Acupuncture analgesia ( abbreviated to A.A. ) is an analgesic method built on the basis of relieving pain and regulating the physiological function of the human body by needling. The procedure produces an absence of pain by stimulating certain points when the patient undergoes an operation in full consciousness. It is considered an important achievement in the successful integration of traditional Chinese and Western medicine.
1. THE CHARACTERISTICS OF ACUPUNCTURE ANALGESIA
1. Safe in Wide Indications
Extensive clinical practice has proven that acupuncture analgesia is completely safe. Millions of surgical operations with acupuncture analgesia have been carried out in China and none of them led to death attributed to needling. Acupuncture analgesia does not produce any side – effects and accidents which might happen when drug anaesthesia is employed. What is more, it does not result in respiratory tract infection, gastrointestinal dysfunction, abdominal distension and retention of urine. It, therefore, is more suitable to the aged patients with weak constitution, and the patients with cardiac, pulmonary, hepatic or renal condition and those who are too sick to sustain drug anaesthesia.
2. Reduced Physiological Disturbance and Rapid Recovery
As acupuncture functions to regulate the physiological condition of the human body, doctors are able to take immediate measures with acupuncture according to the subjective signs of the patient to avoid the physiological disturbance caused by severe pain. Blood pressure, pulse and respiration rates during the operation remain relatively stable in most cases. After the operation, patients ‘ physiological state remain normal, as manifested in early regaining of appetite and ambulatory activities, and satisfactory healing of wound. All these are conducive to an early recovery.
3. Subjective Cooperation of the Patient and Improvement of Operative Results
The patient under acupuncture analgesia is mentally alert and able to communicate with the surgeons. This enables the surgeon to judge operative results as the operation proceeds. During thyroidectomy, for instance, the patient ‘ s phonation may be tested ; in total laryngectomy, the swallowing movement can be checked ; in eye surgery for strabismus, eyeball movement can be examined ; in amputation of trigeminal sensory root and craniocerebral operation, the limits of facial anesthetic region can be observed. The close coordination between the patient and surgeon ensures the desirable operative results.
Simple Apparatus and Easy to Popularize
Acupuncture analgesia does not require any sophisticated medical equipment and is not restrained by preferential environment. The only requisites for success are to observe the patient ‘ s pain endurance carefully, select well – indicated cases, locate the points accurately and puncture skillfully. The practice across the nation has proven that acupuncture analgesia is more practical in backward regions where emergency surgery is possibly delayed due to lack of necessary medical equipment.
Acupuncture analgesia was created in the 1950 ‘ s in China. With researching for more than twenty years, some noteworthy experiences have been accumulated. Like any other science and technology, acupuncture analgesia has a long way to go from imperfection to perfection. Though the mechanism of acupuncture analgesia has been preliminarily outlined, further studies are still needed to reach a thorough explanation. Acupuncture analgesia is able to raise pain threshhold and endurance, but there still exist some drawbacks, such as incomplete analgesia and muscular tension which is likely to cause discomforts due to retraction of internal organs in an introabdominal operation. In this case, administrating a small dose of anesthetic drug or puncturing some acupoints will relieve the pain and discomforts of the patients.retraction of internal organs in an introabdominal operation. In this case, administrating a small dose of anesthetic drug or puncturing some acupoints will relieve the pain and discomforts of the patients.
II. PREOPERATIVE PREPARATIONS FOR ACUPUNCTURE ANALGESIA
1. Explanatory Work to the Patient
As the patient under acupuncture analgesia is mentally alert during the surgical operation, it is essential to consider his attitude toward acupuncture analgesia and his spiritual behaviour because these may afTect his physiological function, pain endurance and ability to accept the operation. It is necessary to let the patient know in detail the characteristics, methods, process, effects of acupuncture analgesia, the operative procedures, and the reaction and sensation caused by needling. It is also important to make the patient mentally relaxed so that he can cooperate with the surgeons to ensure the successful operative results.
2. Preliminary Test of Needling and Pain Endurance
Before acupuncture analgesia, one or more points may be selected on the body of the patient for preliminary test of needling. With this, the patient can experience the needling sensation, free his nervousness from acupuncture analgesia and adapthimself to the needling stimulation. On the other hand, when he knows the tolerance of the patient, the surgeon can decide the method and intensity of stimulation in the operation. Also, physical or chemical stimulation can be applied to measure the patient ‘ s pain endurance. Anyway, the purpose of pain endurance test is for precise determination of the stimulation intensity in acupuncture analgesia.
3. Practice of Deep Breathing
Instruct the patient under thoracic – abdominal operation to practise slow, deep abdominal breathing before operation. It can relieve stuffiness of the chest, heavy sensation and dyspnea after the chest is opened up. In abdominal surgery, deep breathing helps to ease the patient of the muscular spasm, nausea and vomiting caused by retraction of internal organs.
4. Preoperative Plan of Acupuncture Analgesia
The close cooperation between the acupuncturists, surgeons and nursing staff is indispensable for successful operation with acupuncture analgesia. The patient ‘ s psychological state, case history and focus of infection should be brought to thorough analysis and discussion. Prediction of the problems possibly occurring under operation and corresponding emergency measures will guarantee a safe operation on a fully conscious patient.
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