TRANSCUTANEOUS ACUPOINT ELECTRIC STIMULATION IN COMBINATION WITH ENFLURANE ANESTHESIA FOR CRANIOCEREBRAL OPERATIONS

The reinforcing effect of transcutaneous acupoint electric stimulation(TAES)on enflurane anesthesia during craniotomy was studied.One hundred and ten neurosurgical patientswere randomly divided into three groups.Anesthesia was maintained with enflurane in Group A(n=40).In Group B,enflurane anesthesia was supplemented by TAES with Han’s acupoint nerve stimu-lator(HANS)at Hegu(LI 4),Yuyao(EX-HN 4)and Fengchi(GB 20)points on the operated side(n=40).In Group C,enflurane anesthesia was supplemented by TAES and scalp infiltration with 0.5％procaine solution(n=30).The results showed that the minimum alveolar concentration(MAC)of enflurane in Group B and C decreased by 37.8-47.0％and 42.1-66.1％respectively than thatin Group A.The hemodynamics was more stable during operation,and the patients recovered after operation in group B and C.It was concluded that TAES with HANS significantly the anesthetic effect and decreased the side effects of enflurane during operation,and that the triplecombination of TAES,enflurane and scalp infiltration with procaine appeared to be a better anestheticmethod for craniotomy.

CLINICAL SUMMARY ON ACUPUNCTURE COMBINED WITH ENFLURANE-INHALATION ANESTHESIA FOR RESECTION OF ESOPHAGEAL CARCINOMA

Objective: To observe the clinical effect of acupuncture combined with general anesthesia by inhaling enflurane for esophageal carcinoma resection. Methods: 120 cases of esophageal carcinoma patients were randomly divided into acupuncture+inhalation of enflurane (A+IE, n=40), electrical stimulation (ES)+IE (n=41) and IE (control, n=39) groups. In all the 3 groups, vecuronium, fentanyl, propofol (same dose) were given intravenously to induce anesthesia before operation, and during operation, fentanyl (2 ug/kg/hr) and vecuronium (0.03 mg/kg/0.5hr) and appropriate concentration of enflurane were given to the patients for maintaining anesthesia and muscular relaxation. In group A, Xiayifeng (below TE 17), Sanyangluo (TE 8) to Ximen (PC 4) were punctured and stimulated electrically, and in group B, these acupoints were stimulated electrically via cutaneous plate electrodes. Results: The anesthetic effect grade I rates of A+IE, ES+IE and IE groups were 67.50%, 68.29% and 28.21% respectively. There was a significant difference between A+IE or ES+IE and IE groups (P<0.001). In the process of anesthesia, the mean concentrations of the inhaled enflurane in A +IE, ES+IE and IE groups were 0.55% and 0.50% and 0.83% separately. The average concentrations of A+IE and ES+IE groups were lower 33.73% and 39.76% than that of group IE (P<0.005). Conclusion: Acupuncture combined with enflurane inhalation can enhance anesthetic effect, reduce the dose of the inhaled enflurane.

Effect of General Anaesthesia with Combination of Acupuncture and Enflurane Applied in Radical Operation of Laryngocarcinoma

Objective： To observe the effect of general anaesthesia with combination of acupuncture [ conducted with Han＇s acupoint nerve stimulator （HANS） applied] and enflurane in radical operation of laryngocarcinoma （LC）. Methods： Sixty patients with LC of grade Ⅰ -Ⅱ, classified according to the standard of American Society of Anesthesiologists （ASA）, were assigned by randomizing number table to the control group and the tested group, 30 patients in each group. The control group received anaesthesia with enflurane alone for inducing and maintaining; the tested group was anaesthetized with enflurane like that given to the control group but also received additionally needling stimulation conducted by HANS. The dosage of enflurane used, the minimum effective concentration of enflurane in alveolar air （MACEnf） and the changes of heart rate （HR） as well as blood pressure （BP） in patients at different time points in the operational process were observed. Results： As compared with those in the control group, in the tested group, both the MACEnf and the dosage of enflurane were reduced, with the difference between the two groups significant （ P〈0.01 ）. The changes of HR and BP among different time points in the tested group were slight, and as compared with those in the control group at the corresponding time points, the difference was significant （ P〈 0. 05 or P〈0.01）. Conclusion： General anaesthesia with combination of enflurane and needling conducted by HANS applied in radical operation of LC has definite effect with less complication. Needling could be cooperated with narcotics, and so it could be taken as an auxiliary measure of anaesthesia for radical operation of LC.

Anesthetic safety evaluation of Enflurane on pregnant dogs and their fetuses

The safety and feasibility of anesthesia during pregnancy are the public concern to human and veterinary medicines,respiratory and cardiac suppression is the most serious side effect of anesthetic. In order to evaluate the effects of Enflurane on pregnant dogs their fetuses,we established the animal model of the artery catheterization,and investigated the maternal and fetal anesthetic concentrations as well as blood gases in the pregnant dogs anesthetized by inhalation of Enflurane. In this experiment,the femoral artery catheterization of 12 pregnant dogs and their 12 fetuses were performed through the anterior tibia artery by using 17 G and 18 G arterial puncture needle,4F expanded tube,3 F induction tube and the C-arm monitoring system. The results showed that the fetuses survived in uterus for 36 h (two cases),4 ~ 5 d (two cases),6 ~7 d (three cases),8 ~10 d (three cases) and 12 ~14 d (two cases) after operation,respectively. 10 fetuses that survived over 4 days in uterus after the operation were successfully delivered. The fetuses were healthy and their catheters were kept well,the other two pregnant dogs aborted their fetuses. After establishing the model successfully,Atropine sulfate in dose of 0. 04 mg/kg bw were injected into cutaneous muscle of dogs in right clinostatism. 15 minutes later after application of Atropine sulfate,the induced anesthesia was carried out by vein injection of 2. 5% Pentothal sodium (10 mg/kg/bw). The tracheal cannula was performed and the dogs were anesthetized for 10 min by Enflurane inhalation from anesthetic machine. Subsequently,the respiratory rate of experimental animals was controlled to 20-22 times/min by a mechanical ventilator,and the tidal volume was 13 ~ 15 mL/kg/bw. The maternal and fetal arterial anesthetic concentrations and blood gases including pH,PO 2,PCO 2,TCO 2,HCO 3-,SB,BEb and Sat. O 2 were measured after Enflurane inhalation anesthesia. The results showed Enflurane can cross placenta and reach fetal blood. The arterial anesthetic concentrations in fetuses were lower than that in their mothers,but the changes of anesthetic concentrations in fetuses were very similar to their mothers. The pH and BEb in the maternal and fetal blood were significantly lower (P 【 0. 01 or 0. 05),PO 2,PCO 2,and Sat. O 2 were significantly higher (P 【 0. 01 or 0. 05),compared to the prior anesthesia. SB decreased,HCO 3-and T-CO 2 increased (P 】 0. 05) in the early stage of anesthesia,but there were no significant difference after and before anesthesia. These results indicated that Enflurane crosses the placenta very quickly in dogs and is characterized by the quick induction anesthesia and elimination in the body. There were slight respiratory and metabolic acidosis in the period of anesthesia in both pregnant dogs and their fetus and the state were gradually restored to normal with the elimination of the Enflurane in blood. Taken together,Enfluence should be considerated the candidate for the induction and maintenance anesthesia for veterinary and human medicine.

顶空气相色谱法研究循环吸入麻醉过程中氧化亚氮对安氟醚血浓度的影响

八只杂种狗分别进行两次实验,第一次用安氟醚混合70％N_2O进行麻醉,一周后单独使用安氟醚麻醉。在实验过程中,采用气相色谱技术,间断测定安氟醚的血浓度。结果表明,在循环吸入麻醉中,N_2O会影响安氟醚的吸收。