針刺麻醉acupuncture anesthesia

1、Acupuncture Anesthesia針刺麻醉針刺麻醉Group Members： Have you ever heard of acupuncture anesthesia? Acupuncture anesthesia(AA) is a method by which a patient can have an operation in a conscious state（清醒狀態(tài)）by needling acupoints（穴位）to achieve the effect of analgesia（無痛覺）.Acupuncture anesthesia, Journal of Ac

2、upuncture and Tuina Science, Dec. 2003, Vol. 1, No. 6 ：41.ContentsHistory1Clinical Uses2Efficacy3Advantages & Disadvantages4HistoryAcupuncture-drug balanced anesthesiaBe in vogue for a Time（盛極一時）Start to become popularThe first caseIn recent yearsIn 1970sIn 1960sAugust 30th,1958In 1958 In 1958,t

3、he doctors of Chinese and Western medicine in the First Peoples Hospital of Shanghai worked together and learned from each other. On August 30thU Gen-cheng (吳根誠), Acupuncture Anesthesia in China: Retrospect and Prospect, Chin J Integr Med 2007 Sep;13(3):163-165. They applied acupuncture anesthesia t

4、o tonsillectomy（扁桃體切除術(shù)）and the surgery had a satisfactory result.In 1960s In the early 1960s,the subject of penumonectomy（肺切除術(shù)）by acupuncture anesthesia started. After that, satisfactory results were also obtained in many other large-scale and difficult operations in the 1960s and 1970s.*WU Huan-gan

5、 (吳煥淦)，ect. Experience and Thinking on Study of Pneumonectomy by Acupuncture Anesthesia . J. Acupunct. Tuina. Sci. (2008) 6: 70-74 .*WU Gen-cheng (吳根誠), Acupuncture Anesthesia in China: Retrospect and Prospect, Chin J Integr Med 2007 Sep;13(3):163-165.Accepting thoracotomy（胸廓切開術(shù)）underacupuncture ane

6、sthesia In 1970s In 1971,a report titled “Now,About My Operation in Peking” published in New York times.It led “acupuncture heat”in American./wiki/%E9%92%88%E5%88%BA%E9%BA%BB%E9%86%89%E7%96%97%E6%B3%95 In 1972, American President Nixon visited China and he showed an interest in

7、 acupuncture.It made “acupuncture heat” expand to the whole world.In 1976,China Post issued four stamps describing“new achievements in medical and health science”.In recent years Acupuncture-drug balanced anesthesia（針刺復(fù)合麻醉）has been successfully used in anesthesia for surgical operations. It can fulf

8、il the requirement of anesthesia. It is not widely used in clinical practice in recent times.WU Gen-cheng (吳根誠), Acupuncture Anesthesia in China: Retrospect and Prospect, Chin J Integr Med 2007 Sep;13(3):163-165.acupuncture anesthesia(AA)has already developed to acupuncture-assisted anesthesia(AAA)（

9、針刺麻醉發(fā)展為針刺輔助麻醉）Clinical uses123Clinical uses Prospects on acupuncture analgesia：its clinical appifacafion and research.CHEN Huailong，WANG Mingshan，WANG Shiduan.Int J Anesth Resus.2006,347-350Preoperative preparationIntraoperative auxiliary acupuncture anesthesiaTreatment of postoperative painPreventi

10、on and treatment of postoperative nausea and vomitingtooth,tonsil excision, bone surgery, etc.thyroid surgery, cardiac surgery,abortion, esophageal cancer, gallbladder excision, calculi surgeryClinical uses http:/ uses Discussing Acupuncture Anesthesia from Muscle Region Theory WU Huan-gan，ZHANG Ren

11、,KONG Shtto-tang,Li-gong,Sttl ZhengShanghai J Acu-lnox,2006,40-43 Ideal State of Anesthesia Unconsciousness, amnesia(無記憶無記憶), analgesia（鎮(zhèn)痛）（鎮(zhèn)痛） and muscle relaxation Provide minute-to-minute control. Stable state of the body Recover timely Satisfaction ?The Effect of Acupuncture Anesthesia Analgesia

12、 Muscle relaxation Anti-viscera traction actionTangyi Liu, Huayuan Yang, Lizi Chu. The present situation and analysis of acupuncture anesthesia J. Chinese acupuncture and moxibustion, 2008, 27(12): 914-916.020406080-20020406080100120*Pain threshold change (%)Time in minutesneedlemanipulation(n=66)co

13、ntrol group(n=22)Acupuncture-induced analgesiaHuman Observation:Acupuncture at Heku pointSite specificity Meridine/channel (morphological evidence?) Acupoints (precise to mm level?) Body points (Chinese original) or Ear points (French scholars) Bio-electrically sensitive sites, or densely innervated

14、 sites relative rather than absolute specificity測痛是否能預(yù)測針麻效果？測痛是否能預(yù)測針麻效果？術(shù)前測定針刺鎮(zhèn)痛效果術(shù)前測定針刺鎮(zhèn)痛效果外科手術(shù)時外科手術(shù)時 針麻效果針麻效果The mechanism of of Acupuncture AnesthesiaAncient Chinese Natural PhilosophySome schools of thought Neurochemical factors Modulation of Nociception Inflammatory ReflexLin J G, Chen W L. Acu

15、puncture analgesia: a review of its mechanisms of actionsJ. The American journal of Chinese medicine, 2008, 36(04): 635-645.Some schools of thought Neurochemical factors Modulation of Nociception Inflammatory ReflexLin J G, Chen W L. Acupuncture analgesia: a review of its mechanisms of actionsJ. The

16、 American journal of Chinese medicine, 2008, 36(04): 635-645.Evidence showing a neurochemical basis for AATFL, % changeTime, minAA + CSF perfusion 200 100 150 aCSFDoner rabbitLat ventricleIII ventricleperfusate 0 2040 60 0 2040 60Infusion of CSFAcupunctureControl500Recipient rabbitRabbit experiment:

17、 cross infusion of CSFResearch Group of Acupuncture Anesthesia of Peking Medical College. The role of some neurotransmitters of brain in acupuncture analgesia. Sci Sin 1974;17:112-30.Endorphins TheoryAnalgesic effect of electro-acupunctureDYN ABMEK ABn = 13 14 rats100500248163264128Frequency of EA (

18、Hz)腦啡肽抗體腦啡肽抗體阻斷阻斷低頻電針鎮(zhèn)痛低頻電針鎮(zhèn)痛強啡肽抗體強啡肽抗體阻斷阻斷高頻電針鎮(zhèn)痛高頻電針鎮(zhèn)痛脊髓鞘內(nèi)注射脊髓鞘內(nèi)注射正常兔血清正常兔血清Han J S. Acupuncture: neuropeptide release produced by electrical stimulation of different frequenciesJ. Trends in neurosciences, 2003, 26(1): 17-22. The role of CNS 5-HT in EA analgesiaICV injITH injBrain and spinal cord 5

19、-HT mediate EA analgesia5-HTP5-HTPCinanCinan受體拮抗劑受體拮抗劑前體物質(zhì)前體物質(zhì)對照對照ICV injITH injTail flick latency, % changeHan J S. Acupuncture: neuropeptide release produced by electrical stimulation of different frequenciesJ. Trends in neurosciences, 2003, 26(1): 17-22.1 Combine with different types of anesthesi

20、a 2 Good analgesic effect The fMRI of brain functional areas activation after pain stimulation.The fMRI of brain functional areas activation after needle stimulation hegu acupoint.Tong JJ,Liu J, etal .The Research on Acupuncture Anesthesia Based on fMRI .Engineering, 2013, 5, 545-548Advantages 3 Reduce the doses of analgesic or anesthetic drugs Advantages4 Accelerate the postoperative recovery5 Low cost doses of drugs fee stay in hospital WU GC. Acupuncture Anesthesia in China:Retrospect and Prospect J