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Agha Mohammadi D, Bilehjani E, Farzin H, Fakhari S, Naderpour M. Effect of Pressure on the Yinmen Point in Relief of Pain After Middle Ear Surgery: A Randomized Clinical Trial. Anesth Pain Med 2020; 10:e103328. [PMID: 34150560 PMCID: PMC8207841 DOI: 10.5812/aapm.103328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/12/2020] [Accepted: 09/07/2020] [Indexed: 11/30/2022] Open
Abstract
Background Postoperative pain is a common problem after middle ear surgery. Several analgesic agents are available for pain relief, but they cause numerous side effects. Therefore, complementary analgesic methods are developed to reduce patient’s postoperative pain and discomfort. Objectives The current study aimed to investigate the effect of the acupressure on post middle ear surgery pain, applying pressure on the Yinmen acupoint of the sciatic nerve. Methods In this randomized clinical trial, 100 adult patients who were candidate for elective middle ear surgery were selected and divided into two groups of Yinmen and placebo, each with 50 subjects. After admission to the ward, patients’ postoperative pain score was measured using the visual analog score (VAS) tool. Then, patients were placed in the prone position. In the Yinmen group, using a fist, we applied a continuous pressure (11 - 20 kg) to the posterior aspect of the thighs at the Yinmen acupoint for 2 minutes. In the placebo group, only soft contact was kept between the fist and Yinmen point for the same period. The maneuver repeated every two hours for four times. The pain intensity surveyed 10 minutes after the first maneuver, then every hour for 8 hours. For those with a VAS score ≥ 4, intravenous paracetamol and/or meperidine was administered. Any nausea and vomiting was managed using ondansetron 2 mg, IV. The pain score, paracetamol, and meperidine consumption were recorded and compared between the two groups. The chi-square and student t-tests were used to compare the two groups. Results No significant difference was found between patients’ characteristics and the first pain score. For all measurements, pain intensity was lower in the Yinmen group (P value < 0.01). The pain after the first maneuver was relieved exactly when the acupressure was true. The intervention could reduce patients’ need to take paracetamol (6.68 ± 2.58 vs. 10.42 ± 3.87 mg/kg) and meperidine (0.21 ± 0.17 vs. 0.39 ± 0.23 mg/kg) in the Yinmen group. The two groups were not significantly different concerning the need to take ondansetron to manage postoperative nausea and vomiting. Conclusions Applying 2 minutes pressure (11 - 20 kg) on the Yinmen acupoint of the sciatic nerves can reduce post middle ear surgery pain and analgesic consumption.
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Affiliation(s)
- Dawood Agha Mohammadi
- Pain and Palliative Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Eissa Bilehjani
- Department of Anesthesiology, Madani Heart Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Haleh Farzin
- Tabriz University of Medical Sciences, Tabriz, Iran
| | - Solmaz Fakhari
- Pain and Palliative Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Corresponding Author: Pain and Palliative Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Masoud Naderpour
- Department of Otorhinolaryngology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Kwon CY, Lee B. Clinical effects of acupressure on neck pain syndrome ( nakchim): a systematic review. Integr Med Res 2018; 7:219-230. [PMID: 30271710 PMCID: PMC6160503 DOI: 10.1016/j.imr.2018.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/25/2017] [Accepted: 01/11/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Nakchim is a kind of neck pain syndrome that causes neck pain and stiffness without obvious trauma in East Asian traditional medicine. We aimed to summarize and critically evaluate the evidence regarding the efficacy and safety of acupressure on nakchim. METHODS We searched eight databases for studies published up to August 29, 2017. Clinical studies evaluating the efficacy of acupressure on nakchim were included. The acupressure methods of included studies were divided into proximal acupressure performed on acupuncture points located in neck and shoulder, and distal acupressure performed on acupuncture points located in other areas. Overall clinical effective rate (CER) and immediately cured rate (ICR), which means rate of the symptom totally resolved after one treatment session, were calculated as mean percentage with 95% confidence interval. All included studies were assessed for methodological quality. RESULTS Two case studies and 13 case series with 1037 participants were included, and 17 types of proximal acupuncture points and 14 types of distal acupuncture points were used. The most commonly used proximal and distal acupuncture points were GB20 and GB39, respectively. The CER in one study using both proximal and distal acupressure was 100%. The CER and ICR in studies using only proximal acupressure was 95.65% and 71.61%, respectively. The CER and ICR in studies using only distal acupressure was 99.37% and 69.08%, respectively. Eight studies performed simple acupressure technique using one acupuncture point, of which SI11, GB39, BL57, and TE3 were used. None of the studies reported adverse events. CONCLUSION This review suggests that acupressure may be effective on nakchim. However, it is not conclusive due to low methodological quality and low evidence level of included studies.
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Affiliation(s)
| | - Boram Lee
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Korea
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Wellman SM, Eles JR, Ludwig KA, Seymour JP, Michelson NJ, McFadden WE, Vazquez AL, Kozai TDY. A Materials Roadmap to Functional Neural Interface Design. ADVANCED FUNCTIONAL MATERIALS 2018; 28:1701269. [PMID: 29805350 PMCID: PMC5963731 DOI: 10.1002/adfm.201701269] [Citation(s) in RCA: 169] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Advancement in neurotechnologies for electrophysiology, neurochemical sensing, neuromodulation, and optogenetics are revolutionizing scientific understanding of the brain while enabling treatments, cures, and preventative measures for a variety of neurological disorders. The grand challenge in neural interface engineering is to seamlessly integrate the interface between neurobiology and engineered technology, to record from and modulate neurons over chronic timescales. However, the biological inflammatory response to implants, neural degeneration, and long-term material stability diminish the quality of interface overtime. Recent advances in functional materials have been aimed at engineering solutions for chronic neural interfaces. Yet, the development and deployment of neural interfaces designed from novel materials have introduced new challenges that have largely avoided being addressed. Many engineering efforts that solely focus on optimizing individual probe design parameters, such as softness or flexibility, downplay critical multi-dimensional interactions between different physical properties of the device that contribute to overall performance and biocompatibility. Moreover, the use of these new materials present substantial new difficulties that must be addressed before regulatory approval for use in human patients will be achievable. In this review, the interdependence of different electrode components are highlighted to demonstrate the current materials-based challenges facing the field of neural interface engineering.
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Affiliation(s)
- Steven M Wellman
- Department of Bioengineering, Center for the Basis of Neural Cognition, McGowan Institute of Regenerative Medicine, NeuroTech Center, University of Pittsburgh Brain Institute, Center for Neuroscience at the University of Pittsburgh, University of Pittsburgh, 208 Center for Biotechnology, 300 Technology Dr., Pittsburgh, PA 15219, United States
| | - James R Eles
- Department of Bioengineering, Center for the Basis of Neural Cognition, McGowan Institute of Regenerative Medicine, NeuroTech Center, University of Pittsburgh Brain Institute, Center for Neuroscience at the University of Pittsburgh, University of Pittsburgh, 208 Center for Biotechnology, 300 Technology Dr., Pittsburgh, PA 15219, United States
| | - Kip A Ludwig
- Department of Neurologic Surgery, 200 First St. SW, Rochester, MN 55905
| | - John P Seymour
- Electrical & Computer Engineering, 1301 Beal Ave., 2227 EECS, Ann Arbor, MI 48109
| | - Nicholas J Michelson
- Department of Bioengineering, Center for the Basis of Neural Cognition, McGowan Institute of Regenerative Medicine, NeuroTech Center, University of Pittsburgh Brain Institute, Center for Neuroscience at the University of Pittsburgh, University of Pittsburgh, 208 Center for Biotechnology, 300 Technology Dr., Pittsburgh, PA 15219, United States
| | - William E McFadden
- Department of Bioengineering, Center for the Basis of Neural Cognition, McGowan Institute of Regenerative Medicine, NeuroTech Center, University of Pittsburgh Brain Institute, Center for Neuroscience at the University of Pittsburgh, University of Pittsburgh, 208 Center for Biotechnology, 300 Technology Dr., Pittsburgh, PA 15219, United States
| | - Alberto L Vazquez
- Department of Bioengineering, Center for the Basis of Neural Cognition, McGowan Institute of Regenerative Medicine, NeuroTech Center, University of Pittsburgh Brain Institute, Center for Neuroscience at the University of Pittsburgh, University of Pittsburgh, 208 Center for Biotechnology, 300 Technology Dr., Pittsburgh, PA 15219, United States
| | - Takashi D Y Kozai
- Department of Bioengineering, Center for the Basis of Neural Cognition, McGowan Institute of Regenerative Medicine, NeuroTech Center, University of Pittsburgh Brain Institute, Center for Neuroscience at the University of Pittsburgh, University of Pittsburgh, 208 Center for Biotechnology, 300 Technology Dr., Pittsburgh, PA 15219, United States
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Wang X, Zhao W, Wang Y, Hu J, Chen Q, Yu J, Wu B, Huang R, Gao J, He J. A self-administered method of acute pressure block of sciatic nerves for short-term relief of dental pain: a randomized study. PAIN MEDICINE 2014; 15:1304-11. [PMID: 24400593 PMCID: PMC4265330 DOI: 10.1111/pme.12338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objectives While stimulation of the peripheral nerves increases the pain threshold, chronic pressure stimulation of the sciatic nerve is associated with sciatica. We recently found that acute pressure block of the sciatic nerve inhibits pain. Therefore, we propose that, the pain pathology-causing pressure is chronic, not acute. Here, we report a novel self-administered method: acute pressure block of the sciatic nerves is applied by the patients themselves for short-term relief of pain from dental diseases. Design This was a randomized, single-blind study. Setting Hospital patients. Patients Patients aged 16–60 years with acute pulpitis, acute apical periodontitis, or pericoronitis of the third molar of the mandible experiencing pain ≥3 on the 11-point numerical pain rating scale. Interventions Three-minute pressure to sciatic nerves was applied by using the hands (hand pressure method) or by having the patients squat to force the thigh and shin as tightly as possible on the sandwiched sciatic nerve bundles (self-administered method). Outcomes The primary efficacy variable was the mean difference in pain scores from the baseline. Results One hundred seventy-two dental patients were randomized. The self-administered method produced significant relief from pain associated with dental diseases (P ≤ 0.001). The analgesic effect of the self-administered method was similar to that of the hand pressure method. Conclusions The self-administered method is easy to learn and can be applied at any time for pain relief. We believe that patients will benefit from this method.
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Affiliation(s)
- Xiaolin Wang
- Pain Medicine Program, IDD, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Luo D, Wang X, He J. A comparison between acute pressure block of the sciatic nerve and acupressure: methodology, analgesia, and mechanism involved. J Pain Res 2013; 6:589-93. [PMID: 23983488 PMCID: PMC3749058 DOI: 10.2147/jpr.s47693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Acupressure is an alternative medicine methodology that originated in ancient China. Treatment effects are achieved by stimulating acupuncture points using acute pressure. Acute pressure block of the sciatic nerve is a newly reported analgesic method based on a current neuroscience concept: stimulation of the peripheral nerves increases the pain threshold. Both methods use pressure as an intervention method. Herein, we compare the methodology and mechanism of these two methods, which exhibit several similarities and differences. Acupressure entails variation in the duration of manipulation, and the analgesic effect achieved can be short-or long-term. The acute effect attained with acupressure presents a scope that is very different from that of the chronic effect attained after long-term treatment. This acute effect appears to have some similarities to that achieved with acute pressure block of the sciatic nerve, both in methodology and mechanism. More evidence is needed to determine whether there is a relationship between the two methods.
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Affiliation(s)
- Danping Luo
- Pain Medicine Program, Nanfang, Hospital, southern Medical University, Guangzhou, People's Republic of china ; the First Affiliated Hospital of Guangdong college of Pharmacy, Guangzhou, People's Republic of china
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