ABOUT ACUPUNCTURE ANAESTHESIA, HISTORY, INDICATIONS, CONTRAINDICATIONS, PREPARATION & PROCEDURE, MOST COMMONLY USED POINTS, SELECTION OF THEORIES BASED ON NEEDS.
2. ANESTHESIA ?
• Dictionary meaning - the condition of not feeling pain, esp. by use of special drugs.
• Definition - A temporary loss of feeling and a complete loss of awareness that feels like a very
deep sleep. It is caused by special drugs or other substances called anesthetics.
• HISTORY – First App. of acupuncture Anaesthesia was made in 1958 in Sian city.
• It was the case of a breast abscess and an incision drainage was done.
• As a matter of fact , this was not the birth of acupuncture anaesthesia, it was long before this
event when acupuncture analgesia was being practised by the medical workers to alleviate Post
operative pain successfully.
3. • This procedure was first used in Dental surgery then encouraged by the results, and applied it in the
tonsillectomies, thyroidectomies and Herniorrhaphies.
• From1959 Chinese doctors have been using acupuncture anesthesia in Head & Neck surgery,
pneumonectomies, amputations, and abdominal surgery.
• About 10,000 surgery performed between 1958 to 1966.
• From 1966 to 1972 about 4 lack operations were performed under acupuncture anesthesia in China.
• Advantages :
• Quiet Safe
• It is not expensive
• No Dangerous Side effects Like Drug toxicity and Allergy
• No inhibition of Cardiac & respiratory fxns, no fall of blood pressure, no alteration in pulse rate
• Some times slight bradycardia may occur.
• Intravenous Fluids are usually not needed
• Patient can talk during surgery
• It is comfortable to the Patient, not need of keeping fasting before surgery.
• Faster recovery without Nausea and Vomiting
• Intravenous fluids are usually not needed.
• Patients can talk during operation.
• There is Little or no Hemorrhage.
4. DISADVANTAGES
• Sometimes the anesthesia is incomplete.
• Acupuncture Anesthesia works better above the diaphragm than below the diaphragm.
• Not suitable for emergencies b/c it takes 15 to 20 min for induction.
INDICATIONS :
• Orthopedic
• Neuro surgery
• Dental Extraction
• Thyroidectomy
• Tonsillectomy
Contraindications :
• Severe injury to the brain with coma
• Obstruction of the respiratory conditions
• Cardiac arrhythmias
6. • Explain patient about Acupuncture anaesthesia – to prepare him mentally and to gain cooperation from
them during the Surgery.
• Patient have to perform breathing exercises.
• Biochemical analysis (Urine, blood all other routine test) prior to the surgery.
• Electrolyte and water balance should be normal.
• Prior interaction between surgeon and anesthetist is important to rule out and to plan the surgery in a
desired manner.
• Prior Acupuncture test – Selected Points should be pricked to evaluate the status of chi and to check
toleration for stimuli.
• This test will help to access patients threshold to pain and will help to understand the force and type of
needling required.
22. EXTRA ORDINARY POINTS :
• Taiyang. EX – 2
• Huatuo Jiaji Points EX –21
• Lanwei. EX – 33
• Dannang. EX – 35
23. PREMEDICATION :
• Sedatives &Analgesics : administered in low dosages
Ex – Chlorpromazine, Demerol, Luminol
• Anticholinergic Drugs : Atropine &Scopolamine
PROCEDURE :
• Select Points
• ApplyNeedles
• Stimulation
PROCEDURES USED FOR THE STIMULATION :
1. Manual Stimulation of the needles :
• Hold the needle between thumb, index & middle finger.
• while manipulating thrust of needle is maintainedby index& middle fingerwhile rotating movements will be regulated by thumb.
• Depth of Thrust – 0.5-1 cun
• Amplitudeof rotation – 180-360degrees
• Frequencyof twirling – 100- 160movements/min
• Althoughprocedure demands team work
24. 2. Electrical Stimulation :
• Electrical stimulation of needles are done throughout the surgery
• Clinically, 4-6 volts of intensity is used but may vary 6-18 volts
• Rarely, 2000 Hertz is used
• To avoid resistance (by body) points to be stimulated are changed frequently
Other procedures used are :
• Finger massage of point
• Injecting the point with distilled water
• Supplemental local anesthesia along the line of incision can be given
Induction time - 15-20 minutes
Selection of points
Based on practical investigation, observation, experience. With this following steps can be employed :
1. Use different modern or traditional theories for point selection
2. Selecting points based on experience (practical experiences guides better than any book)
3. Combinations of points should be used for better effect
25. SELECTION OF THEORIES BASED ON NEED
• Based on desired effect required and therapeutic properties of points – point selection is performed.
• Analgesic Points
• Tranquilizing points
• Homeostatic points
• Distal points (as per need)
Example :
For Caesarean Section
Main Points - GV –26
GV – 6
GV – 20
Supplementary Points - P- 7
LI– 4
LIV–3
LIV–8
ST–36
UB– 60