Surface Electrostimulation of Acupuncture Points for Sedation of Critically Ill Patients in the Intensive Care Unit – a Pilot Study

Abstract

Background This is a pilot study to investigate the effects of electrostimulation of acupuncture points on sedation and the dose of sedatives in the Intensive Care Unit. Methods Electrostimulation of acupuncture points was performed on 12 critically ill patients requiring sedation for mechanical ventilation. Electrostimulation was applied by point surface electrodes at LI4, ST36, HT7 and LR3 points for 20 minutes every hour for 12 hours using dense dispersed mode with a current frequency of 10-100Hz and maximum intensity of 10mA. All patients were sedated with propofol and alfentanil as required. The dose of propofol was reduced by 10mg/hour provided the patient remained sedated according to our guidelines. Sedation and analgesia scores, dose of sedative and analgesics drugs, respiratory rate, heart rate, mean arterial blood pressure and compliance with the ventilator were recorded before electrostimulation of acupuncture points, and hourly thereafter for 12 hours. Results There was significant reduction in the median propofol consumption from 145mg/hour (range 30-250) to 15mg/hour (range 0-250) (P<0.05), without any significant change in sedation scores or analgesia scores. The haemodynamic and respiratory variables remained stable. All patients were compliant with the ventilator. Conclusion This pilot study showed significant reduction in the dose of propofol required for sedation in critically ill patients following surface electrostimulation of acupuncture points, without any adverse effects. Arandomised controlled trial is warranted.

Ação da TENS acupuntural em acupontos na dor induzida pela hipotermia local (0-2º C)

“…Não temos evidências de que a TENS tenha atuado exclusivamente nos pontos acupunturais, pois os eletrodos possuem área que abrange o nervo mediano, ulnar e radial, mas, pelo posicionamento dos eletrodos em cima dos acupontos, sabemos que a corrente elétrica passou por eles. Isto corrobora um estudo de Nayak et al (27), que conseguiram um aumento no estado de sedação de pacientes de UTI, sem qualquer efeito colateral, com eletroestimulação superficial de acupontos.…”

Electroacupuncture Reduces the Dose of Midazolam Monitored by the Bispectral Index in Critically Ill Patients with Mechanical Ventilation: An Exploratory Study

“…Sedative drugs can even induce true physical dependence and psychological dependence, with or without addiction, leading to drug withdrawal diffi culties, increasing the economic burden of long-term ICU patients. This could enhance the role of acupuncture in treatment for sedation 35 and for analgesia. 36 Numerous studies have demonstrated that the nervous system, neurotransmitters and endogenous substances may respond to needling stimulation and electrical acupuncture.…”

Acupuncture Sedation in An Intensive Therapy Setting

“…1 A pilot study has previously implied a role for acupuncture in sedation of critically ill patients. 2 Surface electrostimulation (at LI4, ST36, HT7 and LR3) signifi cantly reduced the amount of propofol used to sedate 12 patients. 2 In that study, sedation was assessed using a subjective scoring system (Sheffi eld Sedation Scale).…”

“…2 Surface electrostimulation (at LI4, ST36, HT7 and LR3) signifi cantly reduced the amount of propofol used to sedate 12 patients. 2 In that study, sedation was assessed using a subjective scoring system (Sheffi eld Sedation Scale). 2 Zheng et al used BIS and the Ramsay scoring system to guide sedation in 45 patients in intensive care.…”

“…2 In that study, sedation was assessed using a subjective scoring system (Sheffi eld Sedation Scale). 2 Zheng et al used BIS and the Ramsay scoring system to guide sedation in 45 patients in intensive care. 1 One group received midazolam only (group A), other groups additionally received acupuncture (B) or electroacupuncture (C) at GV24 and Yintang.…”