Feng Zhide, Xue Fuchou, Zheng Guancheng, Zhang Junxi, Juan Kuanhong, Zhang Fan, Wang Fuchou (Acupuncture Anesthesia Group for Lobectomy, Sian)
Early in 1975 we obtained a better outcome on intrathoracic procedures using Futu & Jiaji as points of acupuncture anesthesia. Since then, 268 cases of operations have been accomplished, the grade I, II, anesthesia rate was 84.69%.
The types of operations concerned in this study were mainly the operations on the lungs, esophagus as well as operations in the mediastinum. The eldest patient was 63 years old and the youngest 5 years. There were 56 cases of severe pulmonary tuberculosis with extensive adhesions. 62 cases showed marked impairment in both cardiac and respiratory functions preoperatively. The longest operation time lasted 6 hours and 25 minutes.
Futu point: Electroacupuncture on Futu of one side usually caused dryness of the face and the forehead on the same side, but sweating and constriction of the pupil on the opposite side.
The stimulation on Jiaji point will cause the intercostal muscles twitching.
Management of respiration:
At first, all the patients were requested to do abdominal respiration deeply and slowly i.e. to do "Breathing Excercise". It was found that such a maneuver could not overcome effectively the respiratory disturbances due to pneumothorax which inevitable occurred when the chest was opened. Blood gas analysis was done in 29 cases, anoxemia as well as accumulation of carbon dioxide were present in nearly all of them. Endotracheal intubation was then routinely instituted since 1977.
Dissection of the points on cadavers showed that for the Jiaji point, the tip of the needle is within 5 mm from the intercostal nerve and 1 cm from the sympathetic trunk. Experimental electric acupuncture on Jiaji point on human body indicated that it might elevate not only the pain threshold of the skin of the chest on the same segment (P<0.005), but also the pain threshold of the skin over the lower legs (P<0.005). Electric stimulation of the fibular nerve of the rabbit might block the conduction of the C waves on the nerve trunk. The result of these experiments implied that the analgesic effect of electric acupuncture on the Jiaji point might be due not only to a central mechanism, but the peripheral blocking of the intercostal nerve might also play some roles as the experiment of the fibular nerve of the rabbit shows.
In a group of patients we found that both the heart rate & cardiac output, dropped rapidly during the acupuncture, indicating that the electric acupuncture partially blocked the sympathetic fibers that control the heart.
The afferent visceral pain impulses are mediated by the sympathetic nerves. Electric stimulation on Futu and Jiaji points can affect both the cervical and thoracic sympathetic nerves. It is thus believed that the peripheral blocking effect on them will produce a satisfactory analgesia in the thoracic cavity and that Futu and Jiaji act on synergically.
Early in 1975 we obtained a better outcome on intrathoracic procedures using Futu & Jiaji as points of acupuncture anesthesia. Since then, 268 cases of operations have been accomplished, the grade I, II, anesthesia rate was 84.69%.
The types of operations concerned in this study were mainly the operations on the lungs, esophagus as well as operations in the mediastinum. The eldest patient was 63 years old and the youngest 5 years. There were 56 cases of severe pulmonary tuberculosis with extensive adhesions. 62 cases showed marked impairment in both cardiac and respiratory functions preoperatively. The longest operation time lasted 6 hours and 25 minutes.
Futu point: Electroacupuncture on Futu of one side usually caused dryness of the face and the forehead on the same side, but sweating and constriction of the pupil on the opposite side.
The stimulation on Jiaji point will cause the intercostal muscles twitching.
Management of respiration:
At first, all the patients were requested to do abdominal respiration deeply and slowly i.e. to do "Breathing Excercise". It was found that such a maneuver could not overcome effectively the respiratory disturbances due to pneumothorax which inevitable occurred when the chest was opened. Blood gas analysis was done in 29 cases, anoxemia as well as accumulation of carbon dioxide were present in nearly all of them. Endotracheal intubation was then routinely instituted since 1977.
Dissection of the points on cadavers showed that for the Jiaji point, the tip of the needle is within 5 mm from the intercostal nerve and 1 cm from the sympathetic trunk. Experimental electric acupuncture on Jiaji point on human body indicated that it might elevate not only the pain threshold of the skin of the chest on the same segment (P<0.005), but also the pain threshold of the skin over the lower legs (P<0.005). Electric stimulation of the fibular nerve of the rabbit might block the conduction of the C waves on the nerve trunk. The result of these experiments implied that the analgesic effect of electric acupuncture on the Jiaji point might be due not only to a central mechanism, but the peripheral blocking of the intercostal nerve might also play some roles as the experiment of the fibular nerve of the rabbit shows.
In a group of patients we found that both the heart rate & cardiac output, dropped rapidly during the acupuncture, indicating that the electric acupuncture partially blocked the sympathetic fibers that control the heart.
The afferent visceral pain impulses are mediated by the sympathetic nerves. Electric stimulation on Futu and Jiaji points can affect both the cervical and thoracic sympathetic nerves. It is thus believed that the peripheral blocking effect on them will produce a satisfactory analgesia in the thoracic cavity and that Futu and Jiaji act on synergically.
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