Feasibility of Self-administered Neuromodulation for Neurogenic Bladder in Spinal Cord Injury / 대한배뇨장애요실금학회지

PURPOSE: To determine if self-administered transcutaneous tibial nerve stimulation (TTNS) is a feasible treatment option for neurogenic bladder among people with spinal cord injury (SCI) who utilize intermittent catheterization for bladder management. METHODS: Four-week observational trial in chronic SCI subjects performing intermittent catheterization with incontinence episodes using TTNS at home daily for 30 minutes. Those using anticholinergic bladder medications were given a weaning schedule to begin at week 2. Primary outcomes were compliance and satisfaction. Secondary outcomes included change in bladder medications, efficacy based on bladder diary, adverse events, and incontinence quality of life (I-QoL) survey.

Design and application of Shenmen point electronic stimulator for attenuating insomnia and anxiety / 医疗卫生装备

Objective To design and manufacture a Shenmen point electronic stimulator and determine its therapeutic effects for insomnia and anxiety.Methods The stimulator was composed of a single point electrode unit and an electronic stimulation generator.The single point electrode unit consisted of a circular transdermal patch and two circular electrodes which was used for precision stimulation on Shenmen point.The electronic stimulation generator released low-frequency square-wave pulse current based on specific parameters to treat the examinees with insomnia and anxiety.The curative effect of the stimulator was tested by Hamilton rating scale for anxiety and evaluation on improved sleeping.Results The stimulator executed precision stimulation based on specific requirements on the point.30-min treatment with the stimulator before sleeping in 10 d contributed to significantly decreasing Hamilton rating scores for anxiety and improving sleeping quality.Conclusion The stimulator markedly attenuates anxiety and insomnia,and can be a convenient,effective and safe choice for adjunctive therapy of insomnia and anxiety.

Design and application of Shenmen point electronic stimulator for attenuating insomnia and anxiety / 医疗卫生装备

Objective To design and manufacture a Shenmen point electronic stimulator and determine its therapeutic effects for insomnia and anxiety.Methods The stimulator was composed of a single point electrode unit and an electronic stimulation generator.The single point electrode unit consisted of a circular transdermal patch and two circular electrodes which was used for precision stimulation on Shenmen point.The electronic stimulation generator released low-frequency square-wave pulse current based on specific parameters to treat the examinees with insomnia and anxiety.The curative effect of the stimulator was tested by Hamilton rating scale for anxiety and evaluation on improved sleeping.Results The stimulator executed precision stimulation based on specific requirements on the point.30-min treatment with the stimulator before sleeping in 10 d contributed to significantly decreasing Hamilton rating scores for anxiety and improving sleeping quality.Conclusion The stimulator markedly attenuates anxiety and insomnia,and can be a convenient,effective and safe choice for adjunctive therapy of insomnia and anxiety.

Mechanism of acupoint transcutaneous electric stimulation on analgesic anesthesia in the patients undergoing general anesthesia anorectal operation / 中国针灸

<p><b>OBJECTIVE</b>To observe the regulatory effects of acupoint electric stimulation on the analgesic substances and the relevant indices of nerve-immunity-endocrine system in the patients undergoing general anesthesia anorectal operation.</p><p><b>METHODS</b>One hundred and fifty-six patients undergoing hemorrhoids and anal fistula operation were randomized into three groups, 146 cases were included in the analysis. In the No.1 group (48 cases), the conventional intravenous general anesthesia was applied. In the No.2 group (50 cases), besides the conventional intravenous general anesthesia, the acupoint transcutaneous electric stimulation was combined at Neiguan (PC 6), Shenmen (HT 7), Shangliao (BL 31) and Ciliao (BL 32). operation in the No.2 and No.3 groups were lower apparently than that in the No.1 group (<0.05,<0.01).</p><p><b>CONCLUSIONS</b>During the general anesthesia anorectal operation, the acupoint transcutaneous electric stimulation achieves analgesic anesthesia through effectively promoting the release of body analgesic substance and reducing the stress level in the operation. With the comprehensive acupoint selection as Neiguan (PC 6) and Shenmen (HT 7) and the local acupoints, the therapeutic effects are better in comparison with the simple selection of local acupoints. In the No.3 group (48 cases), besides the conventional intravenous general anesthesia, the acupoint transcutaneous electric stimulation was combined at Shangliao (BL 31) and Ciliao (BL 32). The electric stimulation was maintained till the end of operation. The patients' saliva was collected 0.5 h before operation and 1 h after operation separately. The indices that reflect the body pain regulation and nerve-immune-endocrine secretion were detected, such as opiophin protein (OPI), secretory immunoglobulin A (SIgA), saliva amylase (sAA), cortisol (Cor) and tumor necrosis factor α (TNF-α). The pain degree was observed 1 h after operation.</p><p><b>RESULTS</b>In the No.2 group, OPI after operation was higher than that before operation (<0.05). The difference value of OPI in the No.2 group was higher apparently than that in the No.1 group and the No.3 group (both<0.05). SIgA after operation was higher than that before operation in the No.1 group (<0.05). The difference values of SIgA, sAA, Cor in the No.2 group were lower apparently than those in the No.1 group (<0.05,<0.01). TNF-αbefore and after operation and its difference value among the groups were not significant statistically (all>0.05). The pain degrees in 1 h after.</p>

Clinical experience of acupuncture and moxibustion in the diagnosis and treatment of persistent somatoform pain disorder / 中国针灸

The clinical manifestation and clinical diagnosis and treatment of acupuncture for persistent somatoform pain disorder (PSPD) were observed to explore its etiology. It is found that the causative factor of PSPD is probably relevant with pain memory induced by the negative emotions during the first attack of pain, which is in the category of "depression" in TCM. In clinical diagnosis, the medical history should be explored to discover the potential etiology and determine the diagnosis. In treatment, the root cause should be considered, focusing on mind andregulation and associating with analgesia. It is different from the common treatment for analgesia in other pain disorders. For PSPD, the root cause is considerable, with "mind regulation" in priority. The acupoints relevant with mind on the head[such as Baihui (GV 20) and Sishencong (EX-HN1)], the acupoints for warming and tonifying the primary[such as Qihai (CV 6), Guanyuan (CV 4) and Zusanli (ST 36)] and the auricular points (such as xin (CO), gan (CO), shenmen (TF), neifenmi (CO)) are selected to regulateactivity and calm down the mind. Additionally, the therapy for reliving pain specifically is applied with transcutaneous electric stimulation, 2 Hz/100 Hz, disperse-dense wave at bilateral Zusanli (ST 36) and Sanyinjiao (SP 6) to erase pain memory trace. Ultimately, the therapeutic effects are achieved for mind regulation and pain easing.

Dose-Related Prolongation of Ropivacaine Epidural Anesthesia by Epidural Ketamine / 대한통증학회지

BACKGROUND: Besides its general anesthetic effect, ketamine interacts with sodium channels in a local anesthetic-like fashion, including the sharing of binding sites with those commonly used by clinical local anesthetics. This study evaluated the dose related effects of ketamine during epidural anesthesia with 0.5% ropivacaine. METHODS: Sixty ASA physical status I-II patients, scheduled for minor elective surgery under epidural anesthesia using 0.5% ropivacaine, were randomly divided into three groups (n = 20 each). The patients initially received either 0.5% ropivacaine (group 1), ketamine (0.1 mg/kg) in addition to the epidural 0.5% ropivacaine (group 2) or ketamine (0.2 mg/kg) in addition to the epidural 0.5% ropivacaine (group 3). The regression of sensory block was assessed by transcutaneous electric stimulation (TES), equivalent to a surgical incision. Motor block was assessed using the Modified Bromage's scale. Episodes of bradycardia, hypotension and sedation were also recorded. RESULTS: There were no significant differences among the three groups in the maximal levels of sensory block or the times taken for these levels to be reached. The mean times for the block to regress to two and four segments below the maximal level were significantly prolonged by epidural ketamine. CONCLUSIONS: Epidural ketamine prolongs the duration of ropivacaine epidural anesthesia. These results suggest that ketamine has local anesthetic-like actions.

Transcutaneous Electric Stimulation in Chronic Pain Patients

Painful 203 patients with chronic pain were treated with transcutaneous electrical nerve stimulation in the CNS & Pain Management Institute of St. Paul's Hospital, Catholic Medical College, Seoul, Korea. Each patient was instructed on the method of autostimulation with variations in for an initial observation frequency and intensity. The effect were recorded daily period of about 3 weeks. The patients were evaluated at suitable intervals and asked to grade the relief of pain on a percentage scale. Four categories of pain relief were established : 80% to 100%(A), 60% to 80%(B), 30% to 60%(C), 0% to 30%(D). This procedure with modern, solid state devise has been tried enough that it can be recommended as a potentials treatment for most types of pain about 90% of pain problems can be managed in this way. The mode of action of transcutaneous Electrical nerve stimulation is most simple and can not be explained only by gate control theory.