胃切除术中针药复合麻醉应用及实验观察

<正> 针麻胃大部切除术在我院已做过1.185例,但是这一麻醉方法还不能适应所有胃手术的需要.因为它还存在镇痛不全、内脏牵拉反应,肌松不满意等问题。所以胃切除术使用针麻,对病例还得经过一定的挑选。比较理想条件是病人痛阈高,耐针力好,意志较坚强,体形消瘦,胃体较大,病灶较单纯,中医辨证上属阳虚型等.然而临床上理想病例是不多的,这样胃切除术针麻效果就受到一定的限制.

THE APPLICATION OF THE COMBINED ANESTHESIA OF ACUPUNCTURE AND EPIDURAL ANESTHESIA IN GASTRECTOMY AND IT'S EXPERIMENTAL OBSERVATION

In this report, there are altogether 97 cases of gastrectomy including the combined anesthesia group, 25 cases, acupuncture anesthesia group, 36 cases; epidural anesthesia group, 36 cases Comparison of the three groups during operation. 1. Comparison of the dosage of lignocaine used in the combined anesthesia with that in the epidural anesthesia. The average dose of lignocaine administered in the combined anesthesia was 204.3mg. while that in the epidural anesthesia was 514. 2mg. the difference being statistically significant. Comparison of the dosage of lignocaine administered in a certain unit of time (in minutes) between the two. In the former the dose was 1.15mg/min, while in the latter 2.79mg/min,The differnce is also statistically significant. 2. Blood pressure and pulse rate were the objective data of physiological and pathological response to an operation. The preoperative B.P. and pulse rate were taken as the standard values. Range of decrease in these values from the beginning of operation to 1.5 hrs after operation was taken for comparison. We discovered that in comparison of the three groups there are statistically significant difference of decrease in diastolic pressure and systolic pressure. In comparison between acupuncture anesthesia and the combined anesthesia,there were no statistical significance. While in comparison of acupuncture and the combined anesthesia with epidural anesthesia respectively, the differences are statistically very significant: 3. Comparison of postoperative elctromyogram of the combined anesthesia with that of acupuncture anesthesia and epidural anesthesia. The postoperative electromyogram of the rectus muscle is the objective index of incisional pain. We observed and recorded the myoelectricity continuously for three hours after operation ( the average accumulated voltage of myoelectricity). Statistically the difference of the three was not very significant. However we divided the durational records into two equal parts(i. e. 1. 5hrs. each). After analysis, we found that the voltage of myoelectricity in acupuncture anesthesia was obviously minimized in the latter 1.5 hrs. in comparison with the fprmer 1,5 hrs, The fact was also true for the combined