Lou Ailin, Lin Hongxi, Zheng Chaoqiang, Hua Zhongwei, Wang Yujin, Deng Xixian, Sun Dong (Department of Acupuncture Anesthesia, Basical Medical Institute, Chinese Academy of Medical Sciences, Beijing, China)
Xing Chunpu (Department of Medicine, Hospital of Traditional Chinese Medicine, Sian, China)
The purpose of the study is to investigate the regulation of circulatory system and its significiance under acupuncture anesthesia and to offer some scientific data for analyzing the changes of the pulse picture under acupuncture anesthesia.
The changes of the pulse picture were investigated before acupuncture, 15 min. after induction and during main operative procedures under acupuncture anesthesia in 273 patients [155 cases were classified as grade I (excellent), 77 cases grade II (good), 37 cases grade III (poor), 4 cases grades IV (bad)]. Of 100 patients undergoing subtotal gastrectomy among the above cases, a doctor of traditional Chinese medicine felt the pulse, and the blood pressure, heart rate, stroke volume, cardiac output and the total peripheral resistance were measured in the mean-time, which were used as indexes for observing the state of cardiovascular function. In addition, the changes of microcirculation in lingual papillae were observed in another 124 patients. The control values are those taken at about 5 minutes prior to needle insertion and expressed as 100 per cent.
The impedance plethysmography was used as a method for measuring the stroke volume and cardiac output. Comparison was made between the 28 patients who were examined with cardiac catheterization and Fick's method. The relevant coefficiency was significant (R=0.841). The pulse rate and the total peripheral resistance were separately calculated from the intervals of the impedance plethysmogram and the slope of its fall. The blood pressure was periodically measured by the autosphygmo-manometer. The changes of microcirculation in the lingua papillae were taken by the photographic recording under the microscope.
The results of the investigation indicated that in the case with the excellent anesthesia effect, 15 min. after induction of acupuncture anesthesia, the total peripheral resistance decreased 2.4% of the control value, but both the stroke volume and the heart rate increased 1.2% and 4% respectively, thus resulting in an increase of the cardiac output up to 5.7% above the control value (P<0.05). The state of the cardiovascular function as mentioned above is of benefit in guarding against the effect of the operative trauma. During the operation, the pulse picture remained essentially stable, the blood pressure was steady at 140/90 mm Hg, and the cardiac output a little higher than the control value. With the excellent anesthesia effect, the capillary loops in the lingual papillae were always as clear as before acupuncture. On the contrary, 15 min. After induction, the total peripheral resistance increased 9% over the control value, but the stroke volume reduced 2.2%. Even if the heart rate rose to 13% above the control value, the cardiac output did not significantly increase. In these cases, under the effect of the operative trauma, the pulse picture always showed some changes. The cardiac output was significantly decreased at the late period of the operation (P<0.05) and the capillary loops in the lingual papillae were frequently disappeared. The effect of acupuncture anesthesia in these persons was usually poor.
As it is seen from the results mentioned above, acupuncture can regulate the cardiovascular function to the state of the dynamic coordination so that the circulation will be improved in the cases with the excellent anesthetic effect. Its physiological significance may be as follows: On the one hand, it is conducive to remove the harmful chemical substances produced by the operative trauma, and on the other hand, to supply nutrients to neuro-humoral system to elevate its regulatory function.
In the operations under acupuncture anesthesia, the simultaneous observations on the changes of the pulse picture and the state of the cardiovascular function have proved that different pulse pictures represent the different states of the cardiovascular function. The bow-string pulse is related to an increase of the peripheral vasotonia, and the thready pulse or the feeble pulse is due to a decrease of the stroke volume.
Xing Chunpu (Department of Medicine, Hospital of Traditional Chinese Medicine, Sian, China)
The purpose of the study is to investigate the regulation of circulatory system and its significiance under acupuncture anesthesia and to offer some scientific data for analyzing the changes of the pulse picture under acupuncture anesthesia.
The changes of the pulse picture were investigated before acupuncture, 15 min. after induction and during main operative procedures under acupuncture anesthesia in 273 patients [155 cases were classified as grade I (excellent), 77 cases grade II (good), 37 cases grade III (poor), 4 cases grades IV (bad)]. Of 100 patients undergoing subtotal gastrectomy among the above cases, a doctor of traditional Chinese medicine felt the pulse, and the blood pressure, heart rate, stroke volume, cardiac output and the total peripheral resistance were measured in the mean-time, which were used as indexes for observing the state of cardiovascular function. In addition, the changes of microcirculation in lingual papillae were observed in another 124 patients. The control values are those taken at about 5 minutes prior to needle insertion and expressed as 100 per cent.
The impedance plethysmography was used as a method for measuring the stroke volume and cardiac output. Comparison was made between the 28 patients who were examined with cardiac catheterization and Fick's method. The relevant coefficiency was significant (R=0.841). The pulse rate and the total peripheral resistance were separately calculated from the intervals of the impedance plethysmogram and the slope of its fall. The blood pressure was periodically measured by the autosphygmo-manometer. The changes of microcirculation in the lingua papillae were taken by the photographic recording under the microscope.
The results of the investigation indicated that in the case with the excellent anesthesia effect, 15 min. after induction of acupuncture anesthesia, the total peripheral resistance decreased 2.4% of the control value, but both the stroke volume and the heart rate increased 1.2% and 4% respectively, thus resulting in an increase of the cardiac output up to 5.7% above the control value (P<0.05). The state of the cardiovascular function as mentioned above is of benefit in guarding against the effect of the operative trauma. During the operation, the pulse picture remained essentially stable, the blood pressure was steady at 140/90 mm Hg, and the cardiac output a little higher than the control value. With the excellent anesthesia effect, the capillary loops in the lingual papillae were always as clear as before acupuncture. On the contrary, 15 min. After induction, the total peripheral resistance increased 9% over the control value, but the stroke volume reduced 2.2%. Even if the heart rate rose to 13% above the control value, the cardiac output did not significantly increase. In these cases, under the effect of the operative trauma, the pulse picture always showed some changes. The cardiac output was significantly decreased at the late period of the operation (P<0.05) and the capillary loops in the lingual papillae were frequently disappeared. The effect of acupuncture anesthesia in these persons was usually poor.
As it is seen from the results mentioned above, acupuncture can regulate the cardiovascular function to the state of the dynamic coordination so that the circulation will be improved in the cases with the excellent anesthetic effect. Its physiological significance may be as follows: On the one hand, it is conducive to remove the harmful chemical substances produced by the operative trauma, and on the other hand, to supply nutrients to neuro-humoral system to elevate its regulatory function.
In the operations under acupuncture anesthesia, the simultaneous observations on the changes of the pulse picture and the state of the cardiovascular function have proved that different pulse pictures represent the different states of the cardiovascular function. The bow-string pulse is related to an increase of the peripheral vasotonia, and the thready pulse or the feeble pulse is due to a decrease of the stroke volume.
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