针刺复合小剂量硬膜外麻醉胆囊切除术临床研究报告

本文共观察行择期胆囊切除术患者 46例 ,分为Ａ组针刺复合小剂量硬膜外麻醉 (1 6例 ) ,Ｂ组穴位电极刺激复合小剂量硬膜外麻醉 (1 4例 ) ,Ｃ组 (对照组 )单纯小剂量硬膜外麻醉 (1 6例 )三组。结果Ａ、Ｂ两组优良率 (Ⅰ Ⅱ级 )分别为 1 0 0 %和 92 % ,Ｃ组优良率 (Ⅰ Ⅱ级 )为 1 2 .50 % ,Ａ、Ｂ两组麻醉效果优于Ｃ组 (Ｐ <0 .0 1 )。三组硬膜外麻醉药均应用 1 .5%利多卡因 ,三组硬膜外腔每小时平均用药量 (1 .5%利多卡因 ,ｍＬ)Ａ、Ｂ两组比Ｃ组分别减少 33.50 %和 34.0 0 % (Ｐ <0 .0 1 ) ;第一小时容量及总容量Ａ、Ｂ两组比Ｃ组减少均接…

Clinical Study on Acupuncture Combined with Extradural Administration of Small Dose of Anesthetics for Cholecystectomy

46cases of cholecystectomy were randomly divided into acupuncture combined with extradural injection of small dose of anesthetics group (group A, n=16), acupoint skin electrical stimulation with extradural injection of small dose of anesthetics group (group B, n=14), simple extradural injection of small dose of anesthetics group (group C, n=16). The results revealed that in group A and group B, the excellent plus good rates (class Ⅰ+Ⅱ) were 100% and 92.80% separately, while that of group C was 12.50%. The anesthesic effect of groups A and B was better than that of group C (P<0.01). The average dose of 1.5% lidocaine for extradural anesthesia per hour was reduced by 33.50% and 34.00% respectively in groups A and B compared with that of group C (P<0.01). The amount of lidocaine administered in the first hour and the total amount of lidocaine in groups A and B were reduced by about 30% compared with those of group C. These indicate that acupuncture and acupoint skin electrical stimulation combined with epidural injection of small dose of anesthetics for cholecystectomy may obviously decrease the amount of extradural anesthetics, improve the anesthetic effects and remedy the defects of incomplete analgesic effect, incomplete muscular relaxation and visceral pulling reaction under simple acupuncture anesthesia. Thus these methods meet the elementary demands of cholecystectomy. The values of plasma catecholamine were determined in 33 cases of cholecystectomy with 11 cases in each group. The plasma noradrenaline (NE), adrenaline (E) and dopamine (DA) were detected one day before operation, during operation (30 min after anesthesia) and 3 days after operation in all the cases. Results: In groups A and B, plasma NE contents were 2.282±0.841 ng/mL and 2.341±1.566 ng/mL respectively during operation, which were lower than those of pre operation (3.853±1.476 ng/mL and 2.902±1.490 ng/mL) (P<0.01). In group A, plasma NE lowered significantly in comparison with pre operation (P<0.01). But in group C, the NE level increased slightly during operation compared with pre operation. Plasma E contents of groups A and B increased obviously during operation (P<0.01). Plasma DA of the 3 groups during operation increased in comparison with pre operation. Three days after operation, plasma NE, E and DA values were close to those of pre operation. This indicates that either acupuncture or acupoint skin electrical combined with extradural injection of small dose of anesthetics can function in regulating the activity of sympathetic nerve. The effect of acupuncture anesthesia may be mainly related to plasma NE rather than E and DA. It reveals that acupuncture and acupoint skin electrical stimulation may reduce or suppress the stress response caused by surgical operation.