Transcutaneous
cranial electrical stimulation with Limoge's currents (TCES) consists of high
frequency, low intensity currents which decreased anesthetic requirements during
elective surgery. This action is likely to be mediated by the release of central
endogenous opioids. In a DB PC study of39 ASA physical status I and II patients
undergoing elective abdominal surgery, just before induction of anesthesia,
patients were connected to the electrical stimulator and randomly allocated to
be either stimulated or control during surgery. Postoperatively, patients were
given a patient-controlled analgesia (PCA) device delivering buprenorphine for
the first four postoperative hours. Buprenorphine usage was significantly
reduced in the TCES group versus the control group (2.36 vs 3.43 mcg/kg/hr; P =
0.002). Intraoperative isoflurane anesthetic requirements, as well as hourly
postoperative scores for pain and sedation, were the same for the two groups.
Transcutaneous cranial electrical stimulation (Limoge's currents) decreases
early buprenorphine analgesic requirements after abdominal surgery. Mignon A, et
al. Hospital Bichat, Paris, France. Anesth Analg 1996 Oct;83(4):771-5.
The
effectiveness of electronic dental anesthesia in children.
teDuits
E, Goepferd
S, Donly
K, Pinkham
J, Jakobsen
J.
University of Iowa College of Dentistry, Iowa City.
This study compared the effectiveness of traditional local anesthesia with a
Transcutaneous Electrical Nerve Stimulation unit that controls pain via
electronic dental anesthesia for restorative dental procedures in 6- to
12-year-old children. The sample included 27 children who had two antimere teeth
that required restorations of similar size (preventive resin restorations). In
each case, the cavity preparation extended into dentin. One of the teeth was
treated with conventional local anesthesia and the other with EDA. Selecting
which tooth and which method to complete first was done randomly. Both
restorations were done at the same appointment. Throughout the procedure, the
child was asked to assess the level of discomfort using the Eland Color Scale,
which allowed the children to draw on their past painful experiences to judge
the level of pain they perceived. The patients demonstrated no overall
significant difference in pain perception between the two modalities of
treatment, regarding dentin sensitivity and rubber dam clamp replacement. When
asked which method they preferred after the study, 78% of the patients chose EDA
over local anesthesia. Pediatr Dent 1993 May-Jun;15(3):191-6.
Combined
electroanesthesia: a nontraditional method of anesthesia in pediatric
neurosurgery]
[Article in Russian]
Mal'kovskaia
EV, Gudumak
EM, Salalykin
VI, Iova
AS, Aksentiuk
VI, Petraki
VL, Shiriaeva
NV.
A combination of electrical anesthesia with calypsol and nitrous oxide has been
developed and used in neurosurgical operations performed to 142 children aged 8
days to 15 years, who were divided into two groups. Group 1 included 89 children
administered electrical anesthesia in combination with calypsol and nitrous
oxide, Group 2 consisted of 53 children, to whom only routine calypsol and
nitrous oxide anesthesia was administered. The Lennar apparatus was used to
administer electrical anesthesia. The adequacy of anesthesia was estimated on
the basis of the clinical data and laboratory findings. The results have shown
that a combination of electrical analgesia with calypsol and nitrous oxide
provided sufficient protection of a child from surgical stress, was not
associated with significant changes of the hypothalamo-hypophyseo-adrenal and
thyroid functions and permitted a significant reduction (by 80.8%) of the drug
load. Anestheziol Reanimatol 1993 May-Jun;(3):21-3.
Analgesic
effect of transcutaneous cranial electrostimulation in patients treated by
Nd:YAG laser for cancer of the rectum. A double-blind randomized trial]
[Article in French]
Naveau
S, Barritault
L, Zourabichvili
O, Champagne
C, Prieur
G, Limoge
A, Poynard
T, Chaput
JC.
Service d'Hepato-Gastroenterologie, Hopital Antoine-Beclere, Clamart.
The aim of this double blind cross-over randomized trial was to assess if
transcutaneous cranial electrical stimulation by Limoge current could decrease
the dose of fentanyl required in patients with rectal cancer treated by Nd:YAG
laser. Fifty patients, 29 women, 21 men, 78 +/- 10 years old (range: 53-96
years), were treated by 2 laser sessions with an interval of 48 hours between
each session. Active and sham electrostimulation were given in random order for
the 2 laser sessions. The major end point was the quantity of fentanyl injected
when the score of pain was greater than or equal to 5 according to a visual
analgesic scale. Age, sex, body weight, tumor location and length, tumor
circumferential extent and luminal patency, duration of laser session, amount of
energy delivered per session (watt-seconds), and number of patients with deep
sedation did not differ between the 2 groups. There was no interaction between
the order of treatments and the treatments. The mean quantity of fentanyl was 29
micrograms and 42 micrograms when sham electrostimulation was given. There was a
decrease of 31 percent in the quantity of fentanyl with active
electrostimulation (P less than 0.05). Results were not affected either by the
treatment order nor by tumor location. There were no side effects in either
group. Gastroenterol Clin Biol 1992;16(1):8-11.
Efficiency
of transcranial electrostimulation on anxiety and insomnia symptoms during a
washout period in depressed patients. A double-blind study.
Philip
P, Demotes-Mainard
J, Bourgeois
M, Vincent
JD.
UICA, Centre Hospitalier Specialise Charles Perrens, Bourdeaux, France.
In order to test the efficacy of cerebral electrostimulation (electrosleep) as
an alternative to drug therapy for the treatment of anxiety and insomnia, we
conducted a double-blind study in a sample of 21 depressed inpatients submitted
to a 5-day period of drug washout on admission to the psychiatric department.
During this withdrawal period, anxiety and insomnia were exacerbated in the
placebo group, whereas anxiety decreased and sleep duration improved in the
active treatment group, with a divergent evolution during the 5-day washout
period. The depressive criteria did not respond differentially to treatment,
however. Thus, the effects of this drug washout period are markedly attenuated
by cerebral electrostimulation, which is of possible interest in the management
of psychotropic drug withdrawal. Biol Psychiatry 1991 Mar 1;29(5):451-6.
Non-medicamentous
treatment of labor pain by electrostimulation]
[Article in German]
Kubista
E.
Methods of electric stimulation have been tested for their effect on labour pain
during delivery. Beside the central (cerebral) electric stimulation
electro-acupuncture and transcutaneous electric stimulation have been used.
Because of the only moderate results and the difficulties in clinical handling
electro-acupuncture is not very usefull for pain reduction during child birth.
Central stimulation and transcutaneous stimulation brought relief of pain in
about 60% of the 209 patients treated with these methods in addition to a
significant reduction of the labour period. No side effects on mother or child
were observed. Zentralbl Gynakol 1985;107(9):532-8
Transcutaneous
cerebral electric stimulation by Limoge current during labor]
[Article in French]
Champagne
C, Papiernik
E, Thierry
JP, Noviant
Y.
In order to test the analgesic efficacy of Anesthelec (transcutaneous cranial
electrical stimulation with Limoge currents) during labour and delivery, a
double blind study was performed in 20 cases for whom analgesia was necessary.
In 10 cases Anesthelec was used with the Limoge currents on and in 10 cases as a
sham. Labour and delivery were carried out by a medical team different from that
which set up the Anesthelec. The results showed that this method, with or
without nitrous oxide inhalation, decreased by 80% the number of epidural and
general anaesthesias that would otherwise have been unavoidable. To define the
effects of this new method, maternal and foetal parameters of 50 deliveries
carried out under Anesthelec were compared with 50 deliveries carried out under
epidural analgesia. Anesthelec was used only if analgesia was required. This
study was a retrospective comparison between two similar non paired series.
Despite the fact that analgesia obtained with Anesthelec was less powerful than
with epidural analgesia, this method showed many advantages: total safety for
the child and the mother, easy utilization, shorter labour time, decreased
number of instrumental extractions and potentially reduced costs. Good
acceptance and satisfaction for the mother should allow a rapid evolution of
this new method. Ann Fr Anesth Reanmin 1984;3(6):405-13.
Transcutaneous
cranial electrical stimulation decreases narcotic requirements during neurolept
anesthesia and operation in man.
Stanley
TH, Cazalaa
JA, Atinault
A, Coeytaux
R, Limoge
A, Louville
Y.
The influence of transcutaneous cranial electrical stimulation (TCES) on
fentanyl requirements was evaluated in 50 patients undergoing urologic
operations with pure neuroleptanesthesia (droperidol, diazepam, fentanyl, and
air oxygen) with (group I) or without (group II) simultaneous TCES. All patients
had silver electrodes (three) applied between the eyebrows and behind each
mastoid process and attached to a 167-kHz current generator. Current was
delivered only to group I. The wave form was a complex nonsinusoidal, nonsquare
wave pattern which was applied intermittently in a 3-msec-on 10-msec-off
sequence. All patients had anesthesia induced with droperidol (0.20 mg/kg IV),
diazepam (0.2 mg/kg IV), and pancuronium (0.08 mg/kg IV), and, after tracheal
intubation, had anesthesia maintained with fentanyl in 100-microgram intravenous
increments every 3 minutes whenever and as long as systolic arterial blood
pressure and/or heart rate were greater than 20% of control (preanesthetic
induction) values. Fentanyl requirements averaged 6.1 +/- 0.5 and 7.9 +/- 0.4
microgram/kg/min for a mean total dosage of 9.0 +/- 0.9 and 12.5 +/- 0.8
microgram/kg for the entire operation in groups I and II, respectively. These
differences between groups were statistically significant (p less than 0.05).
The data demonstrate that TCES augments the analgesic effects of fentanyl and
thus reduces fentanyl requirements during urologic operations with
neuroleptanesthesia. Anesth Analg 1982 Oct;61(10):863-6.
Percutaneous
electrical nerve stimulation: a novel analgesic therapy for diabetic neuropathic
pain.
Hamza
MA, White
PF, Craig
WF, Ghoname
ES, Ahmed
HE, Proctor
TJ, Noe
CE, Vakharia
AS, Gajraj
N.
Eugene McDermott Center for Pain Management, Department of Anesthesiology and
Pain Management, University of Texas Southwestern Medical Center at Dallas,
75235, USA.
OBJECTIVE: To evaluate the use of percutaneous electrical nerve stimulation
(PENS) in the management of patients with painful diabetic peripheral
neuropathy. RESEARCH DESIGN AND METHODS: A total of 50 adult patients with type
2 diabetes and peripheral neuropathic pain of >6 months duration involving
the lower extremities were randomly assigned to receive active PENS (needles
with electrical stimulation at an alternating frequency of 15 and 30 Hz) and
sham (needles only) treatments for 3 weeks. Each series of treatments was
administered for 30 min three times a week according to a standardized protocol.
After a 1-week washout period, all patients were subsequently switched to the
other modality. A 10-cm visual analog scale (VAS) was used to assess pain,
physical activity, and quality of sleep before each session. The changes in VAS
scores and daily requirements for oral analgesic medication were determined
during each 3-week treatment period. Patients completed the MOS 36-Item
Short-Form Health Survey (SF-36), the Beck Depression Inventory (BDI), and the
Profile of Mood States (POMS) before and after completion of each treatment
modality. At the end of the crossover study, a patient preference questionnaire
was used to compare the effectiveness of the two modalities. RESULTS: Compared
with the pain VAS scores before active (6.2 +/- 1.0) and sham (6.4 +/- 0.9)
treatments, pain scores after treatment were reduced to 2.5 +/- 0.8 and 6.3 +/-
1.1, respectively. With active PENS treatment, the VAS activity and sleep scores
were significantly improved from 5.2 +/- 1.0 and 5.8 +/- 1.3 to 7.9 +/- 1.0 and
8.3 +/- 0.7, respectively. The VAS scores for pain, activity, and sleep were
unchanged from baseline values after the sham treatments. Patients' daily oral
nonopioid analgesic requirements decreased by 49 and 14% after active and sham
PENS treatments, respectively. The post-treatment physical and mental components
of the SF-36, the BDI, and the POMS all showed a significantly greater
improvement with active versus sham treatments. Active PENS treatment improved
the neuropathic pain symptoms in all patients. CONCLUSIONS: PENS is a useful
nonpharmacological therapeutic modality for treating diabetic neuropathic pain.
In addition to decreasing extremity pain, PENS therapy improved physical
activity, sense of well-being, and quality of sleep while reducing the need for
oral nonopioid analgesic medication. Diabetes Care 2000
Mar;23(3):365-70.
Percutaneous
electrical nerve stimulation (PENS) is a novel electroanalgesic therapy that
combines the advantages of both TENS and electro acupuncture by using
percutaneously placed disposable acupuncture-like needle probes to stimulate
peripheral sensory nerves innervating the region of neuropathic pain. This
therapy has recently been reported to be highly effective in the short-term
management of a wide variety of acute and chronic pain syndromes (9–13). The
needles were placed 1-3 cm into the lower legs at different locations.
Evaluation
of electroacupuncture treatment of horses with signs of chronic thoracolumbar
pain.
Xie
H, Colahan
P, Ott
EA.
Department of Large Animal Clinical Science, College of Veterinary Medicine,
University of Florida, Gainesville, FL 32610-0136, USA.
OBJECTIVE: To evaluate use of electroacupuncture for treatment of horses with
signs of chronic thoracolumbar pain. DESIGN: Prospective study. ANIMALS: 15
horses with signs of chronic thoracolumbar pain. PROCEDURE: Horses were randomly
allocated to 1 of 3 treatment groups. Horses in group 1 received
electroacupuncture stimulation (once every 3 days for 5 treatments), those in
group 2 received phenylbutazone (2.2 mg/kg [1 mg/lb], PO, q 12 h, for 5 days),
and those in group 3 received saline (0.9% NaCl) solution (20 mL, PO, q 12 h,
for 5 days). Thoracolumbar pain scores (TPSs) were evaluated before (baseline)
and after each treatment. RESULTS: Mean +/- SE TPSs in horses receiving
phenylbutazone or saline solution did not change significantly during the study.
After the third treatment, mean +/- SE TPS (2.1 +/- 0.6) in horses receiving
electroacupuncture stimulation was significantly lower than baseline (6.0 +/-
0.6) TPS. Mean +/- SE TPSs in horses receiving electroacupuncture stimulation
were significantly lower than baseline TPSs and TPSs in horses receiving
phenylbutazone or saline solution after the third treatment to 14 days after the
last treatment. CONCLUSIONS AND CLINICAL RELEVANCE: TPSs are useful for
evaluating the efficacy of various analgesic methods used for treatment of
thoracolumbar pain in horses. Electroacupuncture was effective for treatment of
chronic thoracolumbar pain in horses. Results provided evidence that 3 sessions
of electroacupuncture treatment can successfully alleviate signs of
thoracolumbar pain in horses. The analgesic effect induced by electroacupuncture
can last at least 2 weeks. Phenylbutazone administered PO did not effectively
alleviate signs of thoracolumbar pain in horses in this study. J Am Vet Med
Assoc 2005 Jul 15;227(2):281-6.
Transcutaneous
electrical acupoint stimulation versus ondansetron in the prevention of
postoperative vomiting following pediatric tonsillectomy.
Kabalak
AA, Akcay
M, Akcay
F, Gogus
N.
Department of Anesthesiology and Reanimation, Numune Education and Research
Hospital, Ankara, Turkey. drayla2002@yahoo.com
OBJECTIVES: Postoperative retching and vomiting is an important cause of
morbidity that may lead to patient discomfort, distress, and complications.
Stimulation of acupuncture points has been shown to be effective in the
prevention as well as treatment of PONV. The current treatments of choice are
the 5-hydroxytryptamine type 3-antagonists, such as ondansetron. We aimed to
evaluate the efficacy and side-effects of either transcutaneous electrical
acupoint stimulation (TEAS) or Ondansetron compared to a control group receiving
no treatment in the prevention of postoperative retching and vomiting. SUBJECT
AND DESIGN: This randomized, controlled, prospective study was carried out in a
group of 90 children (in three equal randomly assigned groups), aged between 4
and 12 who underwent tonsillectomy under general anesthesia. In the first group,
electrical stimulation via surface electrodes on acupoints Neiguan and Shangwan
was performed (20 Hz, 5 minutes). The second group received a single dose of
Ondansetron (0.15 mg . kg(-1)). No treatment was given to the control group.
OUTCOME MEASURES: The frequency of retching and vomiting attacks and
side-effects were noted on the day of surgery in the postanesthesia care unit
and the day surgery care unit, on the day of surgery after discharge, and on the
first day after surgery. A satisfaction scale was completed by each family.
RESULTS: There was a significant difference between the treatment groups and the
control group in the incidence of emetic episodes occurring in the day surgery
care unit and on the day after discharge (p < 0.001). In the ondansetron
group, side-effects were seen in more patients than in the other groups (p <
0.001). The satisfaction scores of the parents were greater in the treatment
groups than in the control group (p < 0.05). CONCLUSION: Application of TEAS
on sedated children is an easy, painless, reliable and effective method for the
prophylaxis of postoperative retching and vomiting in pediatric tonsillectomy. J
Altern Comple Med 2005 Jun;11(3):407-13.
Electroacupuncture
in obese women: a randomized, controlled pilot study.
Hsu
CH, Hwang
KC, Chao
CL, Chang
HH, Chou
P.
Community Medicine Research Center and Institute of Public Health, National
Yang-Ming University, Taipei, Taiwan.
OBJECTIVE: To compare the effects of electroacupuncture and sit-up exercise on
reducing body weight (BW) and waist circumference (WC) among obese women.
METHODS: A randomized, controlled clinical trial was conducted from July 1,
2002, to June 30, 2003, in the outpatient department of Taipei Hospital, Taiwan.
The subjects were 72 obese women, with WC>90 cm and body mass index
(BMI)>30 kg/m2 and who had not received any other weight control maneuver
within the prior 3 months. The subjects were randomly divided into groups A, B,
and C. Group A (n=22) received electroacupuncture, group B (n=20) was assigned
sit-up exercises, and group C (n=21) received no intervention. All three
treatments lasted for 6 weeks. The measurements of BW, BMI, and WC were
performed in the beginning and after 6 weeks. The data were compared and
expressed as percent reductions. RESULTS: Electroacupuncture showed
significantly greater percent reductions in BW (p=0.009, 0.004), BMI (p=0.008,
0.016), and WC (p=0.013, 0.006) compared with sit-up exercises or no
intervention. CONCLUSIONS: In this pilot study, electroacupuncture treatment was
more effective than situp exercise or no intervention in reducing BW, BMI, and
WC. J Women Health (Larchmt) 2005 Jun;14(5):434-40.
Effect
of scalp acupuncture on glucose metabolism in brain of patients with depression]
[Article in Chinese]
Huang
Y, Li
DJ, Tang
AW, Li
QS, Xia
DB, Xie
YN, Gong
W, Chen
J.
Department of TCM, Nanfang Medical University, Guangzhou 510515. tcmhuang@21cn.com
OBJECTIVE: To observe the effect of scalp acupuncture (SA) on the glucose
metabolism in different regions of brain in patients with depression by positron
emission computed tomography (PET). METHODS: Twelve depressive patients were
treated by scalp acupuncture on middle line of vertex (MS5), middle line of
forehead (MS1) and bilateral lateral line 1 of forehead (MS2), once a day for
six days per week, and received PET detection on different region of brain
before and after 6 weeks acupuncture treatment. Semiquantitative analysis was
used to compare the average values of radioactive count gotten from various
brain regions before and after treatment, which could reflect the condition of
glucose metabolism at the brain region detected. RESULTS: SA could increase the
glucose metabolism at bilateral frontal lobes, bilateral parietal lobes, right
occipital lobe, right caudate nucleus, right cingulated gyrus and left
cerebellum and decrease that at right temporal lobe and bilateral thalamus.
CONCLUSION: SA on MS5, MS1 and MS2 in depressive patients could influence the
glucose metabolism in various brain regions. It primarily illustrated that the
mechanism of SA in treating depression is related with its regulation on
cortex-limbic circuitry dysfunction and increase the glucose metabolism in
various brain regions. Zhongguo Zhong Xi Yi Jie He Za Zhi 2005
Feb;25(2):119-22.
Electroacupuncture
attenuates inflammation in a rat model.
Zhang
RX, Lao
L, Wang
X, Fan
A, Wang
L, Ren
K, Berman
BM.
Center for Integrative Medicine, School of Medicine, University of Maryland,
Baltimore, MD, USA.
BACKGROUND: Acupuncture has traditionally been used in China and is being
increasingly applied in Western countries to treat a variety of conditions,
including inflammatory disease. However, clinical trials investigating the
effectiveness of the anti-inflammatory effects of acupuncture have yielded
inconsistent results, and the underlying mechanisms of acupuncture-produced
anti-inflammation are unclear. OBJECTIVE: To evaluate the effectiveness of
electroacupuncture (EA) on inflammation in a rat model. MATERIALS AND METHODS:
Four experiments were conducted on male Sprague-Dawley rats (n = 8-9 per group).
Inflammation was induced by injecting complete Freund's adjuvant (CFA)
subcutaneously into the plantar surface of one hind paw of the rat. Experiment
1: To determine the effect of EA (10 and 100 Hz) versus sham treatment on
inflammation. Experiment 2: To investigate the involvement of the adrenal glands
on the effect of EA treatment using adrenalectomized (ADX) rats. Experiment 3:
To determine the effects of EA on plasma levels of corticosterone. Experiment 4:
To determine the effects of EA treatment versus immobilization on such stress
indicators as heart rate and blood pressure. RESULTS: At 10 Hz EA significantly
reduced CFA-induced hind paw edema. The effect was partially blocked in the ADX
rats. EA significantly increased plasma levels of corticosterone but produced no
noticeable signs of stress. CONCLUSION: At 10 Hz but not 100 Hz, EA suppresses
inflammation by activating the hypothalamus-pituitary-adrenal axis (HPA) and the
nervous system. J Altern Complement Med 2005 Feb;11(1):135-42.
Low-frequency
transcutaneous nerve stimulation in mild/moderate hypertension.
Kaada
B, Flatheim
E, Woie
L.
Rogaland Central Hospital, Stavanger, Norway.
Low-frequency peripheral nerve stimulation may induce widespread cutaneous and
muscular vasodilatation in animals and humans due to sympatho-inhibition. This
response has in humans been shown to be associated with a lowering of the
systemic vascular resistance and arterial pressure. In the present study the
effectiveness of low-frequency (2 Hz) transcutaneous electrical nerve
stimulation (TNS) has been examined in 46 patients, all 41-43 years of age, with
a primary diagnosis of uncomplicated mild/moderate hypertension (90-115 mmHg
diastolic pressure). The study was designed blind with matched controls in a TNS
group and a placebo group. The blood pressure was measured objectively with an
automatic monitor. In a short-term experiment TNS produced a significant
lowering of systolic, mean arterial, and diastolic pressures amounting to 8 mmHg
(P less than 0.01), 6 mmHg (P less than 0.01), and 4 mmHg (P less than 0.02),
respectively. In a long-term study, after 2 weeks of daily stimulation, a
similar depression was recorded with no stimulation on the day of examination.
An eventual clinical use of the depressor effect of TNS demands further clinical
research. Clin Physiol 1991 Mar;11(2):161-8.
Effects
of electroacupuncture of different frequencies on cerebral blood perfusion and
cerebral function in the patient of stroke]
[Article in Chinese]
Ouyang
G, Jia
SW, Wang
F, Shi
Y, Gao
Z.
Peking University Shenzhen Hospital, Guangdong 518036, China.
OBJECTIVE: To explore effects of electroacupuncture of different frequencies on
stroke. METHODS: Forty-seven cases of stroke were treated with
electroacupuncture at the motor region of the scalp and divided into 2 Hz, 2/15
Hz and 100 Hz groups according to the used frequency. Cerebral blood perfusion
and brain functions before and during electroacupuncture in the 3 groups were
investigated with single photon emission computed tomography (SPECT). RESULTS:
Local cerebral blood perfusion and brain cell functions could be improved by
electroacupuncture of the 3 frequencies, and the actions of 2/15 Hz and 100 Hz
were better. CONCLUSION: Electroacupuncture of 2/15 Hz and 100 Hz has a better
therapeutic effect on stroke when the stimulating intensity is fixed. Zhongguo
Zhen Jiu 2005 Nov;25(11):776-8.
Electroacupuncture
on PC6 (Neiguan) attenuates ischemia/reperfusion injury in rat hearts.
Tsou
MT, Huang
CH, Chiu
JH.
Institute of Traditional Medicine, National Yang-Ming University, Taipei,
Taiwan.
The use of somato-visceral regulation has been proposed as a treatment for a
wide range of diseases. The aim of this study was to test the hypothesis that
through somato-visceral regulation, ischemia-reperfusion (I/R) injury to the
myocardium can be avoided by electroacupuncture (EA) on PC6 (Neiguan).
Electroacupuncture on PC6 (Neiguan) was brought about by the application of
metal needles over the bilateral median nerve at a point 1.5 cm proximal to the
palm crease in male Spraque-Dawley rats. The animals were randomized into two
groups: (1) prevention group with preconditioning by the application of EA on
PC6 (n = 13); and (2) treatment group with EA on PC6 during I/R injury (n = 10).
The protection against myocardial injury was blocked by different mechanisms:
(1) severing of the bilateral median nerve (n = 10), (2) bilateral vagotomy (n =
10), and (3) intravenous naloxone injection (n = 10). The hemodynamic parameters
(mean artery pressure and heart rate), duration of arrhythmia, mortality rate
and cardiac enzymes were evaluated in these groups. The results showed that
there were significant reductions in cardiac enzymes, the duration of arrhythmia
and mortality rate in rats that were either preconditioned or treated with EA on
PC6, compared with those that did not undergo EA on PC6 (P < 0.05). The
cardioprotective effects were blocked by different procedures (P > 0.05). We
conclude that EA on bilateral PC6 (Neiguan) prevents and attenuates I/R injury
to the heart, and that this approach may provide an applicable and preventative
alternative for patients with ischemic heart disease. Am J Chin Med
2004;32(6):951-65.
Ketamine
enhances the efficacy to and delays the development of tolerance to
electroacupuncture-induced antinociception in rats.
Huang
C, Long
H, Shi
YS, Han
JS, Wan
Y.
Neuroscience Research Institute, Peking University, Key Laboratory of
Neuroscience, The Ministry of Education, 38 Xueyuan Road, Beijing 100083, China.
Our previous studies have shown that 100 Hz electroacupuncture (EA) produced
antinociception through the release of endogenous opioids (mainly dynorphin) and
the activated kappa-opioid receptors in normal rats. Acupuncture is an effective
treatment in relieving pain, but it develops tolerance after repeated
administration. It has been reported that N-methyl-D-aspartate (NMDA) receptor
antagonists could increase the antinociceptive effects induced by morphine and
delay the development of tolerance to morphine but nothing has yet been
described to reduce EA tolerance. Here we test whether ketamine, a
non-competitive NMDA receptor antagonist, would enhance 100 Hz EA
antinociception as well as prevent or delay the development of chronic tolerance
to 100 Hz EA in normal rats. The results are as follows: (1) ketamine injected
intraperitoneally (i.p.) 15 min prior to EA enhanced the antinociceptive effects
of 100 Hz EA at a dose of 5.0 mg/kg, but not 0.2 or 1.0 mg/kg. However, ketamine
at either dose did not affect the basal nociceptive threshold (represented by
tail-flick latency). (2) Ketamine at a dose of 5.0 mg/kg delayed the development
of chronic tolerance to 100 Hz EA antinociception. We conclude that ketamine can
enhance antinociception of 100 Hz EA and delay the tolerance to 100 Hz EA in
rats. These results suggest that the development of 100 Hz EA tolerance to
antinociception was mediated, at least in part, through peripheral NMDA
receptors, which may be useful in improving the therapeutic effects of EA in the
treatment of pain when EA tolerance occurs. Neurosci Lett 2005 Feb
28;375(2):138-42.
Electro-acupuncture versus conventional analgesia: a comparison of pain
levels during oocyte aspiration and patients' experiences of well-being after
surgery.
Gejervall
AL, Stener-Victorin
E, Moller
A, Janson
PO, Werner
C, Bergh
C.
Reproductive Medicine, Department of Obstetrics and Gynecology, Institute for
the Health of Women and Children, Sahlgrenska University Hospital, Goteborg
University, SE-413 45 Goteborg, Sweden. anne-louise.gejervall@vgregion.se
BACKGROUND: The primary aims were to compare the pain-relieving effect and
post-operative well-being between electro-acupuncture analgesia (EA) and
conventional analgesia (CA) comprising opiates. Further aims were to compare
time for mobilization, and costs for time and drug consumption. METHODS: In all,
160 women undergoing IVF were randomized, according to a computer-generated
list, to EA or CA. Well-being was evaluated with the State Trait Anxiety
Inventory (STAI). Pain and subjective expectations and experiences were recorded
on a visual analogue scale (VAS). Time and drug consumption were recorded.
RESULTS: Although VAS pain ratings were significantly higher at oocyte
aspiration (P < 0.0001) and after retrieval (P < 0.01) in the EA than in
the CA group, they were similar 60 min after surgery. Both groups had similar
STAI well-being scores. The EA group was significantly less tired and confused
than the CA group after oocyte aspiration. No significant differences in time
and costs for drug consumption were noted. CONCLUSION: EA cannot generally be
recommended as a pain-relieving method at oocyte aspiration but might be an
alternative for women desiring a non-pharmacological method. An advantage of EA
is less post-operative tiredness and confusion compared with CA. Hum Reprod
2005 Mar;20(3):728-35.
Electroacupuncture combined with indomethacin enhances antihyperalgesia in
inflammatory rats.
Zhang
RX, Lao
L, Wang
X, Ren
K, Berman
BB.
Center for Integrative Medicine, School of Medicine, University of Maryland,
Baltimore, MD 21201, USA.
Our previous study showed that electroacupuncture (EA), an adjuvant to
conventional medicine, significantly attenuated hyperalgesia and inflammation.
The present study is an evaluation of the potential synergism of EA and a
subeffective dosage of indomethacin (INDO) in a rat model. Inflammation and
hyperalgesia, manifesting as edema and decreased paw withdrawal latency (PWL) to
a noxious stimulus, were induced by injecting complete Freund's adjuvant (CFA)
subcutaneously into the plantar surface of one hind paw of the rat. EA
treatments were given at acupoint GB30 immediately and 2 h post-CFA. INDO at 2
mg/kg was given (intraperitoneally) 40 min before the second EA. PWL and edema
were measured prior to CFA and 2.5 and 5 h post-CFA. Ten and 100 Hz EA
significantly inhibited CFA-induced hind paw hyperalgesia. Both low- and
high-frequency EA combined with INDO enhanced antihyperalgesia compared to each
component alone, and 10 Hz but not 100 Hz EA significantly reduced CFA-induced
hind paw edema. A combination of low-frequency EA and INDO did not show
synergistic inhibitory effects on edema. The results demonstrate that EA
combined with INDO synergistically inhibits hyperalgesia and suggest an improved
treatment strategy for inflammatory pain. Pharmacol Biochem Behav 2004
Aug;78(4):793-7.
Inhibitory effect of electroacupuncture (EA) on the pressor response induced
by exercise stress.
Li
P, Ayannusi
O, Reid
C, Longhurst
JC.
Dept. of Medicine, University of California, Irvine Medical Science I, C235,
Irvine, CA 92697-4075, USA. pengli@uci.edu
We examined the effect of EA on the exercise stress-induced pressor response in
healthy adult subjects of both sexes. Each subject was subjected to a bicycle
exercise test using a ramp protocol once/week for three or four weeks. Subjects
were asked to perform the following tests in random order: 1) a baseline
exercise test without EA and 2) exercise after acupuncture at P 5-6, LI 4-L 7
and/or G 37-39 acupoints. Brachial systolic (SBP), diastolic (DBP), and mean
blood pressures (MBP), heart rate (HR) and the rate-pressure product (RPP,
systolic BP x HR/100) were measured every three min, while a 12 lead ECG was
monitored continuously. We observed increases in MBP, SBP, HR and RPP in all 17
subjects during exercise. In 12 of the 17 subjects (71 %), EA for 30 min before
exercise, either at Jianshi-Neiguan acupoints (P 5-6) or Hegu-Lique acupoints
(LI 4-L 7), led to an increase in maximal workload, and reduced peak SBP, MBP
and RPP responses to exercise; EA did not alter DBP or HR responses in these
subjects. EA at control acupoints (Guangming-Xuanzhong acupoints, G 37-39) in
five subjects did not alter the hemodynamic responses. Seven additional subjects
were enrolled to study the effect of EA during a bicycle exercise test using a
constant workload. The results were similar, in five of the seven subjects SBP,
MBP and RPP after exercise were attenuated significantly by EA at P 5-6. We
conclude that EA at specific acupoints improves exercise capacity and reduces
the hemodynamic responses in approximately 70% of normal subjects. Clin Auton
Res 2004 Jun;14(3):182-8.
Electroacupuncture for tension-type headache on distal acupoints only: a
randomized, controlled, crossover trial.
Xue
CC, Dong
L, Polus
B, English
RA, Zheng
Z, Da
Costa C, Li
CG, Story
DF.
RMIT Chinese Medicine Research Group, RMIT University, Bundoora, Victoria,
Australia.
OBJECTIVE: To investigate the efficacy of electroacupuncture, applied to distal
acupoints only, for tension-type headache. BACKGROUND: Electroacupuncture is
commonly used for tension-type headache, but when applied to distal acupoints
only, evidence of its efficacy is lacking. DESIGN: A randomized, single-blinded,
sham-controlled, crossover clinical trial. Methods.-The trial had 5 stages:
baseline (2 weeks), phases I and II (each 4 weeks), washout period (2 weeks),
and follow-up (3 months after phase II). Forty patients were randomly assigned
to either group A or group B. Group A received real electroacupuncture during
phase I, then sham electroacupuncture in phase II. Group B received the
treatments in reverse order. Outcome measures were headache frequency and
duration, pain intensity using a visual analog scale, mechanical pain threshold,
headache disability, and sickness impact. Data were analyzed by univariate 2-way
analysis of variance. RESULTS: Thirty-seven patients completed the trial. There
were no significant differences between the 2 groups at baseline. At the end of
phase I, group A, but not group B, demonstrated significant improvement in mean
(standard error of the mean [SEM]) headache frequency (3.0 per month [0.3]
versus 12.0 per month [1.7]), duration (13.3 hours [3.5] versus 32.0 hours
[6.2]), pain intensity (32.8 mm [4.1] versus 47.5 mm [2.7]), pain threshold
(right side, 2.9 kg/second [0.1] versus 0.9 kg/second [0.1]; left side, 2.4
kg/second [0.1] versus 1.1 kg/second [0.1]), headache disability score (6.0
[1.0] versus 16.3 [1.6]), and sickness impact score (288.7 [48.0] versus 687.1
[77.2]). For each parameter, significant differences also were demonstrated for
both groups between baseline and phase II, and baseline and follow-up. There
were no significant differences between the groups at the end of follow-up (P
>.05). CONCLUSION: Electroacupuncture to distal points alone is effective for
short-term symptomatic relief of tension-type headache. Headache 2004
Apr;44(4):333-41.
The short- and long-term benefit in chronic low back pain through adjuvant
electrical versus manual auricular acupuncture.
Sator-Katzenschlager
SM, Scharbert
G, Kozek-Langenecker
SA, Szeles
JC, Finster
G, Schiesser
AW, Heinze
G, Kress
HG.
Department of Anesthesiology and Intensive Care Medicine (B), Outpatient Pain
Center, University of Vienna, Vienna, Austria. sabine.sator@univie.ac.at
Acupuncture is an established adjuvant analgesic modality for the treatment of
chronic pain. Electrical stimulation of acupuncture points is considered to
increase acupuncture analgesia. In this prospective, randomized, double-blind,
controlled study we tested the hypothesis that auricular electroacupuncture (EA)
relieves pain more effectively than conventional manual auricular acupuncture
(CO) in chronic low back pain patients with insufficient pain relief (visual
analogue scale [VAS] > or = 5) treated with standardized analgesic therapy.
Disposable acupuncture needles were inserted in the auricular acupuncture points
29, 40, and 55 of the dominant side and connected to a newly developed
battery-powered miniaturized stimulator worn behind the ear. Patients were
randomized into group EA (n = 31) with continuous low-frequency auricular EA (1
Hz biphasic constant current of 2 mA) and group CO (n = 30) without electrical
stimulation (sham-electroacupuncture). Treatment was performed once weekly for 6
wk, and in each group needles were withdrawn 48 h after insertion. During the
study period and a 3-mo follow-up, patients were asked to complete the McGill
questionnaire. Psychological well being, activity level, quality of sleep, and
pain intensity were assessed by means of VAS; moreover, analgesic drug
consumption was documented. Pain relief was significantly better in group EA
during the study and the follow-up period as compared with group CO. Similarly,
psychological well-being, activity, and sleep were significantly improved in
group EA versus group CO, the consumption of analgesic rescue medication was
less, and more patients returned to full-time employment. Neuropathic pain in
particular improved in patients treated with EA. There were no adverse side
effects. These results are the first to demonstrate that continuous EA
stimulation of auricular acupuncture points improves the treatment of chronic
low back pain in an outpatient population. IMPLICATIONS: Continuous electrical
stimulation of auricular acupuncture points using the new point stimulation
device P-stim significantly decreases pain intensity and improves psychological
well-being, activity, and sleep in chronic low back pain patients. Anesth
Analg 2004 May;98(5):1359-64.
Comparison between electro-acupuncture and hydrotherapy, both in combination
with patient education and patient education alone, on the symptomatic treatment
of osteoarthritis of the hip.
Stener-Victorin
E, Kruse-Smidje
C, Jung
K.
Department of Physiology and Pharmacology, Goteborg University, Goteborg,
Sweden. elisabet.stener-victorin@fhs.gu.se
OBJECTIVES: The aim of the study was to evaluate the therapeutic effect of
electro-acupuncture (EA) and hydrotherapy, both in combination with patient
education or with patient education alone, in the treatment of osteoarthritis in
the hip. METHODS: Forty-five patients, aged 42-86 years, with radiographic
changes consistent with osteoarthritis in the hip, pain related to motion, pain
on load, and ache were chosen. They were randomly allocated to EA, hydrotherapy,
both in combination with patient education, or patient education alone. Outcome
measures were the disability rating index (DRI), global self-rating index (GSI),
and visual analogue scale (VAS). Assessments were done before the intervention
and immediately after the last treatment and 1, 3, and 6 months after the last
treatment. RESULTS: Pain related to motion and pain on load was reduced up to 3
months after last the treatment in the hydrotherapy group and up to 6 months in
the EA group. Ache during the day was significantly improved in both the EA and
hydrotherapy group up to 3 months after the last treatment. Ache during the
night was reduced in the hydrotherapy group up to 3 months after the last
treatment and in the EA group up to 6 months after. Disability in functional
activities was improved in EA and hydrotherapy groups up to 6 months after the
last treatment. Quality of life was also improved in EA and hydrotherapy groups
up to 3 months after the last treatment. There were no changes in the education
group alone. DISCUSSION: In conclusion, EA and hydrotherapy, both in combination
with patient education, induce long-lasting effects, shown by reduced pain and
ache and by increased functional activity and quality of life, as demonstrated
by differences in the pre- and post-treatment assessments. Clin J Pain
2004 May-Jun;20(3):179-85.
The effect of acupuncture on the symptoms of knee osteoarthritis--an open
randomised controlled study.
Tukmachi
E, Jubb
R, Dempsey
E, Jones
P.
Selly Oak Hospital, Birmingham, UK.
BACKGROUND: Using an open randomised controlled study, we examined the
effectiveness of manual and electroacupuncture on symptom relief for patients
with osteoarthritis of the knee. METHODS: Patients with symptomatic
osteoarthritis of the knee were randomised to one of three treatment groups.
Group A had acupuncture alone, group B had acupuncture but continued on their
symptomatic medication, and group C used their symptomatic medication for the
first five weeks and then had a course of acupuncture added. Patients receiving
acupuncture were treated twice weekly over five weeks. Needles were inserted
(with manual and electrical stimulation) in acupuncture points for pain and
stiffness, selected according to traditional acupuncture theory for treating Bi
syndrome. Patients were assessed by a blinded observer before treatment, after
five weeks' treatment and at one month follow up, using a visual analogue pain
scale (VAS) and the Western Ontario McMaster (WOMAC) questionnaire for
osteoarthritis of the knee. RESULTS: The 30 patients in our study were well
matched for age, body mass index, disease duration, baseline VAS pain score and
baseline WOMAC scores. Repeated measure analyses gave a highly significant
improvement in pain (VAS) after the courses of acupuncture in groups A (P =
0.012) and B (P=0.001); there was no change in group C until after the course of
acupuncture, when the improvement was significant (P = 0.001). Similarly
significant changes were seen with the WOMAC pain and stiffness scores. These
benefits were maintained during the one month after the course of acupuncture.
Patients' rating of global assessment was higher than that of the acupuncturist.
CONCLUSION: We conclude that manual and electroacupuncture causes a significant
improvement in the symptoms of osteoarthritis of the knee, either on its own or
as an adjunct therapy, with no loss of benefit after one month. Acupunct Med
2004 Mar;22(1):14-22.
Analgesic effect of auricular acupuncture for cancer pain: a randomized,
blinded, controlled trial.
Alimi
D, Rubino
C, Pichard-Leandri
E, Fermand-Brule
S, Dubreuil-Lemaire
ML, Hill
C.
Pain Management Unit, INSERM, U521, Villejuif, France.
PURPOSE: During the last 30 years, auricular acupuncture has been used as
complementary treatment of cancer pain when analgesic drugs do not suffice. The
purpose of this study is to examine the efficacy of auricular acupuncture in
decreasing pain intensity in cancer patients. PATIENTS AND METHODS: Ninety
patients were randomly divided in three groups; one group received two courses
of auricular acupuncture at points where an electrodermal signal had been
detected, and two placebo groups received auricular acupuncture at points with
no electrodermal signal (placebo points) and one with auricular seeds fixed at
placebo points. Patients had to be in pain, attaining a visual analog score
(VAS) of 30 mm or more after having received analgesic treatment adapted to both
intensity and type of pain, for at least 1 month of therapy. Treatment efficacy
was based on the absolute decrease in pain intensity measured 2 months after
randomization using the VAS. RESULTS: The main outcome was pain assessed at 2
months, with the assessment at 1 month carried over to 2 months for the eight
patients who interrupted treatment after 1 month. For three patients, no data
were available because they withdrew from the study during the first month. Pain
intensity decreased by 36% at 2 months from baseline in the group receiving
acupuncture; there was little change for patients receiving placebo (2%). The
difference between groups was statistically significant (P <.0001).
CONCLUSION: The observed reduction in pain intensity measured on the VAS
represents a clear benefit from auricular acupuncture for these cancer patients
who are in pain, despite stable analgesic treatment. J Clin Oncol 2003
Nov 15;21(22):4120-6.
Electrical stimulation of auricular acupuncture points is more effective than
conventional manual auricular acupuncture in chronic cervical pain: a pilot
study.
Sator-Katzenschlager
SM, Szeles
JC, Scharbert
G, Michalek-Sauberer
A, Kober
A, Heinze
G, Kozek-Langenecker
SA.
Department of Anesthesiology and Intensive Care B,University of Vienna, Vienna,
Austria. sabine.sator@univie.ac.at
In this prospective, randomized, double-blinded, controlled study, we tested the
hypothesis that auricular electroacupuncture relieves pain more effectively than
conventional manual auricular acupuncture. We studied 21 chronic cervical pain
patients without radicular symptoms with insufficient pain relief (visual
analogue scale >5) treated with standardized analgesic therapy. All patients
received disposable acupuncture needles on the dominant side on the following
acupuncture points: cervical spine, shen men, and cushion. In 10 patients,
needles were continuously stimulated (2-mA constant current, 1 Hz monophasic) by
using the electrical point stimulation device P-STIM. In 11 control patients, no
electrical stimulation was administered. All needles were withdrawn 48 h after
insertion. Acupuncture was performed once a week for 6 wk. Patients had to
complete a questionnaire assessing pain intensity, psychological well-being,
activity, sleep, and demand for rescue medication (lornoxicam and tramadol). The
reduction in pain scores was significant in the electrical acupuncture group.
Similarly, psychological well-being, activity, and sleep were significantly
improved in patients receiving electrical acupuncture, and consumption of rescue
medication was significantly less. These results demonstrate that continuous
electrical stimulation of auricular acupuncture points by using the new point
stimulation device P-STIM improves the treatment of chronic cervical pain in an
outpatient population. IMPLICATIONS: Continuous electrical stimulation of
auricular acupuncture points by using the new point stimulation device P-STIM
significantly decreases pain intensity and significantly improves psychological
well-being, activity, and sleep in chronic cervical pain patients. Anesth
Analg 2003 Nov;97(5):1469-73.
The use of electro-acupuncture in conjunction with exercise for the treatment
of chronic low-back pain.
Yeung
CK, Leung
MC, Chow
DH.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University,
Hung Hom, Hong Kong.
OBJECTIVES: To determine the effect of a series of electro-acupuncture (EA)
treatment in conjunction with exercise on the pain, disability, and functional
improvement scores of patients with chronic low-back pain (LBP). DESIGN: A
blinded prospective randomized controlled study. Subjects and interventions: A
total of 52 patients were randomly allocated to an exercise group (n = 26) or an
exercise plus EA group (n = 26) and treated for 12 sessions. OUTCOME MEASURES:
Numerical Rating Scale (NRS), Aberdeen LBP scale, lumbar spinal active range of
movement (AROM), and the isokinetic strength were assessed by a blinded
observer. Repeated measures analysis of variance (R-ANOVA) with factors of group
and time was used to compare the outcomes between the two groups at baseline
(before treatment), immediately after treatment, 1-month follow-up, and 3-month
follow-up. The level of significance was set at p = 0.05. RESULTS: Significantly
better scores in the NRS and Aberdeen LBP scale were found in the exercise plus
EA group immediately after treatment and at 1-month follow-up. Higher scores
were also seen at 3-month follow-up. No significant differences were observed in
spinal AROM and isokinetic trunk concentric strength between the two groups at
any stage of follow-up. CONCLUSIONS: This study provides additional data on the
potential role of EA in the treatment of LBP, and indicates that the combination
of EA and back exercise might be an effective option in the treatment of pain
and disability associated with chronic LBP. J Altern Complement Med 2003
Aug;9(4):479-90.
