Zhuang Xinliang, Wu Weilin, Wang Zhendi, Wang Lianzhen, Zhou Juncheng (Shanghai First People's Hospital)
The commonest method of anaesthesia in epigastric surgery in China is the continuous epidural anaesthesia, which has a rather strong effect on the hemodynamics of the patient and the occurrence of hypotension is high; whereas acupuncture gives a quite different cilnical picture. To make a further comparison of the effect of acupuncture anaesthesia and of epidural anaesthesia on hemodynamics in patients undergoing upper abdominal operations, in 30 patients on whom subtotal gastrectomy was performed, the changes in ballistocardiogram, phonocardiogram, plethysmogram and other data were recorded before and after induction of acupuncture anaesthesia and epidural anaesthesia and the results analyzed. Acupuncture stimulus was applied at the Zhiyang point through an epidural catheter. Epidural anaesthesia was sustained, giving an anaesthetized area extending proximally to T 4-5 and distally to T 10-11.
Resultes: After the induction of acupuncture anaesthesia, an increase was seen in dz/dt amplitude, heart stroke volume, cardiac indices, and the frequency of plethysmographic wave, while the amplitude of plethysmographic wave at the ventricular ejection time and the loudness of heart sound did not show any marked change. Following epidural anaesthesia, dz/dt amplitude was lowered, heart stroke volume and cardiac indices decreased, ventricular ejection time shortened, the amplitude of plethysmographic wave increased, and the heart sound accentuated, but the change in frequency of the plethysmographic wave was inconspicuous.
Conclusion: Epidural anaesthesia has a striking effect on the hemodynamics of the patient, and factors including the reduction of heart stroke volume and the dilatation of peripheral blood vessels resulted in the fall of the patient's blood pressure. However, acupuncture anaesthesia has rather a stimulating effect than an inhibitory effect on circulatory functions; in spite of the mild dilatation of peripheral blood vessels, the heart stroke volume is markedly increased, leading to a slight increase in blood pressure, and hence, acupuncture anaesthesia proves to the advantage of patients with relatively poor circulatory functions.
The commonest method of anaesthesia in epigastric surgery in China is the continuous epidural anaesthesia, which has a rather strong effect on the hemodynamics of the patient and the occurrence of hypotension is high; whereas acupuncture gives a quite different cilnical picture. To make a further comparison of the effect of acupuncture anaesthesia and of epidural anaesthesia on hemodynamics in patients undergoing upper abdominal operations, in 30 patients on whom subtotal gastrectomy was performed, the changes in ballistocardiogram, phonocardiogram, plethysmogram and other data were recorded before and after induction of acupuncture anaesthesia and epidural anaesthesia and the results analyzed. Acupuncture stimulus was applied at the Zhiyang point through an epidural catheter. Epidural anaesthesia was sustained, giving an anaesthetized area extending proximally to T 4-5 and distally to T 10-11.
Resultes: After the induction of acupuncture anaesthesia, an increase was seen in dz/dt amplitude, heart stroke volume, cardiac indices, and the frequency of plethysmographic wave, while the amplitude of plethysmographic wave at the ventricular ejection time and the loudness of heart sound did not show any marked change. Following epidural anaesthesia, dz/dt amplitude was lowered, heart stroke volume and cardiac indices decreased, ventricular ejection time shortened, the amplitude of plethysmographic wave increased, and the heart sound accentuated, but the change in frequency of the plethysmographic wave was inconspicuous.
Conclusion: Epidural anaesthesia has a striking effect on the hemodynamics of the patient, and factors including the reduction of heart stroke volume and the dilatation of peripheral blood vessels resulted in the fall of the patient's blood pressure. However, acupuncture anaesthesia has rather a stimulating effect than an inhibitory effect on circulatory functions; in spite of the mild dilatation of peripheral blood vessels, the heart stroke volume is markedly increased, leading to a slight increase in blood pressure, and hence, acupuncture anaesthesia proves to the advantage of patients with relatively poor circulatory functions.
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