上腹部手术中最常见的手术是胃大部切除术

这种手术最常用的麻醉方法在国内是连续硬膜外阻滞

但施行这种麻醉方法发生低血压的机会甚多

提示硬膜外阻滞对循环动力学的影响。自针麻施行于胃大部切除The commonest method of anaesthesia in epigastric surgery in China is the continuous epidural anaesthesia

which has a rather strong effect on the hemodynamics of the patient with a high occurrence of hypotension

whereas acupuncture gives a quite different clinical picture. To make a further comparison of the effects of acupuncture anaesthesia and of epidural anaesthesia on hemodynamics in patients undergoing upper abdominal surgery

30 subtotal gastrectomy patients were selected and the changes in ballistocardiogram

phonocardiogram

plethysmogram and other data were recorded before and after induction of acupuncture anaesthesia and epidural anaesthesia and the results analyzed. Acupuncture stimulus was applied at the Zhiyang point. Epidural anaesthesia was sustained

giving an anaesthetized area extending proximally to T 4-5 and distally to T10-11. Resultes: After the induction of acupuncture anaesthesia

an increase was seen in dz/dt amplitude

heart stroke volume

cardiac indices

and the frequency of plethysmographic wave

while the amplitude of plethysmographic wave at the ventricular ejection time and the loudness of heart sound did not show any marked change. Following epidural anaesthesia

dz/dt amplitupe was lowered

heart stroke voltme and cardiac indices decreased

ventricular ejection time shortened

the amplitude of plethysmgraphic wave increased

and the heart sound accentuated

but the change in frequency of the plethysmotraphic wave was inconspicuous. Conclusion: Epidural anaesthesia has a striking effect on the hemodynamics of the patient

and factors including the reduction of heart stroke volume and the dilatation of peripheral blood vessels resulted in the fall of the patient's blood pressure. However

acupuncture anaesthesia has rather a stimulating effect on circulatory functions; in spite of the mild dilatation of peripheral blood vessels

the heart stroke volume is markedly increase in blood pressure

and hence

acupuncture anaesthesia proves to be advantageous in patients with relatively poor circulatory functions.