71例病员均系喉癌患者

其中男性65例

女性6例

有工人、农民

干部和知识分子

以农民为最多。年龄最大者69岁

最小者29岁

以45～60岁者为多。71例中均行全喉摘除术

其中全喉摘除加成形术者16例。方法术前准备:按喉科常规准备

并给病人介绍针麻的优点及各个手术步骤的感觉

解除病员顾虑

术中与医生合作。术前45分钟常规肌注鲁米那0.1克

分泌物较多的病员术前肌注阿托品0.3～0.4毫克。 Total laryngectomy is a complicated operation in the neck region thatcould not be done properly under local anaesthesia.Formerly these opera-tions were done in our hospital under ether anaesthesia.Ether was giventhrough tracheostomy by a canula

but the operative field was much inter-fered both to the anesthesiologist and the surgeon.Furthermore

afterether anaesthesia

cough and other respiratory reflexes were somehow inhibited and retarded the clear-out of the excretion of the lower respira-tory tract and thus facilitated infection.This is why we prefer acupunc-ture anaesthesia for total laryngectomy. The data presented in this paper were from a study of 71 patients suffering from laryngocarcinoma.Total laryngectomies under acupunctur anaesthesia were done on all these patients and additional operations of laryngoplasty were carried out on 16 of them .In 69 out of 71 cases

acu-puncture anaesthesia may be deemed as successful according to the criteria set up in 1975

and among the 69 successful cases

43 cases(61%)may be classified as grade 1

15 cases(21%)as grade 11

and 11 cases(15%)as grade Ⅲ。 Four different sets of acupuncture loci

i

e.

Hegu and Futu

Simple Futu

Hegu and Xiayifeng

and Hegu and Neiguan have been tested on different patients

but as far as anesthetic effect is concerned

there seems to be no difference .For loci close to the operating fields

the frequency of electrical stimulation ranged from 1一100 Hz and for these far from the operating field

the frequency were of 2-8 Hz.As a rule

0.1 gm of lumi-nal and 1 mg of dolantin per '_;g body weight were given before operation.For nervous patients.5一6 ml of 0.25

procain were applied along the incision line locally and at the time of opening the larynx or trachea

2一4ml of dicaine were sprayed in the trachea in order to prevent coughing. In this paper

the age and profession of the patient

the duration of the operation and the induction period for anaestheesia

blood pressur。and pulse rate二一ere correlated with the effectiveness of acupuncture anaesthesia .It was found that blood pressure and pulse rate of the patient during operation was somehow in relation with the effectiveness of acupuncture anaestheia

while other factors seemed to be unrelated.The blood pressure and pulse rate of most of the effectively anaesthetized Patients usually maintained at a somewhat higher

but stable level

i.e.

varied within 20 mmHg

while in most of the poorly anesthetized patients

their blood pressure and pulse rate varied greatly during operation. In short

the present work suggests that acupuncture anaesthesia seems to be applicable to total laryngectomy and that the blood pressure and pulse rate of the patient during operation may be used as indicatives of the effectiveness of acupuncture anaesthesia.