Zhongguo Zhong Xi Yi Jie He Za Zhi. 2000 Mar; 20(3): 167-9.

[Clinical application of combined acupuncture-drug anesthesia with isoflurane-induced hypotension in cerebral operation]

Wang J, Xie W, Ju X.

Affiliated First Hospital, Wenzhou Medical College, Zhejiang (325000).

OBJECTIVE: To evaluate the feasibility of combined acupuncture-isoflurane anesthesia with deliberated and controlled hypotension induced by isoflurane for the neurosurgical patients. METHODS: Forty-two patients with brain tumor scheduled for selective surgery according to the methods of anesthesia, they were further divided into isoflurane anesthesia (group I, n = 21) and combined acupuncture-isoflurane anesthesia (group II, n = 21). Anesthesia was induced with fentanyl, sodium pentothal and phi avolon intravenously administered. The concentration of isoflurane was elevated to reduce mean arterial pressure (MAP) 30%-40% during dissection and occlusion of the tumor. Compare with the hemodynamic parameters (CO, CI, SV, SI, SVR, LVSWI, RPP) which were measured with Swan-Ganz technique before, during and after isoflurane-induced hypotension. In group II, during tracheal intubation the acupoint of Quanliano (SI 18), Yuyao (EX-HN4), Fengchi (GB 20) and Hegu (LI 4) were stimulated by Han's Acupoint Nerve Stimulator. Meanwhile, the isoflurane was inhalated to maintain anesthesia. RESULTS: As compared with group I, concentration of isoflurane decreased significantly, and isoflurane average dosage per hour reduced by 31%-42% in group II. SVR, PVR, RPP were significantly decreased in the duration of hypotension (P < 0.05). The range change of CO, CI, SV, SI, LVSWI, RPP during controlled hypotension was significantly lower in combined acupuncture-isoflurane anesthesia than that in isoflurane anesthesia (P < 0.05). CONCLUSION: Combined acupuncture-isoflurane anesthesia with isoflurane induced hypotension was used as a selective way for deliberated and controlled hypotension to the neurosurgical patients.