Monday, May 9, 2011

Acupuncture Anesthesia


Acupuncture anesthesia therapy, also known as "acupuncture meridian points of narcotic therapy", referred to as "acupuncture anesthesia therapy." It is based on meridian theory, according to surgical requirements of acupoints along meridians, acupuncture dialectical approach using an anesthesia with the patient fully awake during surgery, intraoperative physiological disturb less so after the body recover faster. This therapy is the inheritance and development of a new medical achievements made, but also for the application of modern scientific methods of meridian theory provides a new way.

    
The therapy was founded in 1958, Shanghai, Xi'an for the conduct of the relevant medical institutions to obtain satisfactory results tonsillectomy. After more than half of the rapid provinces in the country has caused strong repercussions. To the end of 1959, in Shanghai, Shaanxi, Hubei, Shanxi, Henan, Hebei, Jiangsu, Hunan, Jiangxi, Heilongjiang, Gansu, and Guangxi provinces to promote the application of the various subjects involving clinical types of surgery more than 90 species, but basically small surgery, brain tumor removal surgery, mitral valve narrow separation surgery, gastric resection, hysterectomy, splenectomy, and kidney and bladder surgery.

    
With acupuncture anesthesia depth clinical work, theoretical study is becoming more active. Determination of human pain threshold, electrophysiological studies of central nervous system, acupuncture, "De Qi" research, biochemical indexes, and the animal model, and acupuncture anesthesia during surgery the patient's psychological changes, have achieved varying degrees of results also contributed to the improvement of surgical results of clinical acupuncture anesthesia.

    
More than 30 years ago, acupuncture anesthesia experienced a sprout, the foundation, formation, consolidation period of four important clinical application of disease nearly 100 species, almost every variety of common procedures, application cases, more than 2 million cases. More importantly, theoretically explained the mechanism of analgesia of acupuncture anesthesia, acupuncture anesthesia, analgesia that has its material basis. This will acupuncture, anesthesiology, surgical and neurophysiological development of science have a major impact.

   
"Basic content"

    
A, preoperative preparation

    
1. Preoperative must first understand the patient's condition, medical history, neurological type and ideological situation in order to determine the program of acupuncture anesthesia, surgery, and then a full estimate of the situation may arise in operation, to prepare to take the appropriate measures.

    
2. Acupuncture anesthesia during surgery, the patient completely awake, patients will be required before the characteristics of acupuncture anesthesia, methods, processes and results be introduced to the patient to eliminate the concerns, get in close collaboration with patients.

    
3. Preoperative patient selection of points in the test needle, to understand "get air" conditions and tolerance to acupuncture, to determine the surgical method and to stimulate the amount of stimulation.

    
Second, the selection of points

    
Selection of points to easy to get gas, no pain, no bleeding, patient position comfortable, easy to operate by the principle of operation. Point selection method body acupuncture, ear, nose pins, needles and other surfaces. Is focused on the election body acupuncture and ear acupuncture points method.

    
1. The principles of body acupuncture points selected

    
Meridian selected fourteen main points to take the following three selection methods can be used alone, can also be used in conjunction.

   
(1) followed by the selection of points: According to the meridians of the over, attending clinics and theory, selection and location of incision, surgery is closely linked to organ meridians and acupoints.

   
(2) near Point Selection: Selection of surgical site near the acupoints.

   
(3) The Neural Theory of Point Selection: First, segment selection of points, the second is the distribution of neural stem selected points.

    
2. Auricular acupuncture point selection principle

    
Ear selection, selection of points to take the following three methods can be used alone, can also be used in conjunction.

   
(1) as the doctrine of election by dirty points: such as "lung skin and hair," when the skin incision and sewing the lung point: "Kidneys bone", orthopedic or thoracic surgery rib optional kidney point: "The liver opens into the eyes" , ophthalmic surgery and other desirable liver points.

   
(2) The selection of points according to the surgical site: the stomach, such as access points gastrectomy; take appendectomy appendectomy points; cardiac surgery such as core points.

   
(3) in accordance with the ear anatomy and physiology of neural control and selection of points: choice operative abdominal organs such as oral cavity, ear fans root point, due to the vagus nerve; election under the common points cortex can improve performance and reduce the visceral pain reflex, is guided by physiological role.

   
"How To"

    
1. Preoperative

   
Before surgery, the first time on the stimulation of certain acupuncture points, called induction, induction time is generally 20 to 30 minutes.

    
Induction can be divided into two general induction and focus induction. Induction is common to all points in order to stimulate a little longer; focus induction is the key to stimulate acupuncture points, 5 minutes before surgery.

    
2. Intraoperative

    
Surgery is generally light to stimulate the process of surgical site to stimulate acupuncture points may be suspended by a small stimulus to left needle; on the operative site to enhance the acupuncture points-sensitive sensor.

    
Techniques can be used in the method of intraoperative needle acupuncture, electrical stimulation can be applied. Needle technique, the body acupuncture should be combined lift and thrust and twisting; ear twisting only, not to mention plug. Needle frequency of 120 to 200 times per minute is appropriate, twisting range of 90 to 360 degrees, lift and thrust in the range of 5 to 10 mm. Requirements is always in the "De Qi" state. Needle requires skillful technique, uniform and stable. This is a basic knowledge of acupuncture anesthesia. Use of acupuncture, the incision point to dense wave-based high-frequency, low frequency continuous wave long-distance to the main points and stimulate the patient can tolerate the amount of moderate-intensity appropriate.

    
3. Adjuvant

    
Acupuncture anesthesia in the preoperative or intraoperative applications often require a small amount of adjuvant to improve the effectiveness of acupuncture anesthesia, the patients in the safest and most favorable conditions for surgery. Commonly used sedative, analgesic and anticholinergic and other drugs.

    
(1) preoperative treatment: usually 1 hour before surgery due intramuscular sodium benzene 0.1 g dual-bus, 15 to 30 minutes before surgery muscular or intravenous meperidine 50 mg. To reduce the respiratory and digestive tract secretions in patients 30 to 60 minutes prior to subcutaneous or intramuscular injection of atropine, scopolamine 0.5 mg or 0.3 grams.

    
(2) intraoperative treatment: surgery according to patient response and surgical cases, respectively, plus sedation, analgesics, local anesthetic or muscle relaxant agent. For example, in cutting the peritoneum, ligation of major vascular or visceral traction before, it is estimated there was a strong reaction of the patient may be asked to role with 1% procaine local anesthesia. Due to timing of surgery in the medication, the dose right, so as not to lose the initiative with the patient or accident. Patients must be closely observed in a an accident happens, immediately take effective measures.

   
"Contraindications"

    
The complexity of some of the lesions, adhesions are more extensive exploration of the case or need, especially on some of the more difficult of abdominal surgery, acupuncture anesthesia effect was not stable, care should be used with caution.

   
"Notes"

    
1. Acupuncture operation, regardless of technique or needle acupuncture, patients are able to tolerate the strong sense is appropriate, not too strong, so as not to affect the results.

    
2. Acupuncture anesthesia during surgery, the patient is awake, requiring surgery for a cutting knife, a needle knot, so steady, accurate, light, fast, to avoid duplication operation.

    
3. Acupuncture anesthesia for surgery in some cases or some aspects, there are still incomplete analgesia, muscle tension, visceral reactions, so be prepared adjuvant surgery. Medication it is necessary to grasp the opportunity, but also control the dosage and prevent side effects.

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