Acupuncture anaesthesia

ABOUT ACUPUNCTURE ANAESTHESIA, HISTORY, INDICATIONS, CONTRAINDICATIONS, PREPARATION & PROCEDURE, MOST COMMONLY USED POINTS, SELECTION OF THEORIES BASED ON NEEDS.

1. Acupuncture Anesthesia DR. SATYENDRA SINGH BNYS, MD

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. From 1959 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

5. Preparation & procedure

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.

7. Most commonly used acupuncture points

8. LUNG MERIDIAN : Yunmen L – 2 Chize L – 5 Kongzui L – 6 Lieque L – 7 Yuzu L - 10

9. LARGE INTESTINE MERIDIAN : Sanjian LI – 3 Hegu LI – 4 Quchi LI – 11 Jianyu LI – 15 Neck – Futu LI – 18 Yingxiang LI – 20

10. STOMACH MERIDIAN : Chengqi ST – 1 Juliao ST – 3 Jiache ST – 6 Xiaguan. ST – 7 Biguan. ST – 31 Zusanli. ST – 36 Xiajuxu ST – 39 Fenglong. ST – 40 Xiangu. ST – 43 Neiting. ST – 44

11. HEART MERIDIAN : Qingling. H – 2 Shaohai. H – 3 Tongli. H – 5

12. SPLEEN MERIDIAN : Taibai. SP – 3 Gongsun SP – 4 Sanyinjiao SP – 6 Yinlingquan SP – 9 Xuehai SP – 10 Fushe SP – 13 Daheng SP – 15

13. SMALL INTESTINE MERIDIAN : Houxi. SI – 3 Yanglao. SI – 6 Jianzhen. SI – 9 Jianzhongshu. SI – 15 Quanliao. SI – 18

14. URINARY BLADDER MERIDIAN : Zanzhu. UB – 2 Ganshu. UB – 18 Dachangshu UB – 25 Baihuanshu UB – 30 Shangliao UB – 31 Ciliao. UB – 32 Zhongliao. UB - 33 Chengshan. UB – 57 Kunlun. UB – 60 Jinggu UB – 64

15. KIDNEY MERIDIAN : Yongquan. K – 1 Taixi. K – 3 Dazhong K – 4 Zhaohai K – 6 Fuliu. K – 7

16. PERICARDIUM MERIDIAN : Ximen. P – 4 Neiguan. P – 6

17. TRIPLE WARMER MERIDIAN : Zhongznu. TW – 3 Waiguan. TW – 5 Zhigou TW – 6 Sanyangluo TW – 8 Yifeng TW – 17

18. GALL BLADDER MERIDIAN : Tinghui GB – 2 Shuaigu GB – 8 Yangbai GB – 14 Fengchi GB – 20 Daimai GB – 26 Wushu. GB – 27 Weidao. GB – 28 Huantiao. GB – 30 Yanglingquan. GB – 34 Waiqui GB – 36 Yangfu. GB – 38 Xuanzhong. GB – 39 Foot – Linqui GB – 41 Xiaxi GB – 43

19. LIVER MERIDIAN : Taichong. Liv – 3 Zhongdu Liv – 6 Zhangmen Liv – 13

20. GOVERNING VESSELS MERIDIAN : Yaoshu. GV – 2 Yaoyangguan. GV – 3 Mingmen. GV – 4 Jizhong. GV – 6 Taodao. GV – 13 Dazhui GV – 14 Baihui. GV – 20 Renzhong GV – 26

21. Conceptional Vessels Meridian : Qugu. CV – 2 Zhongji. CV – 3 Qihai CV – 6 Zhongwan. CV – 12 Jiuwei. CV – 15 Chengjiang. CV - 24

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 Apply Needles Stimulation PROCEDURES USED FOR THE STIMULATION : Manual Stimulation of the needles : Hold the needle between thumb, index & middle finger. while manipulating thrust of needle is maintained by index & middle finger while rotating movements will be regulated by thumb. Depth of Thrust – 0.5 - 1 cun Amplitude of rotation – 180 - 360 degrees Frequency of twirling – 100 - 160 movements/min Although procedure 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 : Use different modern or traditional theories for point selection Selecting points based on experience (practical experiences guides better than any book) 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 Ear Points – ( Both sides ) - Ovary Shenmen

26. UB – 65 SP – 6 Ear Points – ( Both sides ) - Ovary Shenmen Lung Uterus Abdomen

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