electrical acupuncture Flashcards
Uses
pain
Hideko uses Pointer Excell II
What is the electrical acupuncture?
1) As a treatment method;
mechanical stimulation from a needle
+
electrical stimulation
(Replaces the manual needle stimulation)
Can give the stimulation longer than the manual stimulation
The stimulation is consistent.
Electrical stimulation is usually stronger than manual stimulation.
Intensity can be controlled easily.
Can control the type of stimulation by changing the electrical waveform
What is electroacupuncture (2)
2) As a diagnostic method; electric permeability
History of electrical acupuncture
1903 Ledu (French) — the first anesthesia by using electricity
1943 Tong Cheng “ the Study of electrical acupuncture
1950 Yoshio Nakatani – Ryodoraku (She learned from his disciple)- he discovered which channels work and which dont.
1953 Zhu Long Yue (China) suggested clinical use of electrical acupuncture
1958 acupuncture anesthesia
– tonsillectomy at Shang Hai First Republic Hospital
1959 Chong Ken extraction of the tooth using acupuncture anesthesia
1965 Chong Xiang study of basics of acupuncture anesthesia
1965 New York Times-beginning of age of acupuncture in USA.
– Mr. Leston reported about acupuncture anesthesia in China
NIH started a study on acupuncture anesthesia
Wien University in Austria – tonsillectomy by acupuncture anesthesia
What does electrical stimulation do?
It stimulates the nerves.
nerves: A, C
A—myelinated: thick, fast transmission of the impulse
C – unmyelinated: thin, slow transmission of the impulse
Human body; conductor as a whole.
Some areas are insulated
HT, nerve fibers
2 kinds of machines
AC or DC;
- diagnosis – DC (direct current)
- treatment – AC (alternating current) or DC
Variety of electrical acupuncture stimulation for the treatment.
AC – needle electrode-clip to needle
– TEAS
– TENS
DC – Ryodorsku
depth of stimulation
Area between needles
(should be 1 hand width) x3
D=Ax3
Which type of needle is appropriate for a needle electrode?
- stainless steel
- good quality
- thick needle
- disposable
General contraindications to electrical acupuncture
- area around the HT
- an area that causes current to flow trans-cerebrally (through the head)
- patient with HT diseases,
- especially patients with pacemakers - the patients with implant-type medical devices
- the patients with artificial heart/lung or other devices for life-support
- pregnant woman
- the patients sensitive to electric stimulation
- patients running a fever
- site of inflammation
- site of bleeding
- patients with a malignant tumor
- patients who are acutely symptomatic
- tuberculosis or hemophilia patients (affects breathing)
- unconscious patients
- the patients who feel abnormal during treatment
- the patients who can’t communicate
- patients unable to control their movements or cooperate.
- patients who are wearing electronics instruments (e.g., watches, hearing aid)
- very weak patient-not even w/ regular acupuncture
＊ Never use it with an attachable medical device such as an ECG monitor.
＊ Never install the unit juxtaposed to each other
never cross
Center line: side to side or
top to bottom
or points on different limbs w/ same cord
Cautions
- hypertension
- Electrical stimulation excites the sympathetic nervous system.
＊ Measure the patient’s BP before the treatment all the time. Patient with
hypertension and angina require weaker stimulation and close monitoring
of their condition throughout the treatment period.
Dont give if BP over 150 (140) - initial treatment-do manually first
possible accidents during electrical acupuncture
7: transmission of infection Broken needle Pneumothorax HT tamponade Macro-shock Micro-shock Leakage of electricity from the circuit
transmission of infection
a. practitioner patient; by not washing hands, unsterilized needle
b. patient practitioner：needle prick, patient’s blood, saliva, open wound
c. each other
broken needle
Electricity melts the needle. easier for the needle to get broken
Pneumothorax
cause : deep, rough needle insertion, manipulation on the chest, upper back
* pleural cavity = negative pressure
hole in the pleura external air and the air in the Lu flow into
the pleural cavity. LU shrink
SX: 1. chest pain
2. difficulty of breathing
3. cyanosis
* needs hospitalization
* bilateral pneumothorax death in 20 min.
HT tamponade
deep needle insertion in the chest area injury to the pericardium accumulation of blood or exudates in the pericardial cavity HT cannot contract or dilate SX: 1. SOB 2. difficulty of breathing 3. shock 4. anxiety
Macro-shock
— big electric shock
— happens when the electricity flows from the body surface to another
part of the body
SX: 1. difficulty of breathing damage to CNS paralysis of muscles used for breathing 5 * diaphragm * external and internal intercostals muscles 2. HT fibrillation 3. bleeding 4. burn 5. death
Micro-shock
— electric shock that reaches HT through an electrode inside the body
— It causes HT fibrillation
Dont needle near heart
Leakage of electricity from the circuit
— when used with another electric device
needle electrode electrical stimulation
current: C spike wave or square wave
(The square wave is ideal, because the sudden change of
voltage or amperage evokes stimulation.)
frequency: -3 Hz
amount of voltage: strong enough to cause muscle twitching/tapping not spasm
(pumping effect)
Don’t cause pain.
Length of stimulation: around 20min.
how many pairs: 1-3 pairs
the distance of electrodes: less than the width of a hand
Depth of needles: Insert them into the muscles.
Caution:
Don’t cross the HT, brain, or spinal cord.
- Avoid inserting needles into thick nerve axon bundles.
- Don’t puncture any internal organs.
- Don’t give strong stimulation to patients with sensory numbness. Pt wont know how much stim getting.
- Don’t give electrical stimulation when the patient is;
- very tired
- extremely hungry
- fearful - Don’t apply to the patient with a pacemaker or severe HT disease.
Important features of electrical stimulation
- being able to give a stable continuous stimulation
- better result in pain control
- increase of pain threshold
- increase of local blood flow
- increase of deep body temperature
endorphin, enkephalin production - being able to stimulate muscles & nerves more effectively
The best method for obtaining the elevation of pain threshold;
- point electrode
- narrow pulse-width, such as 50 to 80 μ sec.
- poly segmental stimulation (a plural number of spinal segmental areas)
- simple frequency of less than 3 Hz, such as 2 Hz.
- approximately 20 min. stimulation period. (It takes at least fifteen minutes to accomplish
simulation-produced analgesia.)
＊ The random rhythm or mixed rhythm is less effective to increase the patient’s
pain threshold. Consistent is best
30 length needles
40-50 for buttox
UB 53, 30 for back, SP 9 LV
needles hand width part
Impedance;
The resistance to electricity
the highest impedance on the body = skin
20 – 25 % of the electric resistance is supposed to come from the permeability of the cell membrane
Ohm’s law
— Ohm’s law doesn’t apply to the human body. Usually, the skin will lose
its electric resistance as time goes.
Ohm’s law
E = IR
E = voltage, I = current, R= resistance
The baseline of the skin impedance, itself, changes in hourly periods similar to the
tide of the ocean, as it slowly changes the level of seawater.
The skin electric resistance changes gradually with time when electricity flows
through the skin in minute periods. Excessive current will easily destroy the skin’s
physiological situation; the electric resistance of the skin would easily be destroyed,
and all of the sudden the subject perceive electric burning-like pain, which might
leave blister. (Dr. Hirohisa Oda)
Factors that affect the skin impedance;
1. higher voltage
2. continuous electrical stimulation
3. excitement of sympathetic nerve
4. temperature of the environment
5. humidity
6. age
7. male or female
8. injury
9. skin diseases (eczema, dermatitis)
How much stimulation is needed?
strong enough to cause muscle twitching
Increase the voltage gradually. The practitioner should be careful about increasing the
amount of electricity during the simulation.
Don’t insert the needle too deep. Don’t give too strong simulation
It may cause;
- decrease of pulse rate, BP, arrhythmia, cyanosis, cold sweat
(due to increase of Vagus nerve activity)
- local burn.
