Li Chunjiu, Gao Rixin, Pan Ruiqin (Beijing Hospital)
From March 1977 to January 1978, 57 patients with breast carcinoma were operated upon under acupuncture anesthesia, 56 of them were female and 1 was male. The age of the youngest was 29 years and the oldest 67. The effect of anesthesia was divided into 4 groups: excellent, good, poor and bad respectively. The result of acupuncture anesthesia in 57 operations is listed in the following table.
The points used for acupuncture were Xiayifeng, Binao, Hegu and Neiguan. Electric acupuncture apparatus type 57-6 was used as stimulator. The minimal period of induction was 30 minutes and the needles were retained throughout the operation.
Premedication consisted of sodium luminal and dolantin. At the time of operation 0.125% procaine, 4cc/kg of body weight, was used for local infiltration and a limited amount of ketamine, dolantin, fentanyl was added if necessary.
Preliminary experiences were: 1). The extent of subcutaneous dissection marked out on the skin and a good subcutaneous infiltration with very dilute procaine was an important factor in achieving good results. 2) A fine operative technique was essential. The dissection should be clean, accurate and gentle with good hemostasis. In general, the shorter the time of operation, the better the result. In those 30 cases of grade I and II, the time of operative procedure was less than 2 hours.
Radical mastectomy for breast cancer is done very frequently in daily surgical practice. Previously the preferred anaesthetic method for these operations was mainly general or high epidural anaesthesia. For those patients with poor cardiac or lung functions, these types of anaesthesia are not without risk and postoperative pulmanary complications such as pneumonia are more apt to occur. Furthermore, general anesthesia needs more facilities and high epidural anesthesia may give rise to serious respiratory suppression if the anaesthetic level is not properly managed. Local anaesthesia alone is usually insufficient to control pain and the amount of the anaesthetic used could be big enough to give rise to toxic side effect.
Acupuncture anaesthesia has the following advantages: (1) Those patients do not fit for general anaesthesia because of poor liver or kidney function or having chronic bronchitis tolerate acupuncture anaesthesia very well. (2) As soon as the operative procedure is finished, patient can sit up right away. This made the application of pressure bandage much simplified. (3) Postoperative pain is milder and the need for analgesics is less. (4) Infusion is usually unnecessary postoperatively since the patient can take fluid by mouth freely. (5) Recovery is usually rapid with less postoperative complications. None of the 57 cases developed pulmonary or wound infections. (6) No special nursing care is needed.
In conclusion, acupuncture anesthesia in combination with adjuvant drugs is considered to be one of the preferred anaesthetic methods for operations on patients with breast cancer. However, in some instances the feeling of pain is not abolished completely and the method needs further improvement.
From March 1977 to January 1978, 57 patients with breast carcinoma were operated upon under acupuncture anesthesia, 56 of them were female and 1 was male. The age of the youngest was 29 years and the oldest 67. The effect of anesthesia was divided into 4 groups: excellent, good, poor and bad respectively. The result of acupuncture anesthesia in 57 operations is listed in the following table.
The points used for acupuncture were Xiayifeng, Binao, Hegu and Neiguan. Electric acupuncture apparatus type 57-6 was used as stimulator. The minimal period of induction was 30 minutes and the needles were retained throughout the operation.
Premedication consisted of sodium luminal and dolantin. At the time of operation 0.125% procaine, 4cc/kg of body weight, was used for local infiltration and a limited amount of ketamine, dolantin, fentanyl was added if necessary.
Preliminary experiences were: 1). The extent of subcutaneous dissection marked out on the skin and a good subcutaneous infiltration with very dilute procaine was an important factor in achieving good results. 2) A fine operative technique was essential. The dissection should be clean, accurate and gentle with good hemostasis. In general, the shorter the time of operation, the better the result. In those 30 cases of grade I and II, the time of operative procedure was less than 2 hours.
Radical mastectomy for breast cancer is done very frequently in daily surgical practice. Previously the preferred anaesthetic method for these operations was mainly general or high epidural anaesthesia. For those patients with poor cardiac or lung functions, these types of anaesthesia are not without risk and postoperative pulmanary complications such as pneumonia are more apt to occur. Furthermore, general anesthesia needs more facilities and high epidural anesthesia may give rise to serious respiratory suppression if the anaesthetic level is not properly managed. Local anaesthesia alone is usually insufficient to control pain and the amount of the anaesthetic used could be big enough to give rise to toxic side effect.
Acupuncture anaesthesia has the following advantages: (1) Those patients do not fit for general anaesthesia because of poor liver or kidney function or having chronic bronchitis tolerate acupuncture anaesthesia very well. (2) As soon as the operative procedure is finished, patient can sit up right away. This made the application of pressure bandage much simplified. (3) Postoperative pain is milder and the need for analgesics is less. (4) Infusion is usually unnecessary postoperatively since the patient can take fluid by mouth freely. (5) Recovery is usually rapid with less postoperative complications. None of the 57 cases developed pulmonary or wound infections. (6) No special nursing care is needed.
In conclusion, acupuncture anesthesia in combination with adjuvant drugs is considered to be one of the preferred anaesthetic methods for operations on patients with breast cancer. However, in some instances the feeling of pain is not abolished completely and the method needs further improvement.
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