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acupuncture

Acupuncture

Although acupuncture has existed for over 2000 years, its application as an anesthetic aid began in the 1950s in China. The first surgical procedure performed under acupuncture anesthesia was a tonsillectomy. Soon thereafter, major and minor surgical procedures took place with electroacupuncture alone providing the anesthesia. The procedures performed were diverse, ranging from cardiothoracic surgery to dental extractions. Usage of acupuncture anesthesia, specifically in neurosurgery, has been well documented in hospitals across China, especially in Beijing, dating back to the 1970s.

Sidhu et al., present a case of a 65-year-old man who presented with right-sided body weakness. He had a past medical history of uncontrolled diabetes mellitus, hypertension, and obstructive sleep apnea requiring use of a nasal continuous positive airway pressure device during sleep. We performed a computed tomography brain scan, which revealed a left-sided acute on chronic subdural hemorrhage. Due to his multiple comorbidities, we decided to perform the surgical procedure under electroacupuncture anesthesia. The aim of this case report is to describe a craniotomy performed under electroacupuncture on an elderly patient with multiple comorbidities who was awake during the procedure and in whom this procedure, if it had been performed under general anesthesia, would have carried high risk 1).


Acupuncture can be an option in the treatment of idiopathic trigeminal neuralgia ITN due to its analgesic effect in both ITN and secondary myofascial pain syndrome associated with it 2).


A total of 539 patients with hemifacial spasm (HFS) underwent MVD treatment in the Xinhua Hospital between January 2014 and June 2017. Among them, 83 patients had received botulinum toxin (BT) injection before surgery and were recorded as BT group. Eighty-three patients underwent acupuncture before surgery and were recorded as acupuncture group. Five patients received both BT injection and acupuncture before surgery and were recorded as mixed group. A total of 368 patients who had not received any treatment before surgery were recorded as simple MVD group. Zhang et al. calculated the immediate and long-term remission rates after surgery. Abnormal Muscle Response (AMR) and Compound Motor Action Potential (CMAP) monitoring were routinely performed during surgery.

Immediate remission rate after surgery was 96.4% (80/83) in BT group, 100% (83/83) in acupuncture group, 100% (5/5) in mixed group, and 95.1% (350/368) in simple MVD group, and the immediate remission rate of BT group is significantly higher than that of simple MVD group (p = 0.04). Long-term remission rate: the remission rates of the four groups were 94.0% (78/83), 97.6% (81/83), 100.0% (5/5) and 92.7%(341/368), respectively, and there is no statistical difference between them (p > 0.05). The amplitude of one branch or several branches of CMAP on the affected side was lower than the healthy side in BT or acupuncture treatment patients.

A preoperative BT injection or acupuncture treatment do not reduce the postoperative remission rate of HFS patients treated with MVD, and the amplitude of CMAP on the affected side was lower than the healthy side. 3).

References

1)
Sidhu A, Murgahayah T, Narayanan V, Chandran H, Waran V. Electroacupuncture-Assisted Craniotomy on an Awake Patient. J Acupunct Meridian Stud. 2017 Jan;10(1):45-48. doi: 10.1016/j.jams.2016.06.005. Epub 2016 Sep 15. PubMed PMID: 28254101.
2)
Ichida MC, Zemuner M, Hosomi J, Pai HJ, Teixeira MJ, de Siqueira JTT, de Siqueira SRDT. Acupuncture treatment for idiopathic trigeminal neuralgia: A longitudinal case-control double blinded study. Chin J Integr Med. 2017 Nov;23(11):829-836. doi: 10.1007/s11655-017-2786-0. Epub 2017 Oct 28. PubMed PMID: 29080198.
3)
Zhang WB, Min LZ, Zhong WX, Tao BB, Li B, Sun QY, Wang XQ. Surgical effect and electrophysiological study of patients with hemifacial spasm treated with botulinum toxin or acupuncture before microvascular decompression. Clin Neurol Neurosurg. 2019 Jul 12;184:105417. doi: 10.1016/j.clineuro.2019.105417. [Epub ahead of print] PubMed PMID: 31351214.
acupuncture.txt · Last modified: 2019/07/28 10:24 by administrador