针刺增效药在针刺镇痛复合麻醉肺切除中的作用

自 1 995年 1月至 1 997年 6月 ,我院临床针麻研究室为了提高针麻肺切除效果 ,在用手法针刺加针刺增效药氟哌啶醇、芬太尼静脉复合麻醉基础上 ,在麻醉诱导前 5ｍｉｎ肌肉注射弱阿片类镇痛药曲马多 1 0 0ｍｇ和针刺增效药灭吐灵 2 0ｍｇ ,以进一步减少术中静脉复合液的用量 ,增加针麻术中的镇痛作用。设针药麻组 40例 ,并设全麻对照组 40例进行观察。术前准备 :病人术前都做模拟预测 ,做皮肤及耐痛阈的测试 ,在针刺诱导前后作比较 ,并观察针刺耐受力及针刺感应 ,并进行心理测试 ,用美国伊利诺州大学个性及能力研究所卡特尔教授编制的 1 6种个…

Observation on the Effect of Acupuncture-analgesia-enhancing Medicines Combined with Acupuncture Anesthesia for Pulmonary Lobectomy

Objective: To observe the effect of application of acupuncture analgesia enhancing synergists combined with acupuncture anesthesia to pulmonary lobectomy. Methods: Before anesthesia, intramuscular injection of tramadol(100 mg, a weak analgesic) and maxolon (20 mg, for enhancing acupuncture analgesia) and intravenous administration of holoperidol and fentany were given to the patients. 80 cases of patients were randomly divided into acupuncture combined with anesthetic (ACA) group (n=40) and general anesthesia (GA) group (n=40). Acupoints used were Houxi (SI 3), Zhigou (SJ 6), Neiguan (PC 6), Hegu (LI 4), Ximen (PC 4), Yuji (LU 10), Shugu (BL 65), Zulinqi (GB 41), Taichong(LR 3), Taixi (KI 3) and Taibai (SP 3). After insertion of the needles, every acupoint was stimulated by manipulating the needle for 1 min, 3 times altogether. Then intravenous drip of compound fluid of 1% procaine and scoline and endotracheal intubation were conducted. Before pulmonary lobectomy, procaine 0.25% (60 mL) was injected into the local subcutaneous tissues. During operation, the patient was kept basic consciousness. Results: In ACA group, the excellent rate and successful rate were 78% and 100% respectively. In comparison with GA group, the doses of the used anesthetics in ACA group (0.039±0.004 mL/kg/min) were decreased by 45%, being significantly lower than those of GA group (0.071±0.014 mL/kg/min) (P<0.001). Conclusion: Acupuncture combined with anesthetics for pulmonary lobectomy is effective and can lessen patients' sufferings and thus is an applicable method in clinic.