Zhang Shuquan, Jing Taiming, Tao Huasen, Gao Yunpu, Zhao Qingye (Department of Thoracic Surgery, Qianshan T.B. Hospital, Anshan)
In this paper we reported some improvements in the surgical technique of lung resections in order to improve the effect of acupuncture anesthesia.
A. Method
1. Seven combinations of acupuncture points were adopted and their effects were observed during lung resections.
2. Patients of various thoracic surgical were divided at random into the above mentioned seven groups checking the efficacy of acupuncture anesthesia.
3. Because of the three unsolved problems (incomplete analgesia, muscle spasm and reactions to traction of internal organs) of acupuncture anesthesia, we tried to improve the surgical technique in order to avoid certain maneuvers with strong stimulation. The improvements were:
(1) Mark the incision line according to sternal angle and spinal process before skin incision so that the strong stimulation produced by palpating the ribs before opening the thoracic cage could be avoided.
(2) To improve the surgical procedures: In contrary to the individual ligation technique in the treatment of the hilus of the lung the bronchus was transected first and then the blood vessels were ligated in bundles or as a whole, so that the duration of operation was shortened from 4 to 1.5 hrs. on an average.
(3) To improve the method of drainage: a large bore T-shaped biliary tract drainage tube was inserted into the chest cavity through the chest wall with a self-made tube introducer.
(4) To change the method of closing the chest at the end of operation by with-drawing the pillow beneath the patient, thus approximating the edges of the incision naturally without the use of mechanical means.
4. The criteria for the evaluation of the effect of acupuncture anesthesia follow the standard issued by the National Acupuncture Anesthesia Conference (1975).
B. Results
1. The results obtained showed that the rate of excellent or good result were more than 80% in all the seven groups of acupoints for lung resections. Statistical treatment showed that the T values of the different groups were between 0.51-0.3. The differences were not stastistically significant P>0.05, but from clinical observation it seemed that the first group gave the best result. Its rate of excellent or good result accounted for 98.4%. The points used in this group were Sanyangluo, Lower Yifeng, Ren Channel and Du Channel.
2. Through the above mentioned improvements of the surgical technique, the painful stimulation during the operation was markedly reduced, the duration of operations greatly shortened and the surgical procedures became much more suitable for the chest operations performed under acupuncture anesthesia. Since the application of this new technique, the rate of excellent or good result raised to 88.7%, which is somewhat higher than the rate reported by the National Acupuncture Anesthesia Conference (73.6%).
In this paper we reported some improvements in the surgical technique of lung resections in order to improve the effect of acupuncture anesthesia.
A. Method
1. Seven combinations of acupuncture points were adopted and their effects were observed during lung resections.
2. Patients of various thoracic surgical were divided at random into the above mentioned seven groups checking the efficacy of acupuncture anesthesia.
3. Because of the three unsolved problems (incomplete analgesia, muscle spasm and reactions to traction of internal organs) of acupuncture anesthesia, we tried to improve the surgical technique in order to avoid certain maneuvers with strong stimulation. The improvements were:
(1) Mark the incision line according to sternal angle and spinal process before skin incision so that the strong stimulation produced by palpating the ribs before opening the thoracic cage could be avoided.
(2) To improve the surgical procedures: In contrary to the individual ligation technique in the treatment of the hilus of the lung the bronchus was transected first and then the blood vessels were ligated in bundles or as a whole, so that the duration of operation was shortened from 4 to 1.5 hrs. on an average.
(3) To improve the method of drainage: a large bore T-shaped biliary tract drainage tube was inserted into the chest cavity through the chest wall with a self-made tube introducer.
(4) To change the method of closing the chest at the end of operation by with-drawing the pillow beneath the patient, thus approximating the edges of the incision naturally without the use of mechanical means.
4. The criteria for the evaluation of the effect of acupuncture anesthesia follow the standard issued by the National Acupuncture Anesthesia Conference (1975).
B. Results
1. The results obtained showed that the rate of excellent or good result were more than 80% in all the seven groups of acupoints for lung resections. Statistical treatment showed that the T values of the different groups were between 0.51-0.3. The differences were not stastistically significant P>0.05, but from clinical observation it seemed that the first group gave the best result. Its rate of excellent or good result accounted for 98.4%. The points used in this group were Sanyangluo, Lower Yifeng, Ren Channel and Du Channel.
2. Through the above mentioned improvements of the surgical technique, the painful stimulation during the operation was markedly reduced, the duration of operations greatly shortened and the surgical procedures became much more suitable for the chest operations performed under acupuncture anesthesia. Since the application of this new technique, the rate of excellent or good result raised to 88.7%, which is somewhat higher than the rate reported by the National Acupuncture Anesthesia Conference (73.6%).
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