Acupuncture Anesthesia Group for Hysterectomy, 4th Municipal Hospital, Xian
Since 1958, abdominal total hysterectomy under acupuncture anesthesia has been performed in our hospital. We have observed the clinical results of 657 cases of hysterectomy under acupuncture anesthesia with the points of the nose, body and head, in which 100 cases by head needling were analysed for the relationship between the results of the clinic, physiology, biochemistry, and differentiation of traditional Chinese medicine and the effects of acupuncture anesthesia.
I. Prescriptions of needling points.
Nose needling points: Fei penetrated towards Xin, Qianyin, Luanchao.
Body needling points: Renzhong, Chengjiang.
Head needling points:
(1) Zhongjiao penetrated towards Xiajiao on both sides.
(2) Xiajiao penetrated towards Zhongjiao on both sides.
(3) Xiayao.
(4) Sanyinjiao.
II. Analysis of the effects in different group:
The preestimation of needling endurance was made before operation, showing that the individual difference existed in the patients observed.
For the 38 cases with nose needling, the rate of grade I and II was 39.87%, for the 158 cases with body needling, the rate was 50.32%. It was of no significance from the statistical viewpoint. However, for the 100 cases with head needling performed at the same conditions, the rate of grade I and II reached 86.00%, which might be related to appropriate selection of the patients, relative stability in the operating staff and the improvement in the manipulation of acupuncture.
III. The clinical results of the 100 cases under acupuncture anesthesia by head needling were not related to the kind of disease, size of the tumor, time of the delivery and difficulty in the operation. During the operation 22% had meteorism, but it had nothing to do with postoperative abdominal distension. 46% of them did not take any analgesic postoperatively.
IV. The heart rate of the patient in grade I was rather stable before, during and after operation. The change of heart rate showed manifest difference between grade I and grade III patients (statistically, P<0.05).
The average elevation of B.P. was 3.8 mmHg in cases of grade I, while of grade III mean B.P. elevation reached 9.8 mmHg.
Observation on radial pulse wave showed that the anesthesia results were better in those whose pulse amplitude became lower after acupuncture induction (P<0.01).
The percentage of E-rosette formation rate revealed a postinductional elevation. The percentage of T-lymphocytes transformation increased after acupuncture induction in cases of grades I and II.
Percentage of E-rosette formation increased markedly after induction on deficient type (P<0.025).
Cases of grades I and II in acupuncture anesthesia were mostly of the deficient type, while those of grade III were of the sufficient type or of the deficient and sufficient mixed type.
Pulse condition of grade I manifested little change and recovered more easily after operation; while stasis and rapid pulse were seen mostly in cases of grade III, and their recovery was rather slow. The above facts showed that excellent anesthetic results had usually happened in those whose circulatory functions were relatively stable, and their immune activity being elevated. All these suggested that acupuncture anesthesia had a regulating function on the organism.
Acupuncture of certain points on the head gives rise to analgesic function. These points can be located more precisely and they are easier for manipulation and more convenient for observation. They do not interfere with the operation fields.
The improvement of operative method:
1. The operator and his first assistant should operate from their side alternatively for the convenience of manipulation.
2. The procedures which give rise to acute pain, should be done rather quickly. For example, the incision of the skin, subcutaneous fat and anterior sheath of rectus muscle should be done in such a manner. Some procedures that may cause dull pain should be performed slowly and gently. These include manipulating the uterus, clamping the vessels and ligaments. The proximal ends of the vessels should be clamped first and the distal ends subsequently.
3. The ligaments and vessels on one side are dealt with first before proceeding work on the other side, so that the uterus is turned only once, thus not only lessening the irritation but also shortening the operation time.
Since 1958, abdominal total hysterectomy under acupuncture anesthesia has been performed in our hospital. We have observed the clinical results of 657 cases of hysterectomy under acupuncture anesthesia with the points of the nose, body and head, in which 100 cases by head needling were analysed for the relationship between the results of the clinic, physiology, biochemistry, and differentiation of traditional Chinese medicine and the effects of acupuncture anesthesia.
I. Prescriptions of needling points.
Nose needling points: Fei penetrated towards Xin, Qianyin, Luanchao.
Body needling points: Renzhong, Chengjiang.
Head needling points:
(1) Zhongjiao penetrated towards Xiajiao on both sides.
(2) Xiajiao penetrated towards Zhongjiao on both sides.
(3) Xiayao.
(4) Sanyinjiao.
II. Analysis of the effects in different group:
The preestimation of needling endurance was made before operation, showing that the individual difference existed in the patients observed.
For the 38 cases with nose needling, the rate of grade I and II was 39.87%, for the 158 cases with body needling, the rate was 50.32%. It was of no significance from the statistical viewpoint. However, for the 100 cases with head needling performed at the same conditions, the rate of grade I and II reached 86.00%, which might be related to appropriate selection of the patients, relative stability in the operating staff and the improvement in the manipulation of acupuncture.
III. The clinical results of the 100 cases under acupuncture anesthesia by head needling were not related to the kind of disease, size of the tumor, time of the delivery and difficulty in the operation. During the operation 22% had meteorism, but it had nothing to do with postoperative abdominal distension. 46% of them did not take any analgesic postoperatively.
IV. The heart rate of the patient in grade I was rather stable before, during and after operation. The change of heart rate showed manifest difference between grade I and grade III patients (statistically, P<0.05).
The average elevation of B.P. was 3.8 mmHg in cases of grade I, while of grade III mean B.P. elevation reached 9.8 mmHg.
Observation on radial pulse wave showed that the anesthesia results were better in those whose pulse amplitude became lower after acupuncture induction (P<0.01).
The percentage of E-rosette formation rate revealed a postinductional elevation. The percentage of T-lymphocytes transformation increased after acupuncture induction in cases of grades I and II.
Percentage of E-rosette formation increased markedly after induction on deficient type (P<0.025).
Cases of grades I and II in acupuncture anesthesia were mostly of the deficient type, while those of grade III were of the sufficient type or of the deficient and sufficient mixed type.
Pulse condition of grade I manifested little change and recovered more easily after operation; while stasis and rapid pulse were seen mostly in cases of grade III, and their recovery was rather slow. The above facts showed that excellent anesthetic results had usually happened in those whose circulatory functions were relatively stable, and their immune activity being elevated. All these suggested that acupuncture anesthesia had a regulating function on the organism.
Acupuncture of certain points on the head gives rise to analgesic function. These points can be located more precisely and they are easier for manipulation and more convenient for observation. They do not interfere with the operation fields.
The improvement of operative method:
1. The operator and his first assistant should operate from their side alternatively for the convenience of manipulation.
2. The procedures which give rise to acute pain, should be done rather quickly. For example, the incision of the skin, subcutaneous fat and anterior sheath of rectus muscle should be done in such a manner. Some procedures that may cause dull pain should be performed slowly and gently. These include manipulating the uterus, clamping the vessels and ligaments. The proximal ends of the vessels should be clamped first and the distal ends subsequently.
3. The ligaments and vessels on one side are dealt with first before proceeding work on the other side, so that the uterus is turned only once, thus not only lessening the irritation but also shortening the operation time.
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