under acup uncture anesthesia (86%).
This paper mainly analyses the changes of vital signs and their corresponding treatment during operation on 100 patients with acoustic nerve tumors under acupuncture anesthesia in our hospital for several years, and compares the effectiveness of acupuncture anesthesia for the same operation in 50 cases (group I) with other 50 cases under drug anesthesia (group II). Our findings are as follows:
1. Vital signs: (1) There was no marked difference of blood pressure fluctuation between the two groups; (2) The changes of pulse pressure and pulse rate in group II were greater than that in group I; (3) The change of respiration in group II was more apparent than that in group I, even stoppage of respiration occurred.
2. Recovery after operation: approximately half the number of the patients in group II needed special nursing for more than 24 hours.
3. Complications: 5% of the patient in group II were associated with lung infections and injuries of brain stem, and 2% of them died of these severe complications, which did not occur in group I.
Based on our experiences described above, it is certain that craniotomy under acupuncture anesthesia was definitely superior to drug anesthesia, especially the adoption of acupuncture anesthesia in acoustic nerve tumor resection could not only let the old and feeble patients with cardio vascular dysfunction safely pass through the operation, but also greatly lighten the threat of respiratory and circulatory complications which usually result from choking due to invasion of cranial nerve groups by adhesion between acoustic nerve tumor and brain stem.
The authors pointed out that the appearance of acupuncture anesthesia opened a new page of the development in operative surgery, but it could not substitute all the other methods of anesthesia. Acupuncture anesthesia has its own indications and special effects, and therefore, the combined acupuncture anesthesia should generally be recommended. We also emphasize that before the removal of acoustic nerve tumor under acupuncture anesthesia, instruments of intratracheal intubation for artificial respiration should be ready to meet any contingency that may arise during the operation.
No comments:
Post a Comment