Vagus nerve damage
Vagus nerve is the tenth cranial nerve, located behind the internal jugular vein. Mainly parasympathetic fibers, located in the neck, chest, abdomen, internal organs and body surface. Especially distributed in the heart, lungs and other vital organs, acupuncture improperly, can cause severe vagal reaction. Severe cases, even cause cardiac arrest. Can also be due to stimulation of carotid sinus caused by carotid sinus syndrome. About acupuncture vagus nerve damage caused by improper reported seen in 1972 [1].
[Injury]
An acupoint reasons: lessons learned from a clinical perspective, most likely to lead vagal reactions are Futu and people welcome points. There are also reports, Yifeng also hurt due to improper acupuncture vagus nerve.
Futu anatomical projection is equivalent to cervical plexus, deep plexus is a motor nerve and with the sympathetic, parasympathetic form a network of complex anastomosis vagus nerve also considerable parts of the downlink. Deep Yifeng also vagus nerve distribution. People met for the carotid sinus cavity deep, the deepest sympathetic trunk lines, lateral descending branch of the hypoglossal nerve and vagus nerve. Carotid sinus stimulation of acupuncture improper carotid sinus reflex can cause allergies.
Second, the reason for the action: Multi-deep puncture caused by excessive, such as Yifeng, generally not easy to stab the vagus nerve, just over two inches or more in depth may have thorns. Others, such as people welcome point, early in the “Acupuncture and B by” in that said: “piercing the quarter, too deeply unfortunate murder.” In addition, put plug Twist way too heavy, or power is too large, too frequently, are likely to cause vagal reactions or carotid sinus syndrome.
Clinical manifestations
A vagus nerve damage. Mainly as visceral disorders: such as inhibition of cardiac activity, resulting in decreased heart rate, heart rate, and even arrest; coronary vasoconstriction, cardiac insufficiency, blood pressure, and even shock; bronchial smooth muscle spasm, causing breathing difficulties and even suffocation, gastrointestinal motility increase causes heart patient discomfort, nausea Yu Tu, still pale, sweating, fainting and other symptoms.
Second, the carotid sinus syndrome. The onset of three forms: a vagus type. There reflex bradycardia or atrioventricular block, or both exist, due to systolic dysfunction reflex caused by cerebral insufficiency cause syncope, the most common type; 2, vacuum type. A significant drop in blood pressure without bradycardia or atrioventricular block; 3, the central type: None of these symptoms, only a short syncope.
[Prevention]
Whether the patient should first understand the carotid sinus reflex allergies. Some people advocate for preventive examinations, the method is: the patient supine, relax the neck skin, head turned to check the opposite side, with the thumb or index finger in the human side of welcome points on the pressure to the spine, the first push back to the other side side, where there is intermittent heartbeat, slow heart rate, blood pressure, or pale, etc., immediately stop the presses. This phenomenon occurs as people greet or Futu can not acupuncture points. However, such tests can not be used indiscriminately, bilateral pressed simultaneously are even prohibited, because often lead to cardiac arrest, cerebral embolism or death consequences.
Secondly, no carotid sinus reflex allergies, under normal circumstances Futu hole and people met and it is not deep puncture hole, but can not use heavy tactics. Pulsed electrical stimulation, the current strength is not too strong, the frequency should not be too fast.
[Processing Method]
If there vagal reactions or carotid sinus syndrome, general shall immediately needle injection. As in acupuncture anesthesia, the retreat to the shallow and reduce needle stimulation frequency, lower current intensity, the patient supine. At the same time, can be used for the following treatments: right vagus reaction was, could intramuscular atropine, or propantheline therapy, appropriate intravenous injection of 50% glucose. If syncope associated with decreased blood pressure only without arrhythmia, available epinephrine intramuscularly.