Zhang Jingji, Tian Guixiang, Shi Shouqian, Song Congxin (Department of Physiology and Anesthesia Group of 1st Hospital, Lanzhou Medical College)
We took vasoconstrictive reflex, skin galvanic reflex, skin temperature, pulse volume, blood presure and the activity of blood cholinesterase as the parameters of the activities of the vegetative nervous system. The dihydroergotoxin and haloperidol were used as à-sympathetic blockade to inspect the relationship between the functional state of the vegetative nervous system and the effect of acupuncture anesthesia.
1. Acupuncture anesthesia was more effective in those patients whose natural fluctuation of pulse volume and galvanic skin reflex were more stable when they are at rest before acupuncture than those who were unstable in these indexes (P<0.01). Acupuncture or cold water (4º C) stimulation on the hand results in vasoconstriction, increase of skin galvanic reflex and decrease of the pulse volume. Those patients who had less responses in these indexes would have the better effect on acupuncture anesthesia.
2. After acupuncture anesthesia induction for 15 minutes, the pulse volume of most of the patients increased (about 78%). The skin temperature and the blood cholinesterase activity will also increased (about 71% and 85%). These phenomena indicate that the reactivity of the sympathetic nervous system decreases. The relationship between these changes in reactions and the different degrees of the effects of acupuncture anesthesia was as follows: If the patients' pulse volume increased over 30% and the skin galvanic reflex depressed after acupuncture anesthesia induction, the result would be more effective (P<0.01). After the induction of acupuncture anesthesia, the patients in Grade I anesthesia whose blood cholinesterase activity increased (11%) much more than in Grade II patients (7.9%), and the vasoconstriction reflex under cold stimulation decreased both in Grade I (to 35%) and Grade II (to 12.5%) patients. The Grade III patients whose vasoconstriction reflex increased to 60% were less effective in acupuncture anesthesia. Most of the patients in a series of 80 cases of thyroidectomy under acupuncture anesthesia had no apparent changes in blood pressure under induction. There were only 12 patients whose blood pressure decreased, ten of them with effect in Grade I and two in Grade II. There were 17 patients whose blood pressure increased, three of them in Grade I and others in Grade II and III. Dihydroergotoxin 0.6 mg (35 patients) and haloperidol 5 mg (49 patients) were given to 84 patients intravenously 5-15 minutes before operation in acupuncture anesthesia for blockade of à-sympathetic receptor to reduce the sympathetic activity. Those patients who had received the injections had better result than those who had not (P<0.05 and 0.01).
Conclusion: The stability of the center of vegetative nervous system and the decrease of sympathetic reactivity during acupuncture anesthesia induction are two important factors which can increase the effect of acupuncture anesthesia.
We took vasoconstrictive reflex, skin galvanic reflex, skin temperature, pulse volume, blood presure and the activity of blood cholinesterase as the parameters of the activities of the vegetative nervous system. The dihydroergotoxin and haloperidol were used as à-sympathetic blockade to inspect the relationship between the functional state of the vegetative nervous system and the effect of acupuncture anesthesia.
1. Acupuncture anesthesia was more effective in those patients whose natural fluctuation of pulse volume and galvanic skin reflex were more stable when they are at rest before acupuncture than those who were unstable in these indexes (P<0.01). Acupuncture or cold water (4º C) stimulation on the hand results in vasoconstriction, increase of skin galvanic reflex and decrease of the pulse volume. Those patients who had less responses in these indexes would have the better effect on acupuncture anesthesia.
2. After acupuncture anesthesia induction for 15 minutes, the pulse volume of most of the patients increased (about 78%). The skin temperature and the blood cholinesterase activity will also increased (about 71% and 85%). These phenomena indicate that the reactivity of the sympathetic nervous system decreases. The relationship between these changes in reactions and the different degrees of the effects of acupuncture anesthesia was as follows: If the patients' pulse volume increased over 30% and the skin galvanic reflex depressed after acupuncture anesthesia induction, the result would be more effective (P<0.01). After the induction of acupuncture anesthesia, the patients in Grade I anesthesia whose blood cholinesterase activity increased (11%) much more than in Grade II patients (7.9%), and the vasoconstriction reflex under cold stimulation decreased both in Grade I (to 35%) and Grade II (to 12.5%) patients. The Grade III patients whose vasoconstriction reflex increased to 60% were less effective in acupuncture anesthesia. Most of the patients in a series of 80 cases of thyroidectomy under acupuncture anesthesia had no apparent changes in blood pressure under induction. There were only 12 patients whose blood pressure decreased, ten of them with effect in Grade I and two in Grade II. There were 17 patients whose blood pressure increased, three of them in Grade I and others in Grade II and III. Dihydroergotoxin 0.6 mg (35 patients) and haloperidol 5 mg (49 patients) were given to 84 patients intravenously 5-15 minutes before operation in acupuncture anesthesia for blockade of à-sympathetic receptor to reduce the sympathetic activity. Those patients who had received the injections had better result than those who had not (P<0.05 and 0.01).
Conclusion: The stability of the center of vegetative nervous system and the decrease of sympathetic reactivity during acupuncture anesthesia induction are two important factors which can increase the effect of acupuncture anesthesia.
No comments:
Post a Comment