Transcutaneous electrical nerve stimulation at the PC-5 and PC-6 acupoints reduced the severity of hypotension after spinal anaesthesia in patients undergoing Caesarean section

Arai, Y.-C. P.; Kato, Naoko; Matsura, Masayo; H, Ito; Kandatsu, Nobuhisa; Kurokawa, Shuji; Mizutani, M.; Shibata, Yohei; Komatsu, Toru

doi:10.1093/bja/aem306

Cited by 46 publications

(22 citation statements)

References 18 publications

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“…We originally expected that stimulate different side LI4 also can result in the different effect on HRV, but the results are apparently at odds with our prospective. One possible explanation is according to traditional acupuncture theory: PC6 is a relative specific acupoint for cardiovascular disease and is one of the most commonly used acupoints in classical texts [29–31]; however, LI4 belongs to large intestine meridian and is not sensitive to modulate the cardiovascular function.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Hegu Acupoints Have the Same Effect on the Heart Rate Variability of the Healthy Subjects

Wang

Tian

Jia

et al. 2014

Evidence-Based Complementary and Alternative Medicine

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Background. The specificity of acupuncture points (acupoints) is one of the key concepts in traditional acupuncture theory, but the question of whether there is adequate scientific evidence to prove or disprove specificity has been vigorously debated in recent years. Acupoint laterality is an important aspect of acupoint specificity. Data is particularly scarce regarding the laterality of the same channel, namesake acupoint located on opposite sides of the body. Our previous study results suggest that Neiguan acupoint (PC6) has the laterality. The aim of this study was to investigate whether Hegu (LI4) also has laterality from the perspective of heart rate variability. Methods. A total of twenty-eight healthy female volunteers were recruited for this study and were randomly separated into the group I (n = 14) and the group II (n = 14) according to the register order. In the group I, left LI4 was stimulated in the first epoch and the right LI4 was stimulated in the second epoch. In the group II, right LI4 was stimulated in the first epoch and left LI4 was stimulated in the second epoch. Electrocardiogram was recorded and heart rate variability was analyzed. Results. The results show that there were no significant differences of heart rate variablity between the group I and the group II in the time domain and in the frequency domain. Conclusions. Bilateral Hegu acupoints have the same effect on the heart rate variability of the healthy subjects.

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Section: Discussionmentioning

confidence: 99%

Bilateral Hegu Acupoints Have the Same Effect on the Heart Rate Variability of the Healthy Subjects

Wang

Tian

Jia

et al. 2014

Evidence-Based Complementary and Alternative Medicine

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“…Positional change and fluid loading did not prevent hypotension completely, which required other methods including vasopressor. Arai et al [10] found that transcutaneous electrical nerve stimulation at the Neiguan (PC-6) and Jianshi (PC-5) acupoints resulted in less hypotension and vasopressin requirement than the controls. Bjørnestad et al [11] compared wrapping the legs with tight elastic bandages and applying intravenous boluses of phenylephrine 50 mg, given immediately and at 5 and 10 min after epidural block.…”

Section: Discussionmentioning

confidence: 99%

Comparison of hemodynamic changes between phenylephrine and combined phenylephrine and glycopyrrolate groups after spinal anesthesia for cesarean delivery

Yoon

Cho

Jee

et al. 2012

Korean J Anesthesiol

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BackgroundHypotension remains a common clinical problem of spinal anesthesia for cesarean delivery and phenylephrine is used as a vasopressor to address this. However, phenylephrine reduces maternal cardiac output (CO) due to reflex bradycardia. Glycopyrrolate is safe for the fetus, and increases heart rate (HR). Using a noninvasive measure of CO, we compared maternal hemodynamic changes between the phenylephrine only group (group P) and the phenylephrine plus glycopyrrolate group (group PG).MethodsIn this randomized study, 60 women scheduled for elective cesarean delivery were allocated to group P (n = 30) or group PG (n = 30). In both groups, phenylephrine was infused at 50 µg/min. This infusions stopped if systolic blood pressure (SBP) was higher than the baseline value, and phenylephrine 100 µg was injected if SBP was lower than 80% of the baseline value from spinal anesthesia to delivery. In group PG, glycopyrrolate 0.2 mg was injected intravenously after spinal anesthesia. Hemodynamic parameters, such as SBP, heart rate (HR), stroke volume index (SVI), cardiac index (CI) were measured before and until 15 min after spinal anesthesia.ResultsThere were no significant differences in SBP and SVI compared to the baseline value in each group and between the two groups. HR and CI reduced significantly from 8 min to 15 min in group P compared to the baseline value as well as group PG for each time-point. However, HR and CI were maintained in group PG.ConclusionsThe use of glycopyrrolate added to phenylephrine infusion to prevent hypotension by spinal anesthesia for cesarean delivery was effective in maintaining HR and CI.

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“…Arai et al [26] found that transcutaneous electrical nerve stimulation at the Neiguan (PC-6) and Jianshi (PC-5) acupoints resulted in less hypotension and vasopressor requirement than control. The authors postulated that their findings might be related to augmented sympathetic tone from the electroacupuncture simulation.…”

Section: Other Nonpharmacological Methodsmentioning

confidence: 99%

Prevention of maternal hypotension after regional anaesthesia for caesarean section

Kee

2010

Current Opinion in Anaesthesiology

133

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Transcutaneous electrical nerve stimulation at the PC-5 and PC-6 acupoints reduced the severity of hypotension after spinal anaesthesia in patients undergoing Caesarean section

Cited by 46 publications

References 18 publications

Bilateral Hegu Acupoints Have the Same Effect on the Heart Rate Variability of the Healthy Subjects

Bilateral Hegu Acupoints Have the Same Effect on the Heart Rate Variability of the Healthy Subjects

Comparison of hemodynamic changes between phenylephrine and combined phenylephrine and glycopyrrolate groups after spinal anesthesia for cesarean delivery

Prevention of maternal hypotension after regional anaesthesia for caesarean section

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