Comprehensive Preoperative Forecast Of Effectiveness And Screening Variations In Acupuncture Anesthesia

National Cooperative Group of Preoperative Forecast of Effectiveness of Acupuncture Anesthesia

(Prepared by Wang Youliang, Sun Shanggong)

Acupuncture anaesthesia is a new method of anaesthesia, different from the conventional form. Its effectiveness depends on the physiological functions of the  individual and the individual himself. Determining whether a patient can adapt himself to the acupuncture anaesthesia is a fundamental necessity for popularizing and applying it on a wide scale. From October, to December 1978 we did, under acupuncture anaesthesia, subtotal gastrectomy, hysterectomy, caesarean section, craniotomy, strabotomy, lobectomy, appendectomy, operation on extremeties. The above eight kind of operation were done on 562 patients. We chose and used 19 norms including those of skin sensation, effect of needling, functional state of the vegetative nervous system and phychological factor. From the view point of realistic necessity, all the operated cases were put into two groups. Operations done with satisfactory effect of acupuncture anaesthesia were included in Group 1, while those on which the anaesthesia effect was not satisfactory were put into Group 2. Every operation was well analysed and the data processed with the Multivariable Statistics Analysing Method. e.i. to take the 19 norms as a whole in statistical processing. The 19 norms were screened by considering them simultaneously, e. i., in examining each norm it is not done singly but examined in relation to all other norms. The 19 norms were screened. Then we used the Fisher's Discriminant Function method, and the norms which were selected were made into a formula of comprehensive forecast. Thereafter every case was forecast. These results are in Table No. 1. This table shows the effectiveness of acupuncture anaesthesia in different kinds of operations. The tallying rate of forecast of all these operations was not the same. In table 1, the highest tallying rate was in appendectomy, which went up to 100 per cent.


From the analysis of all these data, we can come to the following conclusions:

1. The effectiveness of acupuncture anaesthesia can be forecast before the operation. The tallying rates in table 1 were calculated from mixed cases from a number of hospitals, the tallying rate in subtotal gastrectomy and hysterectomy is very low. If we single out a case from a hospital and make another forecast formula, then the tallying rate forecast will be raised. For example the tallying rate of subtotal gastrectomy is raised from 64 per cent to 78 per cent, and that of complete hysterectomy from 64 per cent to 69 per cent.


2. As the result of screening norms, those common norms were the norms of basic pain tolerence threshold, the pulse rate at rest, tactile sensation threshold of nei guan point, psychological factor, sex, age, the changing rate of the pain tolerance threshold after needling, changing rate of the pulse rate after needling and changing rate of tactile sensation around the area of the incision afterneedling. These were nine in all. From this we can know that psychological factors have a definite influence on the effectiveness of acupuncture anaesthesia.


3. When forecasting the effect of acupuncture anaesthesia in different kinds of operations the chosen norms are different. Even in the same operation, the norms used in the forecast of analgesic effect on skin incision and forecast of the overall effectiveness on the operations, are also not the same. So, to improve the accuracy of the acupuncture anaesthesia forecasting, we must not only research into the common norms but also find the individual norms under different operations.


4. The formula that has been obtained can be stored in a computer for the realization of automation in forecasting in acupuncture anaesthesia operations.