Zhang Shaohua, Shi Xuejun, Li Shutang, Li Ying, Lin Zhengya Departments of Anesthesiology and Gynecology & Obstetrics, First Hospital, Nanjing
Cesarean section is a commonly-encountered emergency in the department of obstetrics. Whatever anesthesia is used, attention should be paid to its effects on respiration and circulation of the mother and the fetus and uterine contraction. The present paper summarizes the 421 cases of cesarean sections under acupuncture anesthesia performed in 1975-1977, which makes up 79.6% of all the cesarean sections in the same period. The successful rate is 96.4% and the excellent and good rate is 83%. The points selected were Sanyinjiao, Waimadian and the incisional area in 326 cases; Renzhong, Chenjiang and the incisional area in 95 cases.
During the course of operation, stable blood pressure and pulse rate were observed with normal skin colour and uterine contraction, and less amount of bleeding (about 150 ml in 75% cases) and free from respiratory depression. In 30 cases of the patients with cardiopulmonary complications, no depression of cardiopulmonary function happened, and in 33 cases of the patients with anteparturm hemorrhage, no shock manifested. For all the cases, there was no sudden change of the hemodynamics, and the operations were successfully performed. After the operation, very few urinary catheterizations were necessary. Early ambulation facilitated prompt restoration of intestinal function and intake of food, thereby hastening recovery.
Of the 421 newborn babies, with the exception of 10 stillbirths, 143 cases had white or blue asphyxia, in which 85 cases were associated with intrauterine asphyxia, and 58 cases were due to scar of uterine, adhesion of pelvic tissue and excessively low position of the fetal head causing difficulties in delivery of the fetal head. Despite of asphyxia mentioned above, all the 411 babies were born alive and healthy. It is mainly because acupuncture anesthesia produces less physiological interference with the mother's body, keeps respiration and circulation stable, thus ensuring adequate supply of exygen and blood to the fetus. For the safety of the fetus, the use of dolantin as analgesics should be restricted only to the postpartum period and with oxygen inhalation simultaneously. Acupuncture anesthesia is a safe, effective, attended with smooth recovery and high newborn survival-rate in cesarean sections, and now it is applied in our hospital as a method of first choice. It is recommended that intradermal infiltration of small amounts of local anesthetics along the incision line is preferred in those patients in a state of excitment and in critical cases of severe toxemia of pregnancy or threatened rupture of the uterus when there is shortage of time for induction. Local infiltration may lessen stimulation and facilitate quick operation.
Cesarean section is a commonly-encountered emergency in the department of obstetrics. Whatever anesthesia is used, attention should be paid to its effects on respiration and circulation of the mother and the fetus and uterine contraction. The present paper summarizes the 421 cases of cesarean sections under acupuncture anesthesia performed in 1975-1977, which makes up 79.6% of all the cesarean sections in the same period. The successful rate is 96.4% and the excellent and good rate is 83%. The points selected were Sanyinjiao, Waimadian and the incisional area in 326 cases; Renzhong, Chenjiang and the incisional area in 95 cases.
During the course of operation, stable blood pressure and pulse rate were observed with normal skin colour and uterine contraction, and less amount of bleeding (about 150 ml in 75% cases) and free from respiratory depression. In 30 cases of the patients with cardiopulmonary complications, no depression of cardiopulmonary function happened, and in 33 cases of the patients with anteparturm hemorrhage, no shock manifested. For all the cases, there was no sudden change of the hemodynamics, and the operations were successfully performed. After the operation, very few urinary catheterizations were necessary. Early ambulation facilitated prompt restoration of intestinal function and intake of food, thereby hastening recovery.
Of the 421 newborn babies, with the exception of 10 stillbirths, 143 cases had white or blue asphyxia, in which 85 cases were associated with intrauterine asphyxia, and 58 cases were due to scar of uterine, adhesion of pelvic tissue and excessively low position of the fetal head causing difficulties in delivery of the fetal head. Despite of asphyxia mentioned above, all the 411 babies were born alive and healthy. It is mainly because acupuncture anesthesia produces less physiological interference with the mother's body, keeps respiration and circulation stable, thus ensuring adequate supply of exygen and blood to the fetus. For the safety of the fetus, the use of dolantin as analgesics should be restricted only to the postpartum period and with oxygen inhalation simultaneously. Acupuncture anesthesia is a safe, effective, attended with smooth recovery and high newborn survival-rate in cesarean sections, and now it is applied in our hospital as a method of first choice. It is recommended that intradermal infiltration of small amounts of local anesthetics along the incision line is preferred in those patients in a state of excitment and in critical cases of severe toxemia of pregnancy or threatened rupture of the uterus when there is shortage of time for induction. Local infiltration may lessen stimulation and facilitate quick operation.
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