Manual and electroacupuncture for labour pain : study design of a longitudinal randomized controlled trial

Introduction. Results from previous studies on acupuncture for labour pain are contradictory and lack important information on methodology. However, studies indicate that acupuncture has a positive effect on women's experiences of labour pain. The aim of the present study was to evaluate the efficacy of two different acupuncture stimulations, manual or electrical stimulation, compared with standard care in the relief of labour pain as the primary outcome. This paper will present in-depth information on the design of the study, following the CONSORT and STRICTA recommendations. Methods. The study was designed as a randomized controlled trial based on western medical theories. Nulliparous women with normal pregnancies admitted to the delivery ward after a spontaneous onset of labour were randomly allocated into one of three groups: manual acupuncture, electroacupuncture, or standard care. Sample size calculation gave 101 women in each group, including a total of 303 women. A Visual Analogue Scale was used for assessing pain every 30 minutes for five hours and thereafter every hour until birth. Questionnaires were distributed before treatment, directly after the birth, and at one day and two months postpartum. Blood samples were collected before and after the first treatment. This trial is registered at ClinicalTrials.gov: NCT01197950.

Comparison of decompressive surgery, electroacupuncture, and decompressive surgery followed by electroacupuncture for the treatment of dogs with intervertebral disk disease with long-standing severe neurologic deficits

Objective To compare the effects of decompressive surgery (DSX), electroacupuncture (EAP), and DSX followed by EAP (DSX + EAP) for the treatment of thoracolumbar intervertebral disk disease (IVDD) in dogs with severe neurologic deficits of > 48 hours' duration.Design Retrospective case series and prospective clinical trial.Animals-40 dogs between 3 and 6 yEAPs old and weighing between 10 and 20 kg (22 and 44 lb) with long-standing (>48 hours) clinical signs of severe neurologic disease attributable to thoracolumbar IVDD.Procedures Thoracolumbar medullar injury was classified on the basis of neurologic signs by use of a scale ranging from 1 (least severe) to 5 (most severe). The DSX dogs (n = 10) were retrospectively selected from those that underwent DSX for the treatment of thoracolumbar IVDD. In addition, 19 dogs received EAP alone and 11 dogs underwent DSX followed by EAP (DSX + EAP). Outcome was considered a clinical success when a dog initially classified as grade 4 or 5 was classified as grade 1 or 2 within 6 months after the end of treatment.Results The proportion of dogs with clinical success was significantly higher for dogs that underwent EAP (15/19) than for dogs that underwent DSX (4/10); the proportion of dogs with clinical success for dogs that underwent DSX + EAP was intermediate (8/11).Conclusions and Clinical Relevance EAP was more effective than DSX for recovery of ambulation and improvement in neurologic deficits in dogs with long-standing severe deficits attributable to thoracolumbar IVDD. (J Am Vet Med Assoc 2010;236:1225-1229)

Electroacupuncture analgesia in dogs: is there a difference between uni- and bi-lateral stimulation?

Objective To compare the analgesic effect of uni- and bi-lateral electroacupuncture (EA) in response to thermal and mechanical nociceptive stimuli and to investigate the cardiorespiratory, endocrine, and behavioral changes in dogs submitted to EA.Study design Prospective, randomized cross-over experimental study.Animals Eight adult, clinically healthy, cross-breed dogs, weighing 13 +/- 4 kg.Methods Dogs underwent electrostimulation at false acupoints (T-false); bilateral EA at acupoints, stomach 36, gall bladder 34 and spleen 6 (T-EA/bil); unilateral EA at the same points (T-EA/uni) or were untreated (T-control). All animals received acepromazine (0.05 mg kg(-1)) IV; and heart rate, pulse oximetry, indirect arterial blood pressure, respiratory rate, PECO2, rectal temperature, and plasma cortisol concentration were measured before, during, and after EA. Analgesia was tested using thoracic and abdominal cutaneous thermal and mechanical stimuli, and an interdigital thermal stimulus. Behavior was classified as calm or restless. Analysis of variance for repeated measures followed by Tukey's test was used for analysis of the data.Results There were no cardiorespiratory differences among the treatments. The cutaneous pain threshold was higher after EA, compared with false points. The latency period was shorter and analgesia was more intense in T-EA/bil than T-EA/uni, when both were compared with T-false and T-control. Six out of eight animals treated with EA were calm during treatment, and 5/8 and 4/8 of the T-false and T-control animals, respectively, were restless. Latency to interdigital thermal stimulation increased in T-EA/bil compared with the others. There was no difference in plasma cortisol concentrations among the treatments.Conclusions Bilateral EA produced a shorter latency period, a greater intensity, and longer duration of analgesia than unilateral stimulation, without stimulating a stress response.Clinical relevance Bilateral EA produces a better analgesic effect than unilateral EA.

Effects of electroacupuncture on experimental periodontitis in rats

Background: Acupuncture has shown the capability of modulating the immuno-inflammatory response of the host. This study aims to evaluate the effects of electroacupuncture (EA) on ligature-induced periodontitis in rats. Methods: Thirty-two animals were divided into four groups: 1) control; 2) experimental periodontitis (EP); 3) sham-treated (EP/EA-sham); and 4) treated with EA (EP/EA). For the EP groups, a ligature was placed around the right mandibular first molars at day 1. Sessions of EA or EA-sham were assigned every other day. For EA treatment, large intestine meridian points LI4 and LI11 and stomach meridian points ST36 and ST44 were used. EA-sham was performed in off-meridian points. Animals were euthanized at day 11. Histomorphometric and microtomographic analyses were performed. Immunolabeling patterns for the receptor activator of nuclear factor kappa B ligand (RANKL), osteoprotegerin (OPG), and tartrate-resistant acid phosphatase (TRAP) were assessed. Expressions of interleukin (IL)-1 beta, matrix metalloproteinase (MMP)-8, IL-6, and cyclooxygenase (COX)-2 messenger RNAs (mRNAs) were evaluated by quantitative reverse transcription-polymerase chain reaction. Data were analyzed statistically (P < 0.05, analysis of variance). Results: Histomorphometric and microtomographic analyses demonstrated that group EP/EA presented reduced alveolar bone loss when compared to group EP (P < 0.05). Reduced RANKL immunolabeling and fewer TRAP-positive multinucleated cells were observed in the EA-treated group in relation to group EP. No differences were observed in OPG expression among groups. EA treatment decreased the genic expression of IL-1 beta and MMP-8 (P < 0.05), increased the mRNA expression of IL-6 (P < 0.05), and did not modify the genic expression of COX-2 in animals with EP (P > 0.05). Conclusion: It can be concluded that EA reduced periodontal tissue breakdown and the expression of some proinflammatory mediators and a proresorptive factor in EP in rats.

The antinociceptive effect of electroacupuncture at different depths of acupoints and under the needling surface

Background The stimulation of acupoints along the meridians, but not the non-acupoints outside of the meridians, produces analgesia. Although the acupoint is defined at the body surface, the exact location of the acupoints is not known. This study aims to examine whether the intensity and duration of the analgesic effect of electroacupuncture (EA) at the Zusanli (ST36) and Sanynjiao acupoints (SP6) change according to the depth of the stimulation. Methods Ninety-six male Wistar rats classified as responders were arbitrarily allocated into 16 groups of six rats each. Six groups received EA with uninsulated acupuncture needles (type I) or needles that were immersed in varnish and had the varnish circularly peeled 0.2 mm from the tip (type II), 0.2 mm at 3 mm (type III) or 5 mm (type IV) from the tip, or 0.2 mm at 5 and 1 mm from the tip (type V), or EA sham for 20 min. Five groups received injection of formalin into the acupoint bilaterally at 5 mm or 1 mm deep into ST36, 5 mm below ST36 but inserting the needle at 45° to the skin surface, or 5 mm deep into non-acupoints. The remaining groups received intraplantar injection of saline, 1% or 2.5% formalin. The analgesic effects were measured by the rat tail-flick test. Results The bilateral stimulation of ST36 and SP6 by uninsulated or insulated needles produced analgesia in the rat tail-flick test. The stronger and longer lasting effects occurred after EA with the types I and V needles, or injection of formalin 5 mm deep into ST36. The remaining needles produced weaker and shorter lasting effects. Slow analgesic effect also occurred after formalin injection at 1 mm or 5 mm below ST36 by inserting the needle at 45° to the skin surface. Conclusion The experimental results suggest that the efficacy of the EA stimulation depends on the spatial distribution of the current density under the needling surface rather than only the acupoint or the depth of needling.

Effects of adjunct electroacupuncture on severity of postoperative pain in dogs undergoing hemilaminectomy because of acute thoracolumbar intervertebral disk disease

OBJECTIVE: To compare severity of postoperative pain in dogs undergoing hemilaminectomy because of acute thoracolumbar intervertebral disk disease treated with a combination of conventional analgesics and electroacupuncture (EAP) or with conventional analgesics alone. DESIGN: Controlled clinical trial. ANIMALS: 15 dogs undergoing surgery because of acute thoracolumbar disk disease. PROCEDURES: Dogs were alternately assigned to treatment (conventional analgesics and adjunct EAP) and control (conventional analgesics alone) groups. Analgesic treatment was adjusted as necessary by the attending clinician, who was not aware of group assignment. Pain scores were assigned 1, 3, and 12 hours after surgery and every 12 hours thereafter for 72 hours by the same individual who performed acupuncture treatments. RESULTS: Total dose of fentanyl administered during the first 12 hours after surgery was significantly lower in the treatment group than in the control group, but dosages of analgesics administered from 12 through 72 hours after surgery did not differ between groups. Pain score was significantly lower in the treatment group than in the control group 36 hours after surgery, but did not differ significantly between groups at any other time. CONCLUSIONS AND CLINICAL RELEVANCE: Results provided equivocal evidence that adjunct EAP might provide some mild benefit in regard to severity of postoperative pain in dogs undergoing hemilaminectomy because of acute thoracolumbar intervertebral disk disease.

Eletroacupuntura na anestesia com propofol em cães

Resultados satisfatórios têm sido relatados com o emprego da eletroacupuntura (EA), como adjuvante da anestesia geral no homem e em animais. O objetivo do trabalho é avaliar a dose de indução anestésica do propofol em função do emprego da eletroacupuntura em cães. Foram utilizados 20 cães, distribuídos em dois grupos de igual número, GEA: foi realizada EA nos acupontos estômago 36 (E36), vesícula biliar 34 (VB 34) e baço-pâncreas 6 (BP 6), bilateralmente, durante 45 minutos antes da indução anestésica e GC: não foi realizada EA antes da indução anestésica. Os animais foram tranqüilizados com acepromazina intravenosa (0,05mg.kg-1) 60 minutos antes da indução anestésica, realizada com propofol na taxa de 0,2ml.kg.min-1. A análise estatística foi realizada por test t não pareado(P<0,05). Os valores foram apresentados em média±SD. Não houve diferença significativa na dose do propofol entre os grupos (5±2mg kg-1 no GC e 5,2±1,6mg kg-1 no GEA), sugerindo que a eletroacupuntura não potencializou o efeito depressor do propofol sobre o sistema nervoso central.

A structure excited by a DC motor of limited power supply and controlled by a pendulum like device

In this paper, a mathematical model is derived via Lagrange's Equation for a shear building structure that acts as a foundation of a non-ideal direct current electric motor, controlled by a mass loose inside a circular carving. Non-ideal sources of vibrations of structures are those whose characteristics are coupled to the motion of the structure, not being a function of time only as in the ideal case. Thus, in this case, an additional equation of motion is written, related to the motor rotation, coupled to the equation describing the horizontal motion of the shear building. This kind of problem can lead to the so-called Sommerfeld effect: steady state frequencies of the motor will usually increase as more power (voltage) is given to it in a step-by-step fashion. When a resonance condition with the structure is reached, the better part of this energy is consumed to generate large amplitude vibrations of the foundation without sensible change of the motor frequency as before. If additional increase steps in voltage are made, one may reach a situation where the rotor will jump to higher rotation regimes, no steady states being stable in between. As a device of passive control of both large amplitude vibrations and the Sommerfeld effect, a scheme is proposed using a point mass free to bounce back and forth inside a circular carving in the suspended mass of the structure. Numerical simulations of the model are also presented Copyright © 2007 by ASME.

Comparação entre eletroacupuntura, cirurgia e cirurgia associada à eletroacupuntura no tratamento da doença do disco intervertebral em cães

Pós-graduação em Medicina Veterinária - FMVZ

Comparação entre o ponto P6 (NEIGUAM), ondansetron e da associação de ambos na prevenção de náuseas e vômitos em cirurgia ortopédica de membros inferiores sob bloqueio subaracnoideo

Pós-graduação em Anestesiologia - FMB

Efeito da acupuntura no tratamento de animais com sequelas neurológicas decorrentes de cinomose

Pós-graduação em Medicina Veterinária - FMVZ

Avaliação ultrassonográfica dos efeitos da acupuntura na involução uterina em cadelas

The aim of this study was to evaluate, by means of ultrasound exam, acupuncture effects on uterine involution during the postpartum period in bitches with electroacupuncture. The phenomenon of eutocic uterine involution was studied in 16 bitches, randomly divided into two groups of eight animals each. Group 1 (G1) was treated with electric stimulation (electroacupuncture) of the needle at the points SP6, L3, Bai Hui, TB1, B23, B26, and group 2 (G2), the control group, received treatment in Sham points (placebo points), also with electrical stimuli. The monitoring of the phenomenon of uterine involution was performed by ultrasonography on days 0 (partum), 1, 3, 7 and 14 postpartum. We used SAS statistical analysis method, in order to compare the groups. The results of ultrasound examinations (mean and standard deviations in cm) for the period of observation were as follows: G1: 0.30 ± 0.01 (P), 2.08 ± 0.21 (LU), 4.13 ± 0.23 (DU) and G2: 0.31 ± 0.01 (P) 1.82 ± 0.09 (LU), 3.92 ± 0.11 (DU). We concluded that electroacupuncture affected uterine tone (lasting and uniform at the end of treatment). Electroacupuncture produces a positive tone in the uterus, aiding at the prevention of puerperal diseases.

Avaliação da eficácia da analgesia com acupuntura pela análise imuno-histoquimica da expressão de proteína C-Fos: estudo em modelo experimental de dor aguda em ratos

The behavior and experience of pain are characterized by alertness and anxiety, which disappear soon after the healing process begins. Based on this area, the present study aimed to quantify the expression of c-fos in segments of the brain of rats after surgical stimulation in one rear hind paw (analgesia), using anesthesia with sodium thiopental and practices of acupuncture pre and post operative. The animals were stimulated with intraperitoneal injections of solution (NaCl) 0.2% (2ml), and divided into three groups, control, preoperative and postoperative. Each treatment was divided in manual acupuncture (AM) and electroacupuncture (EA). The animals were randomly distributed in each group. The c-fos expression was quantitated using immunohistochemistry for all situations. The results showed a great efficiency of all treatment compared to the control group (p <0.001), thus reenforcing data in the literature on the potential of acupuncture analgesia. There were no statistical differences among the different treatments, although there was a trend of EA being more efficient than AM

Utilização da acupuntura no tratamento de cães com discopatia intervertebral

The intervertebral disc diseases have a high casuistic in clinical routines veterinary among dogs. These conditions can cause pain, paresis or paralysis of limbs depending on the degree of injury. Clinical signs are not limited to the intervertebral disc, other anatomical parts are included. In conventional medicine, treatment may be surgical or clinical, by the use of corticosteroids with muscle relaxants. Acupuncture was an alternative to treating these diseases due to its anti-inflammatory and analgesic effects. Although there are few studies for the treatment of discopathies, acupuncture triggers the release of substances such as dynorphins, beta-endorphins and serotonin, among others; that act inhibiting somatic and visceral pain. Electroacupuncture is used to potentiate the effects of acupuncture. It can be performed with different frequencies according to the clinical evolution. However there are different opinions related to the greater efficacy in relation to acupuncture. The restraint and monitoring of the treated animal are important factors for its recovery. The association between acupuncture and conventional treatment (surgical or clinical) achieved better results than acupuncture alone. This proves that acupuncture can be considered an option in order to minimize the complications of surgery or assist in patient recovery