Electroanaesthesia--from torpedo fish to TENS.

In 153 AD, the Roman physician Scribonius Largus identified that electric current had analgesic properties, instructing patients to stand on an electric ray for the treatment of gout. In 2014, transcranial magnetic stimulation was approved by the National Institute for Health and Care Excellence for the treatment of migraine. Although separated by nearly two millennia, these milestones represent the evolution of the utilisation of electric current in medical and anaesthetic practice. Significant advances have been made over the last century in particular, and during the 1960s and 1970s, tens of thousands of patients were reportedly anaesthetised for surgical interventions using electric current as the anaesthetic agent. Many medical interventions, including transcutaneous electrical nerve stimulation and deep brain stimulation, have evolved in the aftermath of investigations into electroanaesthesia; the potential for electric current to be an anaesthetic agent of the future still exists.

Effect of tricainemethanesulfonate (MS222), clove oil and electro-anaesthesia on respiratory burst activity in whole blood and serum alternative complement response in rainbow trout (Oncorhynchus mykiss), during the narcosis stage.

There is a little available information on the suppressive effect of anaesthesia on immune response in fish, especially electro-anaesthesia. In the present study, two anaesthetics, MS222 (50 ppm), clove oil (25 ppm), and electro-anaesthesia were tested in rainbow trout (Oncorhynchus mykiss) during the narcosis stage in order to observe their effects on the innate immune system. The results showed that electro-anaesthesia reduces light emission in chemiluminescence assay both 1 and 24 h post anaesthesia. Clove oil and MS222 decreased light emission 24 h post anaesthesia. In addition, clove oil, MS222 and electro-anaesthesia had no effect on alternative complement (ACH50) response. From the perspective of aquaculture practice, these data show that the type of anaesthesia should be taken into account to avoid possible immunosuppression in rainbow trout.

[The combined rehabilitative treatment of the children with obesity and metabolic syndrome].

The present study included a total of 66 children at the age from 11 to 16 years with obesity and metabolic syndrome. The latter condition in the childhood and adolescence is characterized by the pronounced disturbances of basal metabolism, vasoactive systems, psychoemotional status, and regulatory hormonal functions that determine the choice of rehabilitative modalities. The combined treatment of such disturbances is considered to be an efficacious method for the rehabilitation of these patients. It is recommended that cortexin be prescribed to the children presenting with obesity and metabolic syndrome because this medication promotes correction of the hormonal and metabolic status and improves the brain cognitive function.

[Non-medication treatment of patients with chronic cystitis].

Combined application of ultrasound, modulated sinusoidal currents (MSC), and iodine-bromine baths is known to be a highly efficacious method for the rehabilitative treatment of patients with chronic cystitis in the phase of latent inflammation. The present study has demonstrated that combination of ultrasound with electrotherapeutic sleep and iodine-bromine baths exerts pronounced anti-inflammatory effect and bacteriostatic action whereas modulated sinusoidal currents combined with electrotherapeutic sleep and iodine-bromine baths significantly improve urodynamics in the lower urinary tract and produce marked anesthetic effect. Evaluation of the immediate and long-term results of the treatment of 16 patients presenting with chronic cystitis revealed the absence of exacerbation of infectious and inflammatory processes in the bladder within 6 months after physiotherapy

Improvement of postoperative analgesia during cancer surgery with Limoge's current: a personal experience.

BACKGROUND: The anesthesiologist took advantage of a personal experience to determine whether transcutaneous cranial electrical stimulation using Limoge's current (TCES-LC) improved the level of postoperative analgesia by potentiating anesthetic agents used during the intra- and postoperative phases. Included were analgesics injected through an epidural thoracic catheter (T8-T9) positioned at the end of an esophagectomy. Another reason for a self-experimentation was to be able to evaluate the psycholeptic effects of TCES-LC to gain a better understanding of the problems linked with pain during treatment. METHODS: The Limoge' current is bidirectional and consists of a high-frequency biphasic asymmetrical wave composed of modulated, high-frequency (166-kHz) pulse trains with a repetition cycle of 100 Hz. TCES-LC was initiated 2 hours before anesthetic induction without any tranquilizer or other medication. TCES-LC was continuously applied during the entire surgical procedure and continued 48 hours postoperatively in the intensive care unit (ICU). As the objective was not to obtain electrical anesthesia, the usual anesthetic protocol was used during surgery. RESULTS: During the initial 48 postoperative hours with continuous application of TCES-LC (D0-D1), a decrease of the epidural anesthetic dose requirement was observed for ropivacaine, and sufentanil (-25% and -60% respectively). A similar decrease in these medications was also measured on day 2 (D2), while TCESLC was terminated. This decrease was amplified day 3 (D3) for both ropivacaine and sufentanil (-50% and -73% respectively). On day 4 (D4) the epidural anesthetics were totally suppressed (1 day before the normal conventional schedule planned for by the ICU physician with this type surgery). CONCLUSION: Future clinical trials need to be conducted to show the significant advantages of TCES-LC in alternative and complementary medicine.

Eletroanestesia odontologica (EAO) / Eletronic dental anesthesia

A Elotroanestesia Odontólogica é um método de anestesia antigo que volta a ser estudado e divulgado. Não tem como intenção substituir ou eliminar a anestesia por injeção, mas é, sem dúvida alguma, uma arma poderosa a mais no arsenal terapêutico do Cirurgião Dentista. Neste trabalho, os autores apresentam um novo aparelho de eletroanestesia e relatam um caso de extração dentária realizada com este método de analgesia

Princípios físicos da estimulação magnética transcraniana / Magnetic stimulation: physical and technical aspects

Este trabalho descreve brevemente os principais aspectos da física e da tecnologia envolvidos no processo de estimulação magnética. Apresenta a lei de indução de Faraday e descreve como um pulso de campo magnético, intenso e rápido, tem condições de gerar campos elétricos localizados, adequados à produção de correntes elétricas em determinados tecidos. Discute-se, também, como a geometria da bobina e o perfil temporal dos pulsos de corrente que a percorrem, são usados para otimizar a distribuição e intensidade dos campos elétricos induzidos.

Evaluación clínica de la analgesia dental electrónica / Clinical evaluation of the electronic dental anesthesia

Durante mucho tiempo se ha usado en odontología anestesia química local. Pero ahora, hay una nueva alternativa llamada anestesia dental electrónica. El respaldo fisiológico está basado en la teoría de control de puerta de Melzack y Wall. En el presente estudio, una unidad llamada H-Wave se ha usado para comparar la eficiencia de la anestesia electrónica en lugar de anestesia química. El estudio mostró que no hay diferencias significativas en el efecto anestésico y el 64 por ciento de los pacientes prefirieron la electrónica

New horizons in local anesthesia.

The computer-controlled local anesthesia system and the TEA system present 21st-century alternatives to the traditional syringe. The TEA system is a non-invasive form of anesthesia that blocks pain electronically, using the same cellular mechanism as local chemical anesthesia. Targeted electronic anesthesia provides pain control for restorative dental procedures without the use of needles or postoperative discomfort, numbness, and swelling. The computer-assisted system outperforms syringes for traditional injections. This new system generates a precisely controlled anesthetic flow rate that eliminates the need for the operator to use thumb pressure to administer the injection. The lightweight pen-grasp handle results in greater tactile feedback, precision, operator ease, and patient comfort. The greatest advantage may be in the new techniques that it makes available. With these techniques, a dentist can target the teeth to achieve profound pulpal anesthesia, often without the annoying side effects of facial numbness. With this new advanced system in the maxillary arch, the AMSA injection offers clinical advantages over traditional anesthesia techniques, according to Dr. Mark Friedman, whom I consulted with earlier this year. In the mandibular arch, a safe and predictable PDL injection technique may replace the need for an inferior alveolar block in numerous clinical situations. The use of these modified injection techniques can have a positive influence on patient safety, patient comfort, and office productivity. Both of these systems take the fear and anxiety out of dental injections. They offer exciting advanced technology for local pain control. Significantly, if patient stress and anxiety are reduced, the operator immediately benefits. New horizons in local anesthesia offer improved opportunities for patient comfort using computer-controlled local anesthetic systems and TEA.

[Transcranial electrostimulation: a new approach (experimental and clinical bases and equipment)]. / Transkranial'naia élektrostimuliatsiia: novyi podkhod (éksperimental'no-klinicheskoe obosnovanie i apparatura).

The paper deals with one type of electrostimulation-transcranial electrostimulation (TES). It outlines the physiological mechanisms underlying TES, the clinical features of its application, the equipment performing TES, defines its optimum analgesic mode.

[The effect of combined transcerebral magnetic and electric impulse therapy on the cerebral and central hemodynamic status of stroke patients in the early rehabilitation period]. / Vliianie sochetannoi transtserebral'noi magnitnoi i élektroimpul'snoi terapii na sostoianie mozgovoi i tsentral'noi gemodinamiki u bol'nykh s mozgovym insul'tom v rannem periode reabilitatsii.

75 clinical cases of acute impairment of cerebral circulation treated with sinusoidal modulated currents in combination with transcerebral magnetic field have been analysed. Functional and clinical findings indicate that the above combination is much more effective than magnetic field and sinusoidal modulated currents alone: 62% against 35% and 33%, respectively.

[The importance of electroencephalographic studies for evaluating the action of physical treatment methods in patients with a neuroendocrine syndrome and disordered menstrual function]. / Znachenie élektroéntsefalograficheskikh issledovanii dlia otsenki deistviia fizicheskikh metodov lecheniia bol'nykh neiroéndokrinnym sindromom s narusheniem menstrual'noi funktsii.

Electroencephalograms of 43 females (mean age 27.3 +/- 5.2 years) were examined for integral power of various EEG rhythms, delta, beta, alpha, beta 1 intervals for occipital, parietal and frontal region, right and left hemispheres. The frequency analysis was made with regard of EEG type. A particular role of the right hemisphere in development of neuroendocrine pathology is discussed.

Activation of anterior lobe corticotrophs by electroacupuncture or noxious stimulation in the anaesthetized rat, as shown by colocalization of Fos protein with ACTH and beta-endorphin and increased hormone release.

A marked expression of the c-fos proto-oncogene has been recently reported in cells of the anterior lobe of the pituitary gland in rats subject to electroacupuncture or noxious thermal stimulation under pentobarbital anaesthesia. The present study was undertaken to identify the activated pituitary cells. Following both kinds of stimulation, most Fos-immunoreactive anterior lobe cells showed colocalization with adrenocorticotropic hormone or beta-endorphin immunoreactivity. No c-fos expression occurred in pituitary cells immunoreactive for growth hormone, prolactin, luteinizing hormone, or thyrotropin-stimulating hormone. A marked rise of adrenocorticotropic hormone and beta-endorphin concentrations occurred in plasma. In the hypothalamus, c-fos expression was increased in the mediobasal nuclei-namely, the arcuate nucleus-and in the paraventricular nucleus, but more in the former. It is suggested that somatosensory noxious input, or the partly noxious input evoked by electroacupuncture, activate the hypothalamo-pituitary-adrenocortical axis as in common forms of stress, but with a specific activation of the mediobasal hypothalamic nuclei and no stimulation of intermediate lobe cells. Opiate release from the pituitary gland may contribute to acupuncture analgesia or the intrinsic antinociceptive reactions triggered by noxious stimulation.

Meta-analysis of randomized controlled trials of cranial electrostimulation. Efficacy in treating selected psychological and physiological conditions.

To clarify the diverse published results of cranial electrostimulation (CES) efficacy, we conducted an extensive literature review that identified 18 of the most carefully conducted randomized controlled trials of CES versus sham treatment. For the 14 trials that had sufficient data, we used the techniques of meta-analysis to pool the published results of treating each of four conditions: anxiety (eight trials), brain dysfunction (two trials), headache (two trials), and insomnia (two trials). Because studies utilized different outcome measures, we used an effect size method to normalize measures which we then pooled across studies within each condition. The meta-analysis of anxiety showed CES to be significantly more effective than sham treatment (p < .05). Pooling did not affect results that were individually positive (headache and pain under anesthesia) or negative (brain dysfunction and insomnia). Most studies failed to report all data necessary for meta-analysis. Moreover, in all but two trials, the therapist was not blinded and knew which patients were receiving CES or sham treatment. We strongly recommend that future trials of CES report complete data and incorporate therapist blinding to avoid possible bias.