全子宫切除术中针、药麻醉结合的探讨

<正> 根据祖国医学理论,妇女经、带、胎、产疾病冲、督、任三脉皆起于胞中(即子宫),并络于带脉,说明冲、任、督、带四脉与子宫关系密切,因此我们在针麻全子宫切除术中把取穴的选择集中到背部督脉上。通过临床实践、观察到命门、腰俞对针麻的镇痛不全、次髎对内脏牵拉反应有较好的效果,但存在着腹肌紧张、鼓肠等问题。我们学习

STUDIES ON THE COMBINATION OF DRUG AND ACUPUNCTURE AS A METHOD OF ANESTHESIA IN TOTAL HYSTERECTOMY

Fifty cases of total hysterectomy using acupuncture as the primary method of anesthesial withadjunct analgesics were compared with a control group of another 50 total hysterectomies using acu-puncture alone.Patients were classified into 3 groups according to the acupuncture tolerance testapplied to Hegu point:Group A,good tolerance to acupuncture,simple pelvic lesions,acupunctureonly was used,50 cases;Group B,adherent pelvic lesions,25 cases;Group C,poor tolerance toacupuncture,lesions with extensive adhesions and/or complicated by medical problems.All the pati-ents received Hyminal 0.4gm orally the night before operation,and Luminal 0.1gm given an hourbefore operation together with Atropine 0.5mg or Scoplamine 0.3mg For Group A patients Pethi-dine 1 mg/kg was added 5 minutes before operation;Group B patients received Pethidine 1.5 mg/kg and Haloteridol 5 mg;Group C patients had pethidine 1 mg/kg and 100 mg Lidocaine in a 2%solution extradurally.In Group A,50 patients,45 cases were successful,of which the “excellent” rate was 78%;Group B,25 patients,24 were successful with an “excellent” rate of 96%;Group C,25 patients,all successful,of which the “excellent” rate was also 96%.To patients presenting muscular tension 40 mg of Flaxedil were given;for those with incompleteanalgesia Fentanyl 0.1 mg or Pethidine 50 mg was used;in cases with massive adhesions extraduralLidocaine 100 mg in a 2% solution was added to produce a synergistic action and thus enhance theeffect of Acupuncture Anesthesia.