[Clinical application of combined acupuncture-drug anesthesia with isoflurane-induced hypotension in cerebral operation].

OBJECTIVE

To evaluate the feasibility of combined acupuncture-isoflurane anesthesia with deliberated and controlled hypotension induced by isoflurane for the neurosurgical patients.

METHODS

Forty-two patients with brain tumor scheduled for selective surgery according to the methods of anesthesia, they were further divided into isoflurane anesthesia (group I, n = 21) and combined acupuncture-isoflurane anesthesia (group II, n = 21). Anesthesia was induced with fentanyl, sodium pentothal and phi avolon intravenously administered. The concentration of isoflurane was elevated to reduce mean arterial pressure (MAP) 30%-40% during dissection and occlusion of the tumor. Compare with the hemodynamic parameters (CO, CI, SV, SI, SVR, LVSWI, RPP) which were measured with Swan-Ganz technique before, during and after isoflurane-induced hypotension. In group II, during tracheal intubation the acupoint of Quanliano (SI 18), Yuyao (EX-HN4), Fengchi (GB 20) and Hegu (LI 4) were stimulated by Han's Acupoint Nerve Stimulator. Meanwhile, the isoflurane was inhalated to maintain anesthesia.

RESULTS

As compared with group I, concentration of isoflurane decreased significantly, and isoflurane average dosage per hour reduced by 31%-42% in group II. SVR, PVR, RPP were significantly decreased in the duration of hypotension (P < 0.05). The range change of CO, CI, SV, SI, LVSWI, RPP during controlled hypotension was significantly lower in combined acupuncture-isoflurane anesthesia than that in isoflurane anesthesia (P < 0.05).

CONCLUSION

Combined acupuncture-isoflurane anesthesia with isoflurane induced hypotension was used as a selective way for deliberated and controlled hypotension to the neurosurgical patients.