Impact of Electroacupuncture Stimulation on Postoperative Constipation for Patients Undergoing Brain Tumor Surgery.

BACKGROUND: Constipation is frequently encountered in patients undergoing brain tumor resection. Constipation has negative effects on daily living, well-being, and individuals' quality of life. We examined the impact of acupuncture and electroacupuncture (EA) stimulation on postoperative constipation for patients undergoing brain tumor resection. METHODS: Patients undergoing brain tumor resection (n = 150) were randomly divided into a nontreatment group, an acupuncture group, and an EA group. Rome III Diagnostic Criteria, Cleveland Clinic Constipation Score, symptom assessment, Patient Assessment of Constipation Quality of Life questionnaire, Self-Rating Anxiety Scale, and a Self-Rating Depression Scale were collected. RESULTS: Acupuncture and EA were effective in relieving postoperative constipation. Electroacupuncture decreased constipation and improved quality of life scores. CONCLUSION: Acupuncture and EA are novel adjuvant therapies to treat constipation.

Intraoperative Low-frequency Electroacupuncture under General Anesthesia Improves Postoperative Recovery in a Randomized Trial.

Neuronal stimulation improves physiological responses to infection and trauma, but the clinical potential of this strategy is unknown. We hypothesized that transdermal neural stimulation through low-frequency electroacupuncture might control the immune responses to surgical trauma and expedite the postoperative recovery. However, the efficiency of electroacupuncture is questioned due to the placebo effect. Here, electroacupuncture was performed on anesthetized patients to avoid any placebo. This is a prospective double-blinded pilot trial to determine whether intraoperative electroacupuncture on anesthetized patients improves postoperative recovery. Patients with electroacupuncture required 60% less postoperative analgesic, even they had pain scores similar to those in the control patients. Electroacupuncture prevented postoperative hyperglycemia and attenuated serum adrenocorticotropic hormone in the older and heavier group of patients. From an immunological perspective, electroacupuncture did not affect the protective immune responses to surgical trauma, including the induction of interleukin-6 and interleukin-10. The most significant immunological effect of electroacupuncture was enhancing transforming growth factor-ß1 production during surgery in the older and lighter group of patients. These results suggest that intraoperative electroacupuncture on anesthetized patients can reduce postoperative use of analgesics and improve immune and stress responses to surgery.

100-Hz Electroacupuncture but not 2-Hz Electroacupuncture is Preemptive Against Postincision Pain in Rats.

Preemptive analgesia involves introducing an analgesic before noxious stimulation. Electroacupuncture (EA) activates descending mechanisms that modulate nociceptive inputs into the spinal dorsal horn. This study evaluated whether preoperative EA is more effective than postoperative EA in reducing incision pain in rats. The nociceptive threshold to mechanical stimulation was utilized to examine the effects of an intraperitoneal injection of saline (0.1 mL/kg) or naloxone (1 mg/kg) on antinociception induced by a 20-minute period of 2-Hz or 100-Hz EA applied to the Zusanli (ST36) and Sanyinjiao (SP6) acupoints before surgical incision, or 10 minutes after or 100 minutes after surgical incision of the hind paw. The extent of mechanical hyperalgesia after the incision was significantly attenuated by the application of 100-Hz EA preoperatively, but not by its application at 10 minutes or 100 minutes postoperatively. By contrast, 2-Hz EA was effective against postoperative hyperalgesia when applied 10 minutes or 100 minutes after surgery but not when it was applied preoperatively. Only the effect of 2-Hz EA applied 10 minutes after surgery was sensitive to naloxone. The present study showed for the first time that 100-Hz EA, but not 2-Hz EA, exerts a nonopioidergic preemptive effect against postincision pain in rats.

[Parametric optimization of electroacupuncture against bone-cancer pain in rats and its intervention on mRNA expression of opioid receptor and precursor].

OBJECTIVE: To observe the intervention of electroacupuncture (EA) with different current frequencies and treatment frequencies on pain thresholt in rats with bone-cancer pain, so as to optimize treatment parameters of EA against bone cancer pain; and by measuring gene expression of opioid receptor and precursor in different tissues to preliminarily explore the possible mechanism of EA against bone cancer pain. METHODS: Ninety healthy female SD rats were randomly divided into a control group, a model group, EA groups (6 subgroups according to different frequencies) and a sham EA group, ten rats in each one. Rats in the control group were injected with 10 µL of amicrobic phosphate buffer solution (PBS) into tibial cavity; rats in the remaining groups were injected with Walker 256 cancer cells to establish model of bone-cancer pain. No treatment was given to rats in the control group and model group; rats in the EA groups were treated with EA at bilateral "Housanli" (ST 36) and "Genduan" with 3 different current frequencies (2 Hz, 100 Hz and 2 Hz/100 Hz), once a day and once every other day, 30 min per treatment (1mA for 15 min, 2 mA for 15 min); rats in the sham EA group were treated with identical acupoints as the EA group, but the acupoints were needled subcutaneously and EA was connected with power off. All the treatment was given for 14 days. Dynamic plantar aesthesiometer was applied to measure the paw withdrawal thresholds (PWTs) of the affected side before the model establishment, 6d, 8d, 10d, 12d, 14d, 16d, 18d, and 20d after model establishment. The mRNA expressions of µ-opioid receptor (MOR), κ-opioid receptor (KOR), δ-opioid receptor (DOR), proopiomelanocortin (POMC) and prodynorphin (PDYN) in dorsal root ganglion (DRG) and lumbar spinal cord dorsal horn (SCDH) of L4-L6 of the affected side were detected by PCR method. RESULTS: There were no differences in PWTs among all groups before model establishment (P>0. 05). Each time point after model establishment, PWTs in model group were obviously lower than those in the control group (all P<0. 01). Compared with the model group, PWTs in each EA subgroup were all increased (all P<0.05), but the differences at different time points were not significant among EA subgroups (P>0.05). The mRNA expressions of MOR, KOR, POMC, and PDYN in L4-L6 DRG in the 2 Hz/100 Hz II group were significantly higher than those in model group (P<0. 05, P<0. 01), while the mRNA expressions of MOR, KOR, DOR, POMC and PDYN in SCDH were not different compared with the model group (P>0. 05). CONCLUSION: EA treatment has obvious analgesic effect on bone-cancer pain, however, its effect is not related with current frequency and treating frequency. EA against bone-cancer pain may be related with increasing the mRNA expression of some peripheral opioid receptors and precursor.

[Effects of acupotomy, electroacupuncture or round-sharp acupuncture needle interventions on expression of Bcl-2, Bax, Caspase-3 proteins of rectus femoris in rabbits with knee ostarthritis].

OBJECTIVE: To observe the effect of acupotomy, electroacupuncture (EA) or round-sharp acupuncture needle intervention on the expression of Bcl-2,Bax and Caspase-3 proteins in the rectus femoris in rabbits with knee ostarthritis (KOA), so as to explore their mechanisms underlying improvement of braking-induced joint damage from the cellular apoptosis. METHODS: Forty-five New Zealand rabbits were equally and randomized into control group, model group, acupotomy (AP) group, EA group and round-sharp acupuncture needle (RSAN) group (n = 9 in each group). The knee-joint injury model was established by fixing the left knee joint in extention position with plaster bandage. EA (2 Hz/100 Hz, 3 mA, 20 min each time) was applied to the left "Yanglingquan" (GB 34)- "Yinlingquan" (SP 9) and left "Neixiyan" (EX-LE 4)- "Waixiyan"(ST 35) for rabbits in the EA group. The EA treatment was given once daily, 3 times a week, 3 weeks in total. For rabbits of the AP group, a needle-knife was held to insert into the front edge of the midpoint, the starting point and the stopping point of the left medial collateral ligamen, lateral collateral ligament and the patellar ligament of the knee to make a loosening manipulation for 5 times in a session of treatment, once a week, 3 times altogether. For rabbits of the RSAN group, a round-sharp needle was performed in the same way to the needle-knife including the stimulation point, the manipulation method and treatment sessions. At the end of the experiment, the left rectus femoris was taken out for detecting the expression of Bcl-2, Bax and Caspase-3 proteins with Western blot. RESULTS: In comparison with the control group, the passive range of motion (PROM) level was significantly decreased 4, 8 and 12 weeks after modeling (P < 0.01), and the expression levels of Bax and Caspase-3 proteins in the rectus femoris were considerably upregulated in the model group (P < 0.05), while the ratio of Bcl-2/Bax was notably down-regulated (P < 0.05) in the model group. Compared with the model group, the PROM level at week 12 after modeling in the AP, EA and RSAN groups were significantly increased (P < 0.01); while Bax and Caspase-3 expression levels in both AP and RSAN groups were considerably downregulated (P < 0.05). No significant differences were found among the five groups in Bcl-2 expression levels (P > 0.05), and between the EA and model groups in Bax and Caspase-3 expression levels and the ratio of Bcl-2/Bax (P > 0.05). CONCLUSION: AP, RSAN and EA interventions are effective in improving the knee-joint motion range in KOA rabbits, and this effect of both AP and RSAN is closely associated with their actions in lowering the expression of Bax and Caspase-3 proteins of the rectus femoris and in raising ratio of Bcl-2/Bax protein (reducing muscular cellular apoptosis). The mechanism of EA intervention in improving PROM may be different.

[Efficacy on analgesia with electric stimulation of long-term retaining needle after laparoscopic cholecystectomy].

OBJECTIVE: To observe the clinical effect of electric stimulation of long-term retaining needle on analgesia after laparoscopic cholecystectomy (LC) and the impacts on the post-surgical flatus time. METHODS: Under static absorptive composite general anesthesia, 90 cases of LC were randomized into three groups, 30 cases in each one. In the control group, the analgesia was not applied after LC. In the analgesia-pumper group, the patient controlled intravenous analgesia (PCIA) was used. In the needle-retaining group, the electric acupuncture stimulator was used. The needles were inserted transversely at Riyue (GB 24), Qichong (ST 30) and Yanglingquan (GB 34) and fixed with sterile sticker. Separately, in 8 h and 24 h after surgery, the electric acupuncture stimulation with disperse-dense wave, 2 Hz/100 Hz frequency was applied continuously for 30 min. Visual analogue scale (VAS), adverse reactions such as vomiting and nausea and the postoperative flatus time in 2, 4, 8, 12, 24 and 36 h after surgery were observed and recorded in the three groups. RESULTS: In 2, 4, 8, 12 and 24 h after surgery, VAS scores in the needle-retaining group and the analgesia-pumper group were all lower than those in the control group (P < 0.05, P < 0.01). The analgesia effect at the above time points in the needle-retaining group was better than that in the analgesia-pumper group (all P < 0.05). There was not adverse reaction in the needle-retaining group. But there were 3 cases of somnolence, 6 cases of nausea and 3 cases of vomiting in the analgesia-pumper group, and 2 cases of nausea and 1 case of vomiting in the control group. The flatus time was quite earlier in the needle-retaining group as compared with the other two groups [(14.77 +/- 4.99) h vs (18.50 +/- 4.22) h, P < 0.01; (14.77 +/- 4.99) h vs (18.17 +/- 4.69) h, P < 0.05]. CONCLUSION: The electric stimulation of long-term retaining needle is safe and effective in analgesia after LC. It avoids the adverse reactions of analgesics and promotes postoperative flatus.

Interventions for the management of dry mouth: non-pharmacological interventions.

BACKGROUND: Xerostomia is the subjective sensation of dry mouth. Common causes of xerostomia include adverse effects of many commonly prescribed medications, disease (e.g. Sjogren's Syndrome) and radiotherapy treatment for head and neck cancers. Non-pharmacological techniques such as acupuncture or mild electrostimulation may be used to improve symptoms. OBJECTIVES: To assess the effects of non-pharmacological interventions administered to stimulate saliva production for the relief of dry mouth. SEARCH METHODS: We searched the Cochrane Oral Health Group's Trials Register (to 16th April 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 3), MEDLINE via OVID (1948 to 16th April 2013), EMBASE via OVID (1980 to 16th April 2013), AMED via OVID (1985 to 16th April 2013), CINAHL via EBSCO (1981 to 16th April 2013), and CANCERLIT via PubMed (1950 to 16th April 2013). The metaRegister of Controlled Clinical Trials (www.controlled-trials.com) and ClinicalTrials.gov (www.clinicaltrials.gov) were also searched to identify ongoing and completed trials. References lists of included studies and relevant reviews were also searched. There were no restrictions on the language of publication or publication status. SELECTION CRITERIA: We included parallel group randomised controlled trials of non-pharmacological interventions to treat dry mouth, where participants had dry mouth symptoms at baseline. DATA COLLECTION AND ANALYSIS: At least two review authors assessed each of the included studies to confirm eligibility, assess risk of bias and extract data using a piloted data extraction form. We calculated mean difference (MD) and 95% confidence intervals (CI) for continuous outcomes or where different scales were used to assess an outcome, we calculated standardised mean differences (SMD) together with 95% CIs. We attempted to extract data on adverse effects of interventions. Where data were missing or unclear we attempted to contact study authors to obtain further information. MAIN RESULTS: There were nine studies (total 366 participants randomised) included in this review of non-pharmacological interventions for dry mouth which were divided into three comparisons. Eight studies were assessed at high risk of bias in at least one domain and the remaining study was at unclear risk of bias.Five small studies (total 153 participants, with dry mouth following radiotherapy treatment) compared acupuncture with placebo. Four were assessed at high risk and one at unclear risk of bias. Two trials reported outcome data for dry mouth in a form suitable for meta-analysis. The pooled estimate of these two trials (70 participants, low quality evidence) showed no difference between acupuncture and control in dry mouth symptoms (SMD -0.34, 95% CI -0.81 to 0.14, P value 0.17, I(2) = 39%) with the confidence intervals including both a possible reduction or a possible increase in dry mouth symptoms. Acupuncture was associated with more adverse effects (tiny bruises and tiredness which were mild and temporary). There was a very small increase in unstimulated whole saliva (UWS) at the end of 4 to 6 weeks of treatment (three trials, 71 participants, low quality evidence) (MD 0.02 ml/minute, 95% CI 0 to 0.04, P value 0.04, I(2) = 57%), and this benefit persisted at the 12-month follow-up evaluation (two trials, 54 participants, low quality evidence) (UWS, MD 0.06 ml/minute, 95% CI 0.01 to 0.11, P value 0.03, I(2) = 10%). For the outcome of stimulated whole saliva (SWS, three trials, 71 participants, low quality evidence) there was a benefit favouring acupuncture (MD 0.19 ml/minute, 95% CI 0.07 to 0.31, P value 0.002, I(2) = 1%) an effect which also persisted at the 12-month follow-up evaluation (SWS MD 0.28 ml/minute, 95% CI 0.09 to 0.47, P value 0.004, I(2) = 0%) (two trials, 54 participants, low quality evidence).Two small studies, both at high risk of bias, compared the use of an electrostimulation device with a placebo device in participants with Sjögren's Syndrome (total 101 participants). A further study, also at high risk of bias, compared acupuncture-like electrostimulation of different sets of points in participants who had previously been treated with radiotherapy. None of these studies reported the outcome of dry mouth. There was no difference between electrostimulation and placebo in the outcomes of UWS or SWS at the end of the 4-week treatment period in the one study (very low that provided data for these outcomes. No adverse effects were reported.A single study at high risk of bias, compared the stimulatory effect of powered versus manual toothbrushing and found no difference for the outcomes of UWS or SWS. AUTHORS' CONCLUSIONS: There is low quality evidence that acupuncture is no different from placebo acupuncture with regard to dry mouth symptoms, which is the most important outcome. This may be because there were insufficient participants included in the two trials to show a possible effect or it may be that there was some benefit due to 'placebo' acupuncture which could have biased the effect to the null. There is insufficient evidence to determine the effects of electrostimulation devices on dry mouth symptoms. It is well known that dry mouth symptoms may be problematic even when saliva production is increased, yet only two of the trials that evaluated acupuncture reported dry mouth symptoms, a worrying reporting bias. There is some low quality evidence that acupuncture results in a small increase in saliva production in patients with dry mouth following radiotherapy.There is insufficient evidence to determine the effects of electrostimulation devices on dry mouth symptoms or saliva production in patients with Sjögren's Syndrome. Reported adverse effects of acupuncture are mild and of short duration, and there were no reported adverse effects from electrostimulation.

[Effect of electroacupuncture at different frequencies on serum estradiol and progesterone levels in late-stage pregnancy rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) at different frequencies on serum estradiol (E2), progesterone (P), thromboxance B2 (TXB2), 6-Keton-prostaglandin F 1 alpha (6-keto-PGF1alpha) contents in late pregnancy rats so as to study its mechanisms underlying labor promotion. METHODS: A total of 66 late-stage pregnant Wistar rats were randomly divided into 6 groups: normal control, late-pregnancy model (model), 2 Hz-EA, 20 Hz-EA, 50 Hz-EA and 100 Hz-EA groups, with 11 rats in each group. On the 19th day after pregnancy, EA (2 Hz, 20 Hz, 50 Hz, 100 Hz, 0.1 mA) was applied to bilateral "Hegu" (LI 4) for 20 min first and to bilateral "Sanyinjiao" (SP 6) for 5 min afterwards. Serum E2, P, TXB2 and 6-keto-PGF1alpha contents were assayed by radioimmunoassay, and the ratios of E2/P and TXB2/6-keto-PGF1alpha were calculated. RESULTS: Compared to the normal control group, serum E2 contents in 2 Hz-EA, 20 Hz-EA, 50 Hz-EA and 100 Hz-EA groups were increased significantly (P < 0.001, P < 0.01, P < 0.05). Compared to the model group, serum E2 levels in the 2 Hz-EA and 20 Hz-EA groups were up-regulated further significantly (P < 0.05). Comparison among the four EA groups showed that serum P level in the 100 Hz-EA group was significantly higher than those in the 20 Hz-EA and 50 Hz-EA groups (P < 0.05). Compared to the normal control group, the contents of serum TXB2 and the ratios of E2/P in both 2 Hz-EA and 50 Hz-EA groups were significantly higher (P < 0.05, P < 0.001, P< 0.01). CONCLUSION: Both 2 Hz and 20 Hz EA can effectively increase serum E2 content, and 2 Hz and 50 Hz EA can raise serum TXB2 and E2/P levels in late pregnancy rats, which may contribute to their effects in strengthening the uterine contractility to promote labor by regulating hormone secretion.

[Effects of encircled needling plus electroacupuncture on hyperplastic mammary glands and serum sex hormones in the rat].

OBJECTIVE: To observe the effect of encircled needling plus electroacupuncture (EA) of the second pair of nipples on hyperplastic mammary glands, serum estradiol (E2), progesterone (P), prolactin (PRL) and testosterone (T) contents, estrogen receptor (ER) expression of the mammary glands in mammary hyperplasia rats. METHODS: Forty Wistar rats were equally randomized into normal control, model, acupuncture and medication groups. Mammary gland hyperplasia model was established by intramuscular injection of diethylstilbestrol (0.5 mg/kg, once daily for 25 days) and progesterone (4 mg/kg, once daily for 5 days). For rats of the acupuncture group, 4 filiform needles were inserted into the surrounding tissues of the second pair of breasts, respectively, followed by giving the animal with EA stimulation for 30 min. Another one acupuncture needle was inserted into "Danzhong" (CV 17) and retained for 30 min. For rats of the medication group, tamoxifen solution (1.8 mg/kg) was given by gavage. Both medication and EA intervention were given once daily for 30 days. The diameter and height of the second pair of nipples were measured before and on the 10th, 20th and 30th days of the treatment. Serum E2, P, PRL and T levels were assayed by radioimmunoassay, and the tissues of the second pair of nipples were stained with H. E. method. Estrogen receptor immunoactivity of the breast tissue was detected by immunohistochemistry. RESULTS: The diameter and height of the second pair of nipples, serum E2, PRL and T contents, and breast ER protein expression level were significantly higher in the model group than in the normal control group (P<0.05), while serum P content was remarkably lower in the model group than in the normal control group (P<0.05). In comparison with the model group, the diameter and height of the second pair of nipples, serum E2, PRL and T contents, and breast ER protein expression level were considerably lower in both acupuncture and medication groups (P<0.05), and serum P contents were significantly higher in the latter two groups (P<0.05). In addition, H.E. staining showed that the numbers of the lobule, alveolus and ducts of mammary glands were significantly increased, and the expansion of the acinar lumina and ducts was found in the model group. These pathological changes were relatively milder in both acupuncture and medication groups. CONCLUSION: Encircled needling plus EA stimulation of the surrounding tissues of the nipples can improve the hyperplasic nipples and pathological changes of the breast tissue in mammary gland hyperplasia rats, which is closely associated with its functions in lowering serum estradiol, prolactin, testosterone contents and estrogen receptor protein expression of the breast, and in increasing serum progesterone level.

[Study on dose-effect relationship of electroacupuncture with different current intensities alleviating tibial cancer pain and inhibition of expression of spinal GFAP in rats].

OBJECTIVE: To observe the dose-effect relationship of electroacupuncture of different current intensities combined with Morphine of different dosage on alleviating the rats' tibial cancer pain, and explore the possible mechanism, which could provide the experiment basis for alleviating the tibial cancer pain by electroacupuncture combined with Morphine. METHODS: One hundred female Wistar rats were randomly divided into a normal group, a model group and eight treatment groups, 10 cases in each group. The rats in the treatment groups were treated by combined therapies of electroacupuncture of different intensities with 2 Hz /100 Hz dense-disperse wave on "Jiaji"(EX-B 2)and different dosage Morphine in 2 factor 3 level conditions, once a day for 6 days. The pain thresholds were observed before the treatment and 0 min, 1 h, 2 h and 5 h after the first treatment as well as after 3 and 6 times of treatments. The glial fibrillary acidic protein (GFAP) expression was determined by immunohistochemical method. RESULTS: The rats' pain thresholds were significantly increased with electroacupuncture of 2 mA and 1 mA (all P < 0.01) on the 0 min, 1 h and 2 h of the first treatment, between which there were no significant differences (all P > 0.05). The pain threshold was still increased by electroacupuncture of 2 mA on the 5 h of the treatment (P < 0.01), while that of 1 mA failed to take effect (P > 0.05). After 3 and 6 times of treatments, both electroacupuncture of 2 mA and 1 mA had the effect of increasing the pain threshold (all P < 0.01), and the effect of 2 mA was superior to that of 1 mA (P < 0.05), had the synergistic effect with 5 mg/(kg x d) Morphine (P < 0.05). After 6 times of treatments, both electroacupuncture of 2 mA and 1 mA could inhibit the expression of GFAP (both P < 0.01), and there was no significant difference between them (P > 0.05). Both of 5 mg/(kg x d) and 2.5 mg/(kg x d) of Morphine, however, didn't bring about inhibition effect (P > 0.05). CONCLUSION: There is a does-effect relationship on electroacupuncture of different current intensity for alleviating the tibial cancer pain in rats. The electroacupuncture with 2 mA, which is better than that with 1 mA, has the synergistic effect with 5 mg/(kg x d) of Morphine. The electroacupuncture can inhibit the expression of GFAP to cooperate with Morphine for the purpose of alleviating the rats' tibial cancer pain.

Photoelectric stimulation of defined ear points (Smokex-Pro method) as an aid for smoking cessation: a prospective observational 2-year study with 156 smokers in a primary care setting.

BACKGROUND: Smokex-Pro is a smoking cessation method using a protocol of a standardized consultation and computer-assisted photoelectric stimulation of defined regions in the ear and face. METHODS: We prospectively enrolled 156 consecutive adult smokers (81 males, 75 females; mean age 43.8 years; body mass index 25.5; daily cigarettes 24.7; Fagerström Test for Nicotine Dependence 5; 30 smoking years). The primary end point was the self-reported continuous abstinence rate. RESULTS: Participants completed on average only 32% of recommended visits. A total of 76.7% stopped smoking for more than 7 days. Moreover, 53.4% remained free of smoking for more than 90 days. Long-term abstinence rates were 49.3% (1 year) and 47.95% (2 years). Treatment-related side effects were observed in 24.5% of participants. Side effects were mild and resolved within hours. CONCLUSION: The Smokex-Pro method appears to be an effective aid for smoking cessation. The treatment was well tolerated and showed only mild and temporary side effects. The average cost of treatment is typically less than EUR 90; the total treatment time is typically 60-90 min. These factors make it an attractive alternative compared to traditional smoking cessation methods. Controlled clinical trials will be needed to confirm the results of this study and refine the treatment for maximum efficacy.

Does osteoarthritis of the knee also have a psychogenic component? Psycho-emotional treatment with a radio-electric device vs. intra-articular injection of sodium hyaluronate: an open-label, naturalistic study.

This study is to compare, in patients suffering of knee joint disorder, the effects of intra-articular injection of Sodium Hyaluronate, and those of a treatment aiming at the improvement of the emotional status carried out by means of a Radio Electric Device (REAC). 30 subjects were divided into two groups: 15 who preferred a non-drugs approach (Group A) and 15 who preferred an infiltrative treatment (Group B). The evaluations were expressed for both pain level and knee bending and extension. Group A showed significant decrease in pain, stiffness, joint noises and intra-articular effusion, and significant improvement in motion range, without any patients worsening. 8 patients showed complete disappearance of pain in Visual Analog Pain Scale (VAS) evaluation, evident by a level of 0. The initial VAS results were between 8 and 4. One month after treatment's end, VAS results of the patients in Group A were between 3 and 0. Group B showed significant decrease in pain, stiffness, joint noises and intra-articular effusion, but no significant improvement in motion range; 2 of 15 patients showed worsening symptoms and no significant improvement in muscular hypotrophy. Initial VAS results were between 7 and 4. One month after treatment's end, VAS results were between 6 and 0.

Electro-acupuncture efficacy on pain control after mandibular third molar surgery.

The aim of this study was to evaluate the efficacy of electro-acupuncture (EAC) on postoperative pain control after mandibular third molar surgery. Twenty four young patients (12 male and 12 female) with symmetrically impacted mandibular third molars were selected. Each patient was submitted to two separate surgical procedures under local anesthesia. At one side, extraction was carried out employing both prior (24h) and immediately postoperative application of EAC, while on the contralateral side surgery was carried out without any treatment. EAC was applied on 6 bilateral systemic and 2 auricular points with a WQ10Dl appliance using 40-60Hz frequency for 20 min and individually adjusted intensity. Postoperative pain intensity was rated on a 100 mm visual analog scale (VAS) between 2 and 72 h and recording the amount of analgesics intake after surgery. Statistical analysis was performed using theWilcoxon test. Postoperative pain VAS scores were significantly lower for the EAC group (p<0.05) and analgesic intake decreased (p<0.05) for all evaluated periods (p<0.05). Under the tested conditions EAC therapy is efficient was proved controlling postoperative pain following mandibular third molar surgical removal.

P-Stim auricular electroacupuncture stimulation device for pain relief.

Acupuncture is now accepted as a complementary analgesic treatment. Auricular acupuncture is a distinct form of acupuncture. Electrical stimulation of acupoints (electroacupuncture) increases the effects of acupuncture. Recently, an auricular electroacupuncture device, the P-Stim, has become available. Clinical studies in outpatients have investigated the P-Stim in chronic musculoskeletal pain and its use for minor surgery. In chronic cervical or low back pain, auricular electroacupuncture was more effective than conventional auricular acupuncture. The results in acute pain were controversial. Auricular electroacupuncture reduced pain and remifentanil consumption during oocyte aspiration when compared with conventional auricular acupuncture or a sham treatment. However, after third molar tooth extraction, auricular electroacupuncture and auricular acupuncture failed to reduce either postoperative pain or analgesic consumption. Further large-scale studies are required to evaluate the analgesic efficacy of auricular electroacupuncture.

Electro-acupuncture efficacy on pain control after mandibular third molar surgery

The aim of this study was to evaluate the efficacy of electro-acupuncture (EAC) on postoperative pain control after mandibular third molar surgery. Twenty four young patients (12 male and 12 female) with symmetrically impacted mandibular third molars were selected. Each patient was submitted to two separate surgical procedures under local anesthesia. At one side, extraction was carried out employing both prior (24h) and immediately postoperative application of EAC, while on the contralateral side surgery was carried out without any treatment. EAC was applied on 6 bilateral systemic and 2 auricular points with a WQ10Dl appliance using 40-60Hz frequency for 20 min and individually adjusted intensity. Postoperative pain intensity was rated on a 100 mm visual analog scale (VAS) between 2 and 72 h and recording the amount of analgesics intake after surgery. Statistical analysis was performed using theWilcoxon test. Postoperative pain VAS scores were significantly lower for the EAC group (p<0.05) and analgesic intake decreased (p<0.05) for all evaluated periods (p<0.05). Under the tested conditions EAC therapy is efficient was proved controlling postoperative pain following mandibular third molar surgical removal.

O objetivo desta pesquisa foi verificar a eficácia da aplicação de eletro-acupuntura (EAC) na redução da dor após a exodontia de terceiros molares inferiores inclusos. Foram selecionados 24 pacientes jovens (12 homens e 12 mulheres) com inclusão bilateral de terceiros molares inferiores em posição similar. Cada paciente foi submetido aleatoriamente a dois procedimentos cirúrgicos em dias diferentes: em um deles o dente foi extraído com uma sessão pré-operatória (24 h) e uma pós-operatória imediata de EAC enquanto no outro a extração foi feita sem EAC. A EAC foi aplicada em 6 pontos sistêmicos bilaterais e 2 auriculares com um aparelho WQ10D1 utilizando freqüência de 40-60 Hz por 20 min com intensidade ajustada individualmente. A dor foi avaliada desde 2h até 72h pós-operatórias utilizando a escala visual análoga (EVA) de 100 mm e pelo consumo de analgésicos. Os dados foram comparados pelo teste deWilcoxon. Os escores de dor da EVA foram significantemente menores para o tratamento com EAC (p<0,05) enquanto o consumo de analgésico diminuiu (p<0,05) em todos os períodos (p<0,05). O tratamento com EAC mostrou-se eficiente no controle da dor pós-operatória após cirurgia de extração de terceiros molares inferiores inclusos.

Percutaneous electrical nerve stimulation (PENS): a complementary therapy for the management of pain secondary to bony metastasis.

OBJECTIVE: To evaluate the use of a novel nonpharmacologic analgesic therapy known as percutaneous electrical nerve stimulation (PENS) in the management of opioid-resistant cancer pain. DESIGN: PENS therapy was administered to three cancer patients on three or more occasion using acupuncturelike needle probes that were stimulated for 30 minutes at frequencies of 4-100 Hz. RESULTS: Two of the three patients achieved good to excellent pain relief that lasted 24-72 hours after each treatment session. CONCLUSION: PENS therapy is a useful supplement to opioid analgesics for the management of pain secondary to bony metastasis in terminal cancer patients.

Lack of influence of acupuncture and transcutaneous stimulation on the immunoglobulin levels and leucocyte counts following upper-abdominal surgery.

The changes in immunoglobulins (IgA, IgG and IgM) and total and differential leucocyte counts in the peripheral blood during, and for 6 days after, surgery were evaluated in 29 male patients submitted to standardized upper-abdominal surgery performed under two different anaesthetic techniques. Group 1 received stimulation of ear and paravertebral points, supplemented by small doses of fentanyl (mean 1.2 micrograms kg-1, range 0.0-5.7) and Group 2 received moderate-dose fentanyl (mean 22.9 micrograms kg-1, range: 17.5-29.8). All were induced with thiopentone 5 mg kg-1, intubated after vecuronium 0.1 mg kg-1 and ventilated with 67% nitrous oxide in oxygen. Inhalation anaesthesia was not used. Surgery was followed by a fall in immunoglobulins, lymphocyte and eosinophil counts and a rise in leucocyte and neutrophil counts in both groups (P less than 0.01). No recovery was observed until the last assessment on Day 6 after surgery in IgA, IgG, leucocyte, neutrophil and lymphocyte counts in both groups, whereas IgM and eosinophil counts recovered by Day 4. Monocyte and basophil counts were unchanged in either group. Acupuncture and transcutaneous stimulation analgesia performed for major abdominal surgery did not influence the body's immune system either during or after surgery as measured by the concentrations of immunoglobulin and total and differential WBC counts.