Jing Bing, He Bailing (General Hospital of PLA)
Acupuncture anaesthesia has been advocated bacause of its simplicity of application, minimal disturbance of physiologic function, possibility of patient-surgeon collaboration during operation and speedy recovery. But so far total abolition of pain has not been achieved with this technique.
With a view to produce effective pain relief, a combined method with acupuncture plus some appropriate drugs has been suggested. The drugs used are (a) 10 mg. of diazepam with 0.3 mg scopolamine i.v. to induce amnesia and (b) well planned increments of morphine or innover, which will abolish pain without affecting consciousness.
Acupuncture anaesthesia can produce partial abolition of pain, reduce vomiting, improve bradycardia during traction of the mesentery, and promote respiratory function under narcotic analgesia. It gives fairly good results in cases of thyroidectomy or thoracotomy, but it is not so satisfactory in abdominal surgery. During laparotomy of abdominal viscera, propanidid or sub-dissociative dose of ketamine with scoline can induce transient loss of consciousness. The dosage of amnesic analgesics should not be too large because this may cause unconsciousness or cortical hyperresponsive activity.
In thoracotomy, appendectomy or herniorrhaphy, the most effective way of controlling pain is nerve block with minimal local anesthetics. This is done by applying paravertebral intercostal block with 1 ml. of 1% dicaine in 25% hypertonic glucose for each of the 3 nerves involved.
With the spinous lamina as guide, the needle is inserted gently near the bony margin, 1 ½-2 cm. from the spinous process, to a depth of 1 cm. below the lamina, thus minimizing the risk of piercing the pleura.
Acupuncture anaesthesia has been advocated bacause of its simplicity of application, minimal disturbance of physiologic function, possibility of patient-surgeon collaboration during operation and speedy recovery. But so far total abolition of pain has not been achieved with this technique.
With a view to produce effective pain relief, a combined method with acupuncture plus some appropriate drugs has been suggested. The drugs used are (a) 10 mg. of diazepam with 0.3 mg scopolamine i.v. to induce amnesia and (b) well planned increments of morphine or innover, which will abolish pain without affecting consciousness.
Acupuncture anaesthesia can produce partial abolition of pain, reduce vomiting, improve bradycardia during traction of the mesentery, and promote respiratory function under narcotic analgesia. It gives fairly good results in cases of thyroidectomy or thoracotomy, but it is not so satisfactory in abdominal surgery. During laparotomy of abdominal viscera, propanidid or sub-dissociative dose of ketamine with scoline can induce transient loss of consciousness. The dosage of amnesic analgesics should not be too large because this may cause unconsciousness or cortical hyperresponsive activity.
In thoracotomy, appendectomy or herniorrhaphy, the most effective way of controlling pain is nerve block with minimal local anesthetics. This is done by applying paravertebral intercostal block with 1 ml. of 1% dicaine in 25% hypertonic glucose for each of the 3 nerves involved.
With the spinous lamina as guide, the needle is inserted gently near the bony margin, 1 ½-2 cm. from the spinous process, to a depth of 1 cm. below the lamina, thus minimizing the risk of piercing the pleura.
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