National Cooperative Group of Acupuncture Anesthesia for Abdominal Tuboligation*
*Compiled by Wang Shuyi, et al.
A program of investigation on acupuncture anesthesia for abdominal tuboligation was carried out from May of 1975 to the end of 1977 by research workers and clinicians of 18 provinces, cities and autonomous regions. Operations were performed on 23,554 patients with a rate of success of 97.9%, and a rate of excellent-good result of 85.8%.
For the purpose of studying the factors relevant to acupuncture anesthesia for abdominal tuboligation, clinical observations were made in regard to choice of points, requisite of stimulation, duration of induction, supplementary medication, determination of pain threshold and changes of physiologic status during anesthesia.
For the choice of points, five groups of points were put into trial: (1) Sanyinjiao (bilateral), Ciliao (bilateral); (2) Renzhong, Chengjiang; (3) Ear points: Lung, Shenmen, Uterus, Endocrine; (4) Renzhong, Chengjiang, Ciliao (bilateral); and (5) Ear points: Lung, Shenmen, Uterus, Endocrine, Paraincisional. The rate of excellent-good result for each group was 85.5%, 85.2%, 85.2%, 91.4% and 87.0% respectively. The fourth group showed better result than the other groups (0.05>P>0.01).
In respect to the requisite of stimulation, the influences of the pulse wave, the electrosonic wave and the various other frequencies were observed. No significant difference was noted.
Regarding the duration of induction, 4,763 cases were investigated in four groups. The first group consisted of 584 cases. The duration of induction was 5-9 minutes. The rate of excellent-good result was 94.5%. The second group consisted of 607 cases. The duration of induction was 10-14 minutes, with a rate of excellent-good result of 90.3%. The third group consisted of 1,459 cases. The duration of induction was 15-19 minutes, with a rate of excellent-good result of 84.9%. The fourth group consisted of 2,113 cases. The duration of induction exceeded 20 minutes. The rate of excellent-good result was 87.1%. Marked difference was noted in the rate of excellent-good result between these groups (0.05>P>0.01). It was concluded that 5-10 was the most optimal induction duration.
In this series, in 23,554 cases, neither procaine nor other analgesics was given. Dolantin was used in 3,915 cases. This was compared for three times with the control group of 3,073 cases. It was noted that acupuncture anesthesia without Dolantin could be as effective as with it. However, in patients with lower pain threshold, Dolantin could enhance the effect of acupuncture.
Determination of pain threshold was considered to be an important method in predicting the effectiveness of acupuncture anesthesia. By using methods such as tolerance to manual needling, pain threshold by potassium iontophoresis and by spring pressure method, it was found that among patients with higher pain threshold, more were expected to achieve better results. By using such methods as determination of surface temperature and finger plethysmograph, it was found that patients showing elevation of surface temperature and increase of plethysmographic wave would achieve better result.
It may be concluded that acupuncture anesthesia can be used to perform abdominal tuboligation without the help of supplementary medication. Acupuncture anesthesia has the merits of being safe, simple, effective and with rapid recovery. It is considered to be a preferable method of anesthesia for abdominal tuboligation.
*Compiled by Wang Shuyi, et al.
A program of investigation on acupuncture anesthesia for abdominal tuboligation was carried out from May of 1975 to the end of 1977 by research workers and clinicians of 18 provinces, cities and autonomous regions. Operations were performed on 23,554 patients with a rate of success of 97.9%, and a rate of excellent-good result of 85.8%.
For the purpose of studying the factors relevant to acupuncture anesthesia for abdominal tuboligation, clinical observations were made in regard to choice of points, requisite of stimulation, duration of induction, supplementary medication, determination of pain threshold and changes of physiologic status during anesthesia.
For the choice of points, five groups of points were put into trial: (1) Sanyinjiao (bilateral), Ciliao (bilateral); (2) Renzhong, Chengjiang; (3) Ear points: Lung, Shenmen, Uterus, Endocrine; (4) Renzhong, Chengjiang, Ciliao (bilateral); and (5) Ear points: Lung, Shenmen, Uterus, Endocrine, Paraincisional. The rate of excellent-good result for each group was 85.5%, 85.2%, 85.2%, 91.4% and 87.0% respectively. The fourth group showed better result than the other groups (0.05>P>0.01).
In respect to the requisite of stimulation, the influences of the pulse wave, the electrosonic wave and the various other frequencies were observed. No significant difference was noted.
Regarding the duration of induction, 4,763 cases were investigated in four groups. The first group consisted of 584 cases. The duration of induction was 5-9 minutes. The rate of excellent-good result was 94.5%. The second group consisted of 607 cases. The duration of induction was 10-14 minutes, with a rate of excellent-good result of 90.3%. The third group consisted of 1,459 cases. The duration of induction was 15-19 minutes, with a rate of excellent-good result of 84.9%. The fourth group consisted of 2,113 cases. The duration of induction exceeded 20 minutes. The rate of excellent-good result was 87.1%. Marked difference was noted in the rate of excellent-good result between these groups (0.05>P>0.01). It was concluded that 5-10 was the most optimal induction duration.
In this series, in 23,554 cases, neither procaine nor other analgesics was given. Dolantin was used in 3,915 cases. This was compared for three times with the control group of 3,073 cases. It was noted that acupuncture anesthesia without Dolantin could be as effective as with it. However, in patients with lower pain threshold, Dolantin could enhance the effect of acupuncture.
Determination of pain threshold was considered to be an important method in predicting the effectiveness of acupuncture anesthesia. By using methods such as tolerance to manual needling, pain threshold by potassium iontophoresis and by spring pressure method, it was found that among patients with higher pain threshold, more were expected to achieve better results. By using such methods as determination of surface temperature and finger plethysmograph, it was found that patients showing elevation of surface temperature and increase of plethysmographic wave would achieve better result.
It may be concluded that acupuncture anesthesia can be used to perform abdominal tuboligation without the help of supplementary medication. Acupuncture anesthesia has the merits of being safe, simple, effective and with rapid recovery. It is considered to be a preferable method of anesthesia for abdominal tuboligation.
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