30cases of new glottic reconstruction were performed under acupuncture anesthesia combined with drugs from 1996 to 2000. In these 30 cases of glottic stenosis after laryngeal reconstruction under general anesthesia, t...30cases of new glottic reconstruction were performed under acupuncture anesthesia combined with drugs from 1996 to 2000. In these 30 cases of glottic stenosis after laryngeal reconstruction under general anesthesia, the lumen of the larynx was not much larger than was required for respiration. So all these patients tracheotomized could not be decannulated because of stenosis. A new glottic reconstruction under acupuncture anesthesia combined with drugs was performed in above mentioned 30 patients. Bilateral Futu (ST 32) and Hegu (LI 4) were punctured and stimulated electrically by setting the stimulating frequency of 100 Hz, a bearable strength and duration of 20 min after achieving sore, numb, heavy and distending needling sensations. Pethidine 1 mg/kg, rotundine 60 mg and metoclopramide 10 mg were given intramuscularly to each case as the supplementary medication 15 minutes before operation. Dicaine solution 1% was sprayed into the pharynx and larynx for topical anesthesia. During operation, the incision site of the skin was infiltrated with 0.5% procaine 10 mL. The anesthetic effects of acupuncture anesthesia were evaluated and attributed to: grade Ⅰ(excellent), grade Ⅱ(satisfactory), grade Ⅲ(fair) and grade Ⅳ(poor). According to the patency degree (the light type and the serious type) of glottis, the operative procedures were adopted correspondingly. We conducted quantitative measurement of the glottic width showing by laryngograph before and after operation. As to our experiences, the optimum width of the glottic lumen which is meticulously reconstructed under general anesthesia may be not accommodated the physiological path. Under the circumstances, glottic insufficiency or larynageal stenosis is often induced, resulting in an hypoventilation and often requiring an indwelling tracheotomy tube. Under acupuncture anesthesia, the patients were in conscious and physiological state thus the reconstructed new glottis may be easily achieved the physiological width. Of the 30 cases, 28 were male and 2 female ranging in age from 26 to 80 years. They suffered from glottic stenosis with the glottic width being less than 3 mm. So all these tracheotomized patients could not be decannulated because of respiratory insufficiency. New glottic reconstruction under combined acupuncture and medicinal anesthesia was performed by increasing the width of glottic lumen to about 4 mm～5 mm. 28 cases were successfully decannulated with normal respiratory function and 2 cases failed in removing the tracheal cannula. The success rate of operation was 93.3%. The success rate of this combined anesthesia was 97% including grade Ⅰ, 20 cases, grade Ⅱ, 9 cases, grade Ⅳ, 1 case. No complication occurred.展开更多
文摘30cases of new glottic reconstruction were performed under acupuncture anesthesia combined with drugs from 1996 to 2000. In these 30 cases of glottic stenosis after laryngeal reconstruction under general anesthesia, the lumen of the larynx was not much larger than was required for respiration. So all these patients tracheotomized could not be decannulated because of stenosis. A new glottic reconstruction under acupuncture anesthesia combined with drugs was performed in above mentioned 30 patients. Bilateral Futu (ST 32) and Hegu (LI 4) were punctured and stimulated electrically by setting the stimulating frequency of 100 Hz, a bearable strength and duration of 20 min after achieving sore, numb, heavy and distending needling sensations. Pethidine 1 mg/kg, rotundine 60 mg and metoclopramide 10 mg were given intramuscularly to each case as the supplementary medication 15 minutes before operation. Dicaine solution 1% was sprayed into the pharynx and larynx for topical anesthesia. During operation, the incision site of the skin was infiltrated with 0.5% procaine 10 mL. The anesthetic effects of acupuncture anesthesia were evaluated and attributed to: grade Ⅰ(excellent), grade Ⅱ(satisfactory), grade Ⅲ(fair) and grade Ⅳ(poor). According to the patency degree (the light type and the serious type) of glottis, the operative procedures were adopted correspondingly. We conducted quantitative measurement of the glottic width showing by laryngograph before and after operation. As to our experiences, the optimum width of the glottic lumen which is meticulously reconstructed under general anesthesia may be not accommodated the physiological path. Under the circumstances, glottic insufficiency or larynageal stenosis is often induced, resulting in an hypoventilation and often requiring an indwelling tracheotomy tube. Under acupuncture anesthesia, the patients were in conscious and physiological state thus the reconstructed new glottis may be easily achieved the physiological width. Of the 30 cases, 28 were male and 2 female ranging in age from 26 to 80 years. They suffered from glottic stenosis with the glottic width being less than 3 mm. So all these tracheotomized patients could not be decannulated because of respiratory insufficiency. New glottic reconstruction under combined acupuncture and medicinal anesthesia was performed by increasing the width of glottic lumen to about 4 mm～5 mm. 28 cases were successfully decannulated with normal respiratory function and 2 cases failed in removing the tracheal cannula. The success rate of operation was 93.3%. The success rate of this combined anesthesia was 97% including grade Ⅰ, 20 cases, grade Ⅱ, 9 cases, grade Ⅳ, 1 case. No complication occurred.
