1965年11月中旬

我院首次选用针刺麻醉进行开颅手技获得成功。10余年来

通过大量的临床实践。对各种不同部位的开颅手术

从穴位的筛选、刺激条件、辅助用药、手术操作的改进

到病人个体差异的调查等方面

做了一些工作

摸索出了一套比较完整的针麻开颅常规。至1979年6月底

共做针麻开颅手术2

017例

病种达30余种。实践证明

针麻应用于颅脑外科手术

主要优越性为病人神志清醒、生理功能保持正常

有1. In Beijing Xuan Wu Hospital

the first case of craniotomy under acupuncture anesthesia (A. A.)was successfully performed on November 18

1965. By the end of June 1979

2

017 cases of craniotomiesunder A. A. have been performed based on a great deal of clinical practice

craniotomies in variousregions

selection of suitable puncture points

choice of parameters of stimulation

the use of adjuvantdrugs

improvement of operative techniques and individual variability are discussed

and those factorsinfluencing the results of A. A. are studied and analyzec as well. 2. As to the results of operation under A. A. in cases of intracranial space-occupying lesions invarious regions

the percentage of excellence (excellent rate) was 82.07% in the cases in the frontal re-gions; the excellent rate in cases of acoustic tumours was 82% with early recovery and less postopera-tive complications in spite of the difficulties in the operation and deep location of the tumours

involv-ing the vital centers in the brain stem

for these tumours A. A. has been the method of choice of analge-sia so far. 3. It was found to be most important to select. patients in order to get good results of A. A. In 1972

474 patients for operation under A. A. were chosen according to their individual variabilityand in 70-80% the effect forecast of A. A. proved to be correct. Then in 1973

120 patients were chosenaccording to their skin-electricity

pain-threshold

cortioal function status and pattern dialecticallyclassified in the view of Chinese Traditional Medicine

the results of effect fore-cast was the same. Ifthe conditions for A. A. are improved

better results can be obtained. Good results should be expected in following conditions: (a) if the patient's cortical function status is stable and sound; (b) in patients with high pain-threshold; (c) in cases of "kidney deficiency" type

especially yang dificiency type according to the dialecticclassification in Chinese Traditional Medicine; (d) in patients eagerly desireing operation and being willing to accept A. A. and psychologicalcalm and quiet. 4. Troubles mostly often encountered in operation under A. A.: (a) imcompleteness of analgesia at the side of the scalp incision; (b) reactions to traction of the intracranial structures; (c) reactions to low intracranial pressure; (d) when the intracranial pressure is too high for the dura to be incised; (e) problems connected with bleeding and blood transfusion; (f) uncomfortable position. To all these problems attention should be paid as soon as possible. 5. Complications (incomplete statistics): (a) fainting during needling (collapse) 3 cases; (b) transient unconciousness during the exposure of the brain stem 3 cases; (c) intraoperative inhalation of vomitus in one case

when fasting was not observed. (d) epileptic seizures during operation 5 cases; (e) shock caused by severe bleeding and delayed blood transfusion 8 cases; (f) restlessness

uncooperative movements caused by unbearable position and prolonged operation6 cases; (g) complicatious in group under A. A. and in group under drug anesthesia (each 50 cases foracoustic nerves tumours): (I) In group under drug anesthesia there were 3 cases with lung infection

5 cases with brain stemdamage and one case with secondary postoperative intracranial haemorrhage. (2) In group under A. A.

there was postoperative intracranial haemorrhage in one case and a mild lung infection in one case. (3)Before 1965 the percentage of cases of preservation of VII nervous was 49%

but in 1971

it was 72.1%.This increase of the percentage was due to the introduction of A. A. 6. In the end the authors point out that A. A. is one kind of the modern methods of anaesthesia

but can not replace all the other methods

and there are still several problems which should be studiedproperly. For more serious cases and prolonged operations andandfor those patients who are nervous and poor-ly tolorate pain it is better to use the combined A. A. (i. e. to use 150 ml of 0.1% Procaine for infiltra-tion of the scalp at the side of incision and to give tranquillizers in adequate dosage) in order to getbetter results. This combined method is worth recommending to improve the effects of A. A. and spreadits application

as it can be readily accepted by both patients and surgeons.