Acupuncture Anesthesia Method
I. Acupoint Prescription:
Commonly used are the following two groups.
(1) Ear Acupuncture: Adrenal gland through internal nose, Shenmen (HT7) through sympathetic.
Body Acupuncture: Juliao (ST3) through Sibai (ST2), Hegu (LI4), Zhigou (TE6).
(2) Sibai (ST2), Juliao (ST3), Hegu (LI4), Zhigou (TE6).
II. Stimulation Frequency:
Ear acupuncture and Hegu (LI4), Zhigou (TE6) 4～7Hz; Juliao (ST3), Sibai (ST2) 30～50Hz.
III. Induction Time:
20～30 minutes.
IV. Auxiliary Medication:
Take 0.1g of phenobarbital orally two hours before surgery. Intramuscular injection of pethidine 1～2mg/kg body weight 30 minutes before surgery, with some adding promethazine 25mg or haloperidol 5mg.
Effectiveness of Acupuncture Anesthesia
For some patients with stable emotions, localized lesions, and less bleeding, the application of acupuncture anesthesia for nasal lateral incision surgery can achieve good results.
Surgical Procedures and Precautions
Patients under acupuncture anesthesia are in a conscious state, especially during head surgery, where patients are sensitive to sensations. Therefore, it is necessary to improve surgical operation methods to enhance the effectiveness of acupuncture anesthesia.
There are nine main steps in acupuncture anesthesia nasal lateral incision surgery: (1) Skin incision; (2) Exposure of the lateral nasal bone wall; (3) Removal of the nasal bone and pear-shaped aperture edge bone; (4) Chiseling open the anterior wall of the maxillary sinus to examine the sinus cavity; (5) Chiseling off the frontal process of the maxilla; (6) Chiseling open the lateral bone wall tissue of the nasal cavity, removing the nasal cavity tumor along with the adjacent turbinate; (7) Cleaning the surgical field, electrocautery; (8) Nasal cavity packing; (9) Incision suturing. Generally, the four surgical steps of skin incision, bone removal, lateral nasal wall incision, and electrocautery are most likely to cause pain. Before skin incision, local injection of saline (with a little adrenaline) can be used to reduce bleeding. When cleaning the surgical field and removing bone, 1～2% tetracaine cotton pads can be placed in the nasal cavity for pain relief. During electrocautery, the current should not be too large, and after quick electrocautery, gauze strips should be packed and sutured.
Due to the large incision area of the nasal lateral incision surgery, the rich blood supply in the head and face area makes it prone to bleeding. During surgery, the head should be tilted back to prevent blood from flowing into the throat through the posterior nasal aperture and choking into the trachea. Pay attention to the patency of the respiratory tract. When incising the nasal cavity, it is advisable to place gauze strips at the posterior nasal aperture and frequently suction.