Description bilateral Liver 3 and Large Intestine 4
Experimental Description
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).
Sample Count
56
Age
18-65
Control
Sham
Sham control group(n=27)
Experiment
Acupuncture group(n=29)
Indicator
Pre-operative anxietyIntraprocedural alfentanil consumptionVisual analogue scale(VAS)Time to dischargeNumber of oocytes retrievedNumber of embryo transfersNumber of positive pregnancy tests per embryo transferNumber of clinical pregnancies
Auxiliary Medication
The anesthesiologist connected the patient to an alfentanil patient-controlled analgesia (PCA) pump (3 ug kg-1 bolus of alfentanil with a 5-minute lock- out interval). Patients were told to use the PCA pump when- ever they experienced pain and were asked to indicate any pain during the procedure if the self-administered alfentanil was not adequate. The anesthesiologist was instructed to give supplemental alfentanil boluses (3 ug kg-1) only if the patient complained of pain while the PCA pump was in a lockout period. Next, the anesthesiologist administered an intravenous dose of 20 ug kg-1 of midazolam, 10 ug kg-1 of alfentanil, and 10 mg of metoclopramide over 5 minutes to all study patients.
Stimulation Method
EA;MS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
The Patheon® Electro Stimulator
Patheon®(Venice, CA)
2 Hz
symmetrical biphasic waveform, with spikeshaped waves on the top and bottom
Description Patients in the acupuncture group received body acupuncture at bilateral Liver 3 and Large Intestine 4 points. Liver 3 is located on the dorsum of the foot in the depression distal to the junctions of the first and second metatarsals, and Large Intestine 4 is located on the radial side of the middle of the second metacarpal. Body cupuncture interventions were performed using 0.350 mm needles (Addiqui,® Ito Co., Ltd., Shanghai, China). After the body acupuncture insertion process, these needles were attached to a Patheon® Electro Stimulator 4-C (Venice, CA) . This electrical stimulator has four isolate microcurrent output channels, which deliver symmetrical biphasic waveform, with spikeshaped waves on the top and bottom. The positive and negative aspects of the waveform are equal in voltage amplitude, and the net DC bias of the waveform is zero. The pulse width is 4 milliseconds. The acupuncturist adjusted the frequency to 2 Hz and 25 V.
Anesthesia Method
AAA
Clinical Trial Type
random
Contraindications
Exclusion criteria for participation included a history of psychiatric problems, previous experience in acupuncture treatment, and analgesic use within 1 week before the procedure
Effector
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) μg kg 1 minute 1 in the acupuncture group was lower than that of 1.5 (0.9–2.3) μ g 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). 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.
Acupuncture as an adjunct for sedation during lithotripsy.
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."
