Shanghai First Tuberculosis Hospital
Since June 1960 up to November 1978, 1,067 pulmonary resections were done under acupuncture anaesthesia in cooperation with the Shanghai Acupuncture Institute. This is a report of the technique and efficacy of acupuncture anaesthesia for pulmonary resections.
Preoperative preperation: Owing to the preservation of consciousness and retaining of tactile sensation, the method of acupuncture anaesthesia and operative procedures should be fully explained to the patient so as to obtain appropriate cooperation during operation. Training of the patient should be taken on voluntary deep and slow abdominal breathing exercise until the respiratory rate could be controlled at 4-5 times a minute for 1-2 hours. Immediately before operation a small dose of hypnotics and atropine were given. The prescriptions of acupuncture points are mainly made on the basis of the theories of the traditional Chinese medicine "Selection of points according to the course of Channels" and "Discrimination of treatment according to individual character and clinical condition" with the considerations of the analgesic effect and needling sensation on the preliminary tests. There were 3 types of prescriptions being used, multiple, moderate and scanty points; and 3 methods of acupuncture, hand manoeuvre, electrical acupuncture stimulation and combination of both. The needling points should be accurately determined and strong needling sensation obtained. Induction period took about 30 minutes.
During operation: Intensive care should be taken and adjuvant durgs should be used when necessary. After opening the chest it is important to have the respiration to be well controlled and secretions drained.
Of the 1067 cases, there were 799 (74.9%) males and 268 (25.1%) females with the age range mainly between 21-50 years, 51.9% of them were workers and 79.1% suffered from pulmonary tuberculosis. Lobectomies had been the most frequently used resections, for 892 (83.9%) cases. The efficacy of the acupuncture anaesthesia was judged on the extent of pain, mediastinal flutter present together with the amount of adjuvant durgs used and ranked into 4 grades: excellent, no adjuvant durgs used, no or only slight pain, 140 cases (13.1%); good, 739 cases (69.3%); fair, 146 cases (13.7%); and failure, general anaesthesia being used in place, 42 cases (3.9%).
The results indicate that acupuncture anaesthesia is a anaesthesia methods of the traditional Chinese medicine combinated with western medicine. However, there are still some drawbacks such as incomplete analgesic effect, presence of mediastinal flutter and requirement of adjuvant drugs in certain cases. The efficacy of anaesthesia was closely related to the difference of prescriptions of needling points and the individual tolerance of pain. It is also influenced by the factors of the complexity of the disease and duration of operation. For the serious cases, we consider, in combination with intratracheal tubing it is an aceptable method of anaesthesia. For those general anaesthesia not indicated far advanced tuberculous patient with poor pulmonary function and even in semiconscious state, acupuncture anaesthesia may show its merits.
Since June 1960 up to November 1978, 1,067 pulmonary resections were done under acupuncture anaesthesia in cooperation with the Shanghai Acupuncture Institute. This is a report of the technique and efficacy of acupuncture anaesthesia for pulmonary resections.
Preoperative preperation: Owing to the preservation of consciousness and retaining of tactile sensation, the method of acupuncture anaesthesia and operative procedures should be fully explained to the patient so as to obtain appropriate cooperation during operation. Training of the patient should be taken on voluntary deep and slow abdominal breathing exercise until the respiratory rate could be controlled at 4-5 times a minute for 1-2 hours. Immediately before operation a small dose of hypnotics and atropine were given. The prescriptions of acupuncture points are mainly made on the basis of the theories of the traditional Chinese medicine "Selection of points according to the course of Channels" and "Discrimination of treatment according to individual character and clinical condition" with the considerations of the analgesic effect and needling sensation on the preliminary tests. There were 3 types of prescriptions being used, multiple, moderate and scanty points; and 3 methods of acupuncture, hand manoeuvre, electrical acupuncture stimulation and combination of both. The needling points should be accurately determined and strong needling sensation obtained. Induction period took about 30 minutes.
During operation: Intensive care should be taken and adjuvant durgs should be used when necessary. After opening the chest it is important to have the respiration to be well controlled and secretions drained.
Of the 1067 cases, there were 799 (74.9%) males and 268 (25.1%) females with the age range mainly between 21-50 years, 51.9% of them were workers and 79.1% suffered from pulmonary tuberculosis. Lobectomies had been the most frequently used resections, for 892 (83.9%) cases. The efficacy of the acupuncture anaesthesia was judged on the extent of pain, mediastinal flutter present together with the amount of adjuvant durgs used and ranked into 4 grades: excellent, no adjuvant durgs used, no or only slight pain, 140 cases (13.1%); good, 739 cases (69.3%); fair, 146 cases (13.7%); and failure, general anaesthesia being used in place, 42 cases (3.9%).
The results indicate that acupuncture anaesthesia is a anaesthesia methods of the traditional Chinese medicine combinated with western medicine. However, there are still some drawbacks such as incomplete analgesic effect, presence of mediastinal flutter and requirement of adjuvant drugs in certain cases. The efficacy of anaesthesia was closely related to the difference of prescriptions of needling points and the individual tolerance of pain. It is also influenced by the factors of the complexity of the disease and duration of operation. For the serious cases, we consider, in combination with intratracheal tubing it is an aceptable method of anaesthesia. For those general anaesthesia not indicated far advanced tuberculous patient with poor pulmonary function and even in semiconscious state, acupuncture anaesthesia may show its merits.
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