1
|
Beacham MC, McMillen WP, Kirkman SS, Maxey DK, Freedman M, Tillmann HL. "On demand" sedation for colonoscopy with or without auricular acupuncture is non-inferior and may improve quality metrics compared to "upfront" sedation. Dig Liver Dis 2021; 53:669-671. [PMID: 33737006 DOI: 10.1016/j.dld.2021.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/19/2021] [Accepted: 02/24/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Michelle C Beacham
- Greenville Veterans Affairs Health Care Center, 401 Moye Blvd., Greenville, NC 27834, United States.
| | - William P McMillen
- Greenville Veterans Affairs Health Care Center, 401 Moye Blvd., Greenville, NC 27834, United States.
| | - Stacie S Kirkman
- Greenville Veterans Affairs Health Care Center, 401 Moye Blvd., Greenville, NC 27834, United States.
| | - Denise K Maxey
- Greenville Veterans Affairs Health Care Center, 401 Moye Blvd., Greenville, NC 27834, United States.
| | - Michael Freedman
- Greenville Veterans Affairs Health Care Center, 401 Moye Blvd., Greenville, NC 27834, United States.
| | - Hans L Tillmann
- Greenville Veterans Affairs Health Care Center, 401 Moye Blvd., Greenville, NC 27834, United States; Division of Gastroenterology, Hepatology & Nutrition, Department of Medicine, East Carolina University, Greenville, NC 27834, United States.
| |
Collapse
|
2
|
Xu F, Yin J, Xiong E, Wang R, Zhai J, Xie L, Li Y, Qin X, Wang E, Zhang Q, Zuo Y, Fan S, Wang S. COMT gene variants and β-endorphin levels contribute to ethnic differences in experimental pain sensitivity. Mol Pain 2021; 16:1744806920908474. [PMID: 32024434 PMCID: PMC7036500 DOI: 10.1177/1744806920908474] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Feng Xu
- Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Jiangwen Yin
- Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Erfeng Xiong
- Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Ruixue Wang
- Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Jinwen Zhai
- Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Liping Xie
- Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Yan Li
- Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Xinlei Qin
- Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Erqiang Wang
- School of Medicine, Shihezi University, Shihezi, China
| | - Qingtong Zhang
- Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Yansong Zuo
- School of Medicine, Shihezi University, Shihezi, China
| | - Shiwen Fan
- Department of Anesthesiology, First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Sheng Wang
- Department of Anesthesiology, First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| |
Collapse
|
3
|
Teoh AYB, Chong CCN, Leung WW, Chan SKC, Tse YK, Ng EKW, Lai PBS, Wu JCY, Lau JYW. Electroacupuncture-reduced sedative and analgesic requirements for diagnostic EUS: a prospective, randomized, double-blinded, sham-controlled study. Gastrointest Endosc 2018; 87:476-485. [PMID: 28750840 DOI: 10.1016/j.gie.2017.07.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 07/18/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS The role of electroacupuncture (EA) in reducing sedative and analgesic requirements during EUS is uncertain. The aim of this study was to investigate the efficacy of EA in reducing procedure-related pain and discomfort during EUS. METHODS This was a double-blinded randomized controlled study conducted between March 2014 and July 2016. Consecutive patients who were scheduled for diagnostic EUS were recruited and randomized to receive EA or sham-electroacupuncture (SA). The primary outcome was the dosage of propofol used. Other outcome measurements included pain scores, anxiety scores, satisfaction scores, patients' willingness to repeat the procedure, total procedure time, and adverse events. RESULTS A total of 128 patients were recruited to the study. The patients who received EA had significantly fewer requirements for patient-controlled sedation and analgesia (PCA). The median (interquartile range) number of demands for PCA (2 [1-5] vs 16.5 [8.5-33.8]; P < .001), the number of successful demands (2 [1-4] vs 9 [5.3-13]; P < .001), and the total dose of propofol (0.15 [0.08-0.34] vs 0.77 [0.38-1.09]; P < .001) and alfentanil (0.38 [0.20-0.86] vs 1.92 [0.94-2.72]; P < .001) were all significantly less. Patients who received EA also had significantly lower procedural pain scores and anxiety scores (P < .001), and higher satisfaction scores (P < .001), and they were more willing to repeat the procedure (P < .001). Being in the SA group and the procedure time were significant predictors of increased PCA demands (P < .001 and P = .009, respectively). CONCLUSIONS In conclusion, the use of EA reduced sedative and analgesia demands, improved patient experience, and was associated with a low risk of adverse events during diagnostic EUS. (Clinical trial registration number: NCT02066194.).
Collapse
Affiliation(s)
- Anthony Yuen Bun Teoh
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Charing Ching Ning Chong
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Wing Wa Leung
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Simon Kin Cheong Chan
- Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Yee Kit Tse
- Institute of Digestive Disease, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Enders Kwok Wai Ng
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; Institute of Digestive Disease, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Paul Bo San Lai
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; Institute of Digestive Disease, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Justin Che Yuen Wu
- Institute of Digestive Disease, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; Institute of Integrative Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - James Yun Wong Lau
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China; Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| |
Collapse
|
4
|
Tzeng CY, Chang SL, Wu CC, Chang CL, Chen WG, Tong KM, Huang KC, Hsieh CL. Single-blinded, randomised preliminary study evaluating the effects of 2 Hz electroacupuncture for postoperative pain in patients with total knee arthroplasty. Acupunct Med 2015; 33:284-8. [PMID: 25910930 PMCID: PMC4552907 DOI: 10.1136/acupmed-2014-010722] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To explore the point-specific clinical effect of 2 Hz electroacupuncture (EA) in treating postoperative pain in patients undergoing total knee arthroplasty (TKA), METHODS: In a randomised, partially single-blinded preliminary study, 47patients with TKA were randomly divided into three groups: control group (CG, n=17) using only patient-controlled analgesia (PCA); EA group (EAG, n=16) with 2 Hz EA applied at ST36 (Zusanli) and GB34 (Yanglingquan) contralateral to the operated leg for 30 min on the first two postoperative days, also receiving PCA; and non-point group (NPG, n=14), with EA identical to the EAG except given 1 cm lateral to both ST36 and GB34. The Mann-Whitney test was used to show the difference between two groups and the Kruskal-Wallis test to show the difference between the three groups. RESULTS The time until patients first required PCA in the CG was 34.1±22.0 min, which was significantly shorter than the 92.0±82.7 min in the EAG (p<0.001) and 90.7±94.8 min in the NPG (p<0.001); there was no difference between the EAG and NPG groups (p>0.05). The total dosage of PCA solution given was 4.6±0.9 mL/kg body weight in the CG, 4.2±1.0 mL/kg in the EAG and 4.5±1.0 mL/kg in the NPG; there were no significant differences (p>0.05) among the three groups. CONCLUSIONS In this small preliminary study, EA retarded the first demand for PCA in comparison with no EA. No effect was seen on the total dosage of PCA required and no point-specific effect was seen.
Collapse
Affiliation(s)
- Chung-Yuh Tzeng
- Department of Orthopedic Surgery, Taichung Veterans General Hospital, Taichung, Taiwan Department of Nursing, Hung Kuang University, Taiwan
| | - Shih-Liang Chang
- Department of Medicinal Botanicals and Health Care, Da-Yeh University, Chunghwa, Taiwan
| | - Chih-Cheng Wu
- Department of Anesthesia, Taichung Veterans General Hospital, Taichung, Taiwan Department of Financial and Computational Mathematics, Providence University, Taichung, Taiwan
| | | | - Wen-Gii Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Kwok-Man Tong
- Department of Orthopedic Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Kui-Chou Huang
- Department of Orthopedic Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ching-Liang Hsieh
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung, Taiwan
| |
Collapse
|
5
|
The meridian system and mechanism of acupuncture: a comparative review. Part 3: Mechanisms of acupuncture therapies. Taiwan J Obstet Gynecol 2014; 52:171-84. [PMID: 23915848 DOI: 10.1016/j.tjog.2013.04.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2013] [Indexed: 11/23/2022] Open
Abstract
The human body is a hierarchical organism containing many levels of mutually interacting oscillatory systems. From the viewpoint of traditional Chinese medicine, health is a state of harmony emergent from the interactions of these systems and disease is a state of discord. Hence, human diseases are considered as disturbed functions rather than changed structures. Indeed, the change from normal to abnormal structure may be beneficent rather than maleficent. For example, when one kidney becomes twice the normal size following the destruction of the other kidney, it is good and not bad for us because we might be dead otherwise. Therefore, in Part 3 of this three-part series, emphasis is mainly laid on the acupuncture mechanisms of treating disturbed physiological functions rather than disordered structures. At first, the basic tenets of conventional neuroscience and cardiology are reevaluated so that clear understanding of how nervous and cardiovascular systems work together can be obtained. Then, the general principles of diagnosis and treatment in traditional Chinese medicine from the integrative perspective of complex dynamic systems are proposed. Finally, mechanisms of acupuncture therapies for treating 14 different categories of disorders will be elucidated via the magneto-electric inductive effects of the meridian system.
Collapse
|
6
|
Leung WW, Jones AYM, Ng SSM, Wong CYN, Lee JFY. Acupuncture transcutaneous electrical nerve stimulation reduces discomfort associated with barostat-induced rectal distension: A randomized-controlled study. World J Gastroenterol 2013; 19:381-8. [PMID: 23372361 PMCID: PMC3554823 DOI: 10.3748/wjg.v19.i3.381] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Revised: 09/05/2012] [Accepted: 09/22/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To explore the effectiveness of acupuncture transcutaneous electrical nerve stimulation (Acu-TENS), a non-invasive modality in reduction of rectal discomfort during barostat-induced rectal distension.
METHODS: Forty healthy subjects were randomized to receive 45 min of either Acu-TENS or placebo-TENS (no electrical output) over acupuncture points Hegu (large-intestine 4), Neiguan (pericardium 6) and Zusanli (stomach 36). A balloon catheter attached to a dual-drive barostat machine was then inserted into the subjects’ rectum. A step-wise (4 mmHg) increase in balloon pressure was induced until maximal tolerable or 48 mmHg. Visual analogue scale and a 5-point subjective discomfort scale (no perception, first perception of distension, urge to defecate, discomfort/pain and extreme pain) were used to assess rectal discomfort at each distension pressure. Blood beta-endorphin levels were measured before, immediately after intervention, at 24 mmHg and at maximal tolerable distension pressure.
RESULTS: There was no difference in the demographic data and baseline plasma beta-endorphin levels between the two groups. Perception threshold levels were higher in the Acu-TENS group when compared to the placebo group, but the difference reached statistical significance only at the sensations “urge to defecate” and “pain”. The distension pressures recorded at the “urge to defecate” sensation for the Acu-TENS and placebo-TENS groups were 28.0 ± 4.5 mmHg and 24.6 ± 5.7 mmHg, respectively (P = 0.043); and the pressures recorded for the “pain” sensation for these two groups were 36.0 ± 4.2 mmHg and 30.5 ± 4.3 mmHg respectively (P = 0.002). Compared to the placebo group, a higher number of participants in the Acu-TENS group tolerated higher distension pressures (> 40 mmHg) (65% in Acu-TENS vs 25% in placebo, P = 0.02). The plasma beta-endorphin levels of the Acu-TENS group were significantly higher than that of the placebo group at barostat inflation pressure of 24 mmHg (1.31 ± 0.40 ng/mL vs 1.04 ± 0.43 ng/mL, P = 0.044) and at maximal inflation pressure (1.46 ± 0.53 ng/mL vs 0.95 ± 0.38 ng/mL, P = 0.003).
CONCLUSION: Acu-TENS reduced rectal discomfort during barostat-induced rectal distension and concurrently associated with a rise in beta-endorphin level.
Collapse
|
7
|
Wang SM, Kain ZN, White PF. Acupuncture analgesia: II. Clinical considerations. Anesth Analg 2008; 106:611-21, table of contents. [PMID: 18227323 DOI: 10.1213/ane.0b013e318160644d] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Acupuncture and related percutaneous neuromodulation therapies can be used to treat patients with both acute and chronic pain. In this review, we critically examined peer-reviewed clinical studies evaluating the analgesic properties of acupuncture modalities. METHODS Using Ovid and published medical databases, we examined prospective, randomized, sham-controlled clinical investigations involving the use of acupuncture and related forms of acustimulation for the management of pain. Case reports, case series, and cohort studies were not included in this analysis. RESULTS Peer-reviewed literature suggests that acupuncture and other forms of acustimulation are effective in the short-term management of low back pain, neck pain, and osteoarthritis involving the knee. However, the literature also suggests that short-term treatment with acupuncture does not result in long-term benefits. Data regarding the efficacy of acupuncture for dental pain, colonoscopy pain, and intraoperative analgesia are inconclusive. Studies describing the use of acupuncture during labor suggest that it may be useful during the early stages, but not throughout the entire course of labor. Finally, the effects of acupuncture on postoperative pain are inconclusive and are dependent on the timing of the intervention and the patient's level of consciousness. CONCLUSIONS Current data regarding the clinical efficacy of acupuncture and related techniques suggest that the benefits are short-lasting. There remains a need for well designed, sham-controlled clinical trials to evaluate the effect of these modalities on clinically relevant outcome measures such as resumption of daily normal activities when used in the management of acute and chronic pain syndromes.
Collapse
Affiliation(s)
- Shu-Ming Wang
- Center for Advancement of Perioperative Health, Department of Anesthesiology, Yale School of Medicine, 333 Cedar St., New Haven, CT 06510, USA.
| | | | | |
Collapse
|
8
|
Wang SM, Punjala M, Weiss D, Anderson K, Kain ZN. Acupuncture as An Adjunct for Sedation during Lithotripsy. J Altern Complement Med 2007; 13:241-6. [PMID: 17388767 DOI: 10.1089/acm.2006.6262] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To determine whether a combination of auricular and body acupuncture is effective as an adjunct for the preprocedural anxiety and pain management in patients undergoing lithotripsy procedures. DESIGN Randomized controlled study. SETTING AND LOCATION: Lithotripsy suite located at the Yale New Haven Hospital, New Haven CT. SUBJECTS Adult patients who were scheduled to receive elective lithotripsy procedures. INTERVENTIONS Acupuncture group: Preprocedural auricular acupuncture intervention combined with intraprocedural electroacupuncture stimulation (n = 29); Sham control group: Preprocedural sham auricular acupuncture intervention combined with intraprocedural sham electroacupuncture stimulation (n = 27). OUTCOMES MEASUREMENT: Preprocedural anxiety, intraprocedural alfentanil consumption, visual analogue scale for pain. RESULTS Patients in the acupuncture group were less anxious preprocedure than those in the Sham Control Group 32 (29-34) versus 40 (35-45) (p = 0.029). Similarly, patients in the Acupuncture Group used a lesser amount of alfentanil than those in the sham control group (p = 0.040). The adjustable alfentanil consumption as expressed by median rate of alfentanil consumption of 1 (0.6-1.6) microg kg(-1) minute(-1) in the acupuncture group was lower than that of 1.5 (0.9-2.3) microg kg(-1) minute(-1) in the sham control group. Patients in the Acupuncture group also reported lower pain scores on admission to the recovery room (p = 0.014). CONCLUSIONS A combination of auricular and body acupuncture can be used as an adjunct treatment to decrease preprocedural anxiety and intraprocedural analgesia in patients undergoing lithotripsy.
Collapse
Affiliation(s)
- Shu-Ming Wang
- Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06520-8041, USA.
| | | | | | | | | |
Collapse
|
9
|
Sator-Katzenschlager SM, Wölfler MM, Kozek-Langenecker SA, Sator K, Sator PG, Li B, Heinze G, Sator MO. Auricular electro-acupuncture as an additional perioperative analgesic method during oocyte aspiration in IVF treatment. Hum Reprod 2006; 21:2114-20. [PMID: 16679325 DOI: 10.1093/humrep/del110] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of this study was to compare the pain-relieving effect and the subjective well-being between auricular electro-acupuncture (EA) analgesia, auricular acupuncture (A) and conventional analgesia with remifentanil (CO). METHODS A total of 94 women undergoing IVF were randomized to auricular acupuncture with (EA, n = 32) or without (A, n = 32) continuous 1 Hz auricular stimulation (using a battery-powered miniaturized stimulator, P-Stim) or with adhesive tapes instead of needles and no electrical stimulation (control group, CO, n = 30) at the auricular acupuncture points 29, 55 and 57. All patients received patient-controlled analgesia (PCA) with remifentanil. Pain intensity and psychological well-being were assessed by means of visual analogue scales (VAS); tiredness, nausea and vomiting and analgesic drug consumption were documented. RESULTS Pain relief and subjective well-being were significantly greater in group EA during and after the procedure as compared with groups A and CO (P < 0.001). The patients were significantly more tired in group CO than in groups A and EA (P < 0.001). Consumption of the opioid remifentanil was significantly lower in group EA, comparable nausea (P < 0.001). CONCLUSION Auricular EA significantly reduces pain intensity and analgesic consumption of the opioid remifentanil during oocyte aspiration in IVF treatment.
Collapse
|
10
|
Stener-Victorin E, Cummings M, Lundeberg T. Comment on: Acupuncture analgesia during surgery: a systematic review by Hyangsook Lee and Edzard Ernst, Pain 114 (2005) 511-517. Pain 2005; 117:237-8; author reply 238-9. [PMID: 16043288 DOI: 10.1016/j.pain.2005.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2005] [Accepted: 05/23/2005] [Indexed: 11/26/2022]
|
11
|
Affiliation(s)
- Hyangsook Lee
- Complementary Medicine, Peninsula Medical School, University of Exeter and Plymouth, Exeter, United Kingdom
| | | |
Collapse
|
12
|
Fanti L, Gemma M, Passaretti S, Guslandi M, Testoni PA, Casati A, Torri G. Electroacupuncture analgesia for colonoscopy. a prospective, randomized, placebo-controlled study. Am J Gastroenterol 2003; 98:312-6. [PMID: 12591047 DOI: 10.1111/j.1572-0241.2003.07231.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE A study was undertaken to compare the effectiveness of acupuncture in reducing patient's discomfort and anxiety during colonoscopy with a standard sedation protocol. METHODS Thirty patients scheduled to undergo colonoscopy were randomly assigned to receive acupuncture, sham, or no acupuncture. A verbal rating scale was used to measure patient's pain when the endoscope reached four scheduled positions. Midazolam was administered at baseline and again anytime patients complained of "severe" pain. The amount of midazolam administered was recorded. A verbal rating scale was used to assess patient's satisfaction with the level of sedation achieved. RESULTS Pain level was lower, although not significantly, in the acupuncture group. Midazolam boluses were required in three patients with acupuncture (30%), eight in the sham group (80%), and nine in the control group (90%) (p = 0.01). Six patients in the acupuncture group (60%) reported optimum acceptance of colonoscopy compared with only one in the sham group (10%) and none in the control group (0%) (p = 0.016). Satisfaction scores, assessed 24-72 h after colonoscopy, were extremely high (median score 90 of 100) in the three groups. CONCLUSIONS Acupuncture may decrease the demand for sedative drugs during colonoscopy by reducing discomfort and anxiety of the patient and the well-known adverse effects of pharmacologic sedation.
Collapse
Affiliation(s)
- Lorella Fanti
- Department of Gastroenterology, Vita-Salute University of Milan, IRCCS San Raffaele Hospital, Italy
| | | | | | | | | | | | | |
Collapse
|
13
|
|
14
|
Sutherland JA. Meridian therapy: current research and implications for critical care. AACN CLINICAL ISSUES 2000; 11:97-104. [PMID: 11040556 DOI: 10.1097/00044067-200002000-00011] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The National Institutes of Health recently recommended further research on the efficacy of acupuncture and allocated Federal funds to stimulate clinical studies. Their decision was based on a growing body of successful research outcomes in which acupuncture was used in the treatment of acute and chronic pain, nausea, circulatory functions, and mood-related behavioral disorders. Despite a burgeoning body of clinical research, the ability to generalize findings has been affected by design flaws, sample type and size, and multiple methods of acupuncture site stimulation. Complicating the communication of findings is use of the term acupuncture when other strategies are used to stimulate the point, such as electrical probes and low-intensity laser. A more appropriate term for acupuncture is meridian therapy, because it encompasses all methods used to treat an acupoint. The purpose of this article is to define meridian therapy with a focus on current clinical perspectives, to review research outcomes in areas important to the care of critically ill patients, to identify issues related to the application of meridian therapy in the clinical arena, and to elaborate practitioner preparation and licensure requirements.
Collapse
Affiliation(s)
- J A Sutherland
- School of Nursing and Health Sciences, Texas A & M University, Corpus Christi 78412, USA
| |
Collapse
|
15
|
Stener-Victorin E, Waldenström U, Nilsson L, Wikland M, Janson PO. A prospective randomized study of electro-acupuncture versus alfentanil as anaesthesia during oocyte aspiration in in-vitro fertilization. Hum Reprod 1999; 14:2480-4. [PMID: 10527973 DOI: 10.1093/humrep/14.10.2480] [Citation(s) in RCA: 101] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The aim of the present study was to evaluate the anaesthetic effect during oocyte aspiration of a paracervical block (PCB) in combination with either electro-acupuncture (EA) or intravenous alfentanil. In all, 150 women undergoing in-vitro fertilization (IVF) and embryo transfer were randomized to receive either EA plus PCB or alfentanil plus PCB. Visual analogue scales (VAS) were used to evaluate subjective experiences during oocyte aspiration, and IVF outcome parameters were recorded. No differences in pain directly related to oocyte aspiration, adequacy of anaesthesia during oocyte aspiration, abdominal pain, or degree of nausea were found between the two groups in the VAS ratings. Before oocyte aspiration, the level of stress was significantly higher in the EA group than in the alfentanil group (P < 0.05), and the EA group experienced discomfort for a significantly longer period during oocyte aspiration (P < 0. 01). Compared with the alfentanil group, the EA group had a significantly higher implantation rate (P < 0.05), pregnancy rate (P < 0.05), and take home baby rate (P < 0.05) per embryo transfer. In conclusion, EA has been shown to be as good an anaesthetic method as alfentanil during oocyte aspiration, and we suggest that EA may be a good alternative to conventional anaesthesia during oocyte aspiration.
Collapse
Affiliation(s)
- E Stener-Victorin
- Department of Obstetrics and Gynaecology, Göteborg University, SE-413 45 Göteborg, Sweden
| | | | | | | | | |
Collapse
|
16
|
Abstract
Acupuncture has been used for various gastrointestinal (GI) conditions. Voluminous data support the effect of acupuncture on the physiology of the GI tract, including acid secretion, motility, neurohormonal changes, and changes in sensory thresholds. Much of the neuroanatomic pathway of these effects has been identified in animal models. A large body of clinical evidence supports the effectiveness of acupuncture for suppressing nausea associated with chemotherapy, postoperative state, and pregnancy. Prospective randomized controlled trials have also shown the efficacy of acupuncture for analgesia for endoscopic procedures, including colonoscopy and upper endoscopy. Acupuncture has also been used for a variety of other conditions including postoperative ileus, achalasia, peptic ulcer disease, functional bowel diseases (including irritable bowel syndrome and nonulcer dyspepsia), diarrhea, constipation, inflammatory bowel disease, expulsion of gallstones and biliary ascariasis, and pain associated with pancreatitis. Although there are few prospective randomized clinical studies, the well-documented physiological basis of acupuncture effects on the GI tract, and the extensive history of successful clinical use of acupuncture, makes this a promising modality that warrants further investigation.
Collapse
Affiliation(s)
- D L Diehl
- Division of Digestive Diseases, UCLA School of Medicine, USA
| |
Collapse
|