In December 1980, the National Academic Conference on Acupuncture Anesthesia Principles was held in Nanning, Guangxi, with 148 representatives from 27 provinces, municipalities, and autonomous regions participating. The conference particularly emphasized the rational use of auxiliary drugs and the adoption of a combined anesthesia method integrating acupuncture and medication. Among the 98 clinical acupuncture anesthesia articles presented at the conference (out of a total of 362 papers), 13 were on combined acupuncture anesthesia. At that time, there was a general consensus that combined acupuncture anesthesia could achieve painlessness, help overcome the "three barriers," and was acceptable to patients, surgeons, and anesthesiologists. Additionally, due to the reduced amount of anesthetic drugs, it minimized the suppression of the body's immune function, reduced complications, and facilitated patient recovery. In summary, it could leverage the beneficial regulatory effects of acupuncture on the body and the definite analgesic effects of drugs, while overcoming the shortcomings of both. In 1981, the Beidaihe Conference on Clinical Research in Acupuncture Anesthesia more clearly pointed out that years of research in selecting acupoints and stimulation parameters had shown that relying solely on acupoint acupuncture could not satisfactorily solve the problem of incomplete analgesia, and that combined acupuncture anesthesia should be one of the effective methods. By 1983, at the National Acupuncture Anesthesia Academic Symposium held in Kunming, Yunnan, combined acupuncture anesthesia had been accepted by the majority of acupuncture anesthesia practitioners. Consequently, this anesthesia method began to be applied to increasingly complex surgeries.
During the use of combined acupuncture anesthesia, some new issues were discovered: some drugs did not enhance the analgesic effect when used in conjunction with acupuncture. To fully utilize the strengths of both acupuncture and drugs, the selection of auxiliary anesthetic drugs and the research on their optimal doses have increasingly attracted the attention of acupuncture anesthesia researchers and have become one of the key areas of exploration in recent years. The Acupuncture Research Institute of Shanghai Medical University and other institutions conducted experimental observations on animal models, analyzing the effects of individual drugs or combined use with Yaodui acupuncture on analgesia. They found that when drugs were used to assist acupuncture anesthesia, three scenarios could occur: 1. The drug's effect antagonized that of acupuncture (referred to as acupuncture anesthesia reducing drugs); 2. The drug enhanced the analgesic effect of acupuncture (referred to as acupuncture anesthesia enhancing drugs); 3. The drug had no effect on acupuncture anesthesia. Currently, some acupuncture anesthesia enhancing drugs have been screened and are beginning to be used in clinical observations.At the Beidaihe Conference held in 1981, the previously used four-level rating standard for acupuncture anesthesia was revised to a three-level standard. This standard emphasizes maintaining the patient's pain-free state during surgery while preserving the regulatory effects of retaining needle acupuncture as much as possible. This makes the standard stricter and clearer, and more in line with the characteristics of acupuncture anesthesia. Later, in the specific implementation process, some surgeries further proposed rating standards suitable for those surgeries. For example, the nationally unified two-level standard for the anesthetic effect of acupuncture anesthesia in craniocerebral surgery is one such example. A unified and scientific rating standard undoubtedly provides a basis for the evaluation of acupuncture anesthesia surgeries.
In January 1982, thyroid surgery under acupuncture anesthesia was the first to pass the achievement appraisal by the Ministry of Health, being listed as a routine anesthesia method, and became the first acupuncture anesthesia surgery to be appraised at the ministerial level in the history of acupuncture anesthesia in China. In February 1983, more than fifty experts and researchers in neurosurgery, anesthesiology, acupuncture and moxibustion, and neurophysiology gathered in the picturesque city of Wuxi by the Taihu Lake to appraise the research and application of acupuncture anesthesia in anterior cranial fossa (cranium) surgery. Since 1965, China has been using acupuncture anesthesia for cranium surgery. In March 1975, the National Neurosurgery Acupuncture Anesthesia Research Collaboration Group was established, led by Huashan Hospital in Shanghai, with the participation of 24 hospitals, focusing on the study of anterior cranial fossa surgery. Over seven years, a total of 4,827 clinical observations were conducted. In the final year, they completed 242 cases according to new operating procedures and secondary rating standards, resulting in the success rate (Grade I rate) rapidly increasing from the original 80% to 95%. The experts unanimously passed the appraisal and considered the method simple and easy to implement, suitable for national conditions, safe and reliable, and easy to promote, making it one of the anesthesia methods for anterior cranial fossa surgery. Thyroid surgery and anterior cranial fossa surgery under acupuncture anesthesia respectively won the Science and Technology Achievement Awards from the Ministry of Health and the National Science Conference.After this, cervical anterior approach surgery, tooth extraction, and cesarean section under acupuncture anesthesia successively passed evaluation. On November 24 and December 28, 1984, abdominal tubal ligation and lung resection surgery under acupuncture anesthesia were respectively approved in Nanjing and Xi'an. The most recent ministerial-level evaluation was for the clinical summary of total Zigong (EX-CA1) resection under acupuncture anesthesia, passed in Xi'an in January 1976. This surgery, led by the Fourth People's Hospital of Xi'an, started in 1978 and was conducted in collaboration with the Second Affiliated Hospital of Hunan Medical College, among others, totaling over 1200 cases. A unified acupuncture anesthesia prescription and technical operation method combining scalp acupuncture and body acupuncture were summarized, and through various comparisons, the excellent rate of this acupuncture anesthesia technique reached 80.47%. It proved that acupuncture anesthesia for total Zigong (EX-CA1) resection is safe and effective, with fewer complications; patients' blood pressure and pulse were more stable than with drug anesthesia; postoperative recovery was quick, with no significant physiological disturbance reactions. This research and the study on acupuncture anesthesia for abdominal tubal ligation both won the second prize for major scientific and technological achievements from the State Administration of Traditional Chinese Medicine in 1987. By then, eight acupuncture anesthesia surgeries in China had passed evaluation and entered the ranks of conventional anesthesia. Some more challenging acupuncture anesthesia surgeries, such as gastrectomy, are actively summarizing patterns to strive for evaluation.Research on the principles of acupuncture has also made significant progress.
In 1984, Han Jisheng from Beijing Medical University combined the achievements of this phase with previous discoveries to draw a "Diagram of Neural Pathways and Neurotransmitter Principles of Acupuncture Analgesia," succinctly reflecting the contributions of Chinese acupuncture anesthesia workers in principle research.
(In this diagram, the dotted areas represent the pain perception system. The arrows indicate the conduction pathways of nociceptive information. Nociceptive information, including surgical injury, is transmitted by Aδ and C fibers to layers I and V of the dorsal horn, through multisynaptic conduction pathways to the central lateral nucleus and parafascicular nucleus of the diencephalon, possibly further to the cortex, causing pain sensation.
Acupuncture information is mainly transmitted by Aβ and Aδ fibers to the dorsal horn of the spinal cord, then to many areas of the brain, inhibiting the transmission function of the pain perception system at different levels. The periaqueductal gray matter of the midbrain plays a leading role, emitting descending and ascending inhibitory pathways to inhibit the transmission of pain information. Additionally, it can excite the arcuate nucleus of the hypothalamus and the nuclei of the limbic system, activating the "midbrain-limbic analgesic circuit" to exert analgesic effects (the above pathways are all represented by black lines in the diagram). The letters A, G, N, O, S, etc., in the diagram represent the types of neurotransmitters acting at those locations).
From the perspectives of morphology, physiology, generation and transformation, psychology, and other multidisciplinary approaches, it has been fully proven that acupuncture anesthesia is the result of comprehensive factors including multiple pathways, levels, neural and humoral factors from the periphery to the cerebral cortex.
On August 7, 1984, the Second National Acupuncture and Moxibustion, Acupuncture Anesthesia Academic Discussion Meeting, organized by the Chinese Acupuncture and Moxibustion Association, was held in Beijing. This meeting was larger in scale than the first, with 403 domestic representatives and 422 foreign scholars from 52 countries and regions across five continents. Over a thousand domestic papers were submitted, with 643 selected, including 85 on clinical research of acupuncture anesthesia, and 297 on the principles of acupuncture and moxibustion, mainly acupuncture anesthesia. At the plenary session, Xin Yuling and Han Jisheng presented comprehensive reports on "Clinical Research of Acupuncture Anesthesia" and "Principle Research of Acupuncture Anesthesia," respectively.
In September 1986, as one of the seven subcommittees of the Chinese Acupuncture and Moxibustion Association, the Acupuncture Anesthesia Research Society was established in Shanghai. Cao Xiaoding was elected as the chairman, with Wang Youliang, Wang Qiaochu, Li Chunyuan, and Zhao Jianchu as vice-chairmen, and Huang Henian as the secretary-general, totaling twenty council members. The society invited seven senior experts who had contributed to the development of acupuncture anesthesia to serve as advisors. They were: Zhang Xiangtong, Xin Yuling, Xie Rong, Qiu Demao, Liu Jinhui, Chen Shude, and Cai Baoxian. The establishment of the Acupuncture Anesthesia Research Society ensured and promoted the healthy development of acupuncture anesthesia in China from an organizational perspective.
On November 22, 1987, 86 representatives from 28 countries and regions across five continents gathered in Beijing to participate in the establishment of the World Acupuncture and Moxibustion Federation. They represented over 137,800 members from 55 Acupuncture and Moxibustion associations (including 5 international organizations) covering nearly 100 countries. Subsequently, the first World Acupuncture and Moxibustion Congress was held over four days, with acupuncture anesthesia research being one of the key topics of discussion. Apart from China, countries such as Italy, Japan, the former Soviet Union, Pakistan, the Netherlands, and Egypt also affirmed the effectiveness of acupuncture anesthesia. A research report titled "100 Cases of Cardiac Surgery Under Acupuncture Anesthesia" presented by an Italian-Chinese professor received praise from both Chinese and foreign scholars. This conference also showcased some new advancements in China's acupuncture anesthesia work. Clinically, there was a deeper exploration of combined acupuncture anesthesia, comparing pure acupuncture, acupuncture combined with medication, and low-dose medication, as well as comparing acupuncture supplemented with different drugs, doses, and administration routes, yielding a series of data. Additionally, a comprehensive acupuncture anesthesia method (i.e., multi-acupoint stimulation anesthesia) was proposed. In terms of principles, a circular neural pathway related to analgesia was discovered in the brain in recent years. Once activated by acupuncture, this pathway could potentially excite repeatedly. This partially explains why a single acupuncture session can maintain its effects for a prolonged period. Furthermore, animal experiments demonstrated that low-frequency electroacupuncture (equivalent to slow needle manipulation) promotes the release of enkephalins in the spinal cord, while high-frequency electroacupuncture (equivalent to rapid needle manipulation) promotes the release of dynorphins, indicating that different needle manipulation techniques produce different effects. Moreover, individual differences exist in animals subjected to acupuncture.
In 1989 and 1991, the second and third academic symposiums on acupuncture anesthesia and acupuncture analgesia were held in Shanghai and Xi'an, respectively.
In summary, acupuncture anesthesia is not only gaining global recognition but also continuously developing and improving.