Effects of Lidocaine Injection at Acupuncture Points on Perioperative Analgesia in Cats Undergoing Ovariohysterectomy

Camila Menossi Sueza Lima, Camila Zanetti Segatto, Gustavo Ricci Zanelli, Gabriel Montoro Nicácio, Renata Navarro Cassu*

J Acupunct Meridian Stud 2022; 15(4): 255-263 https://doi.org/10.51507/j.jams.2022.15.4.255

Background: Pharmacopuncture is an acupuncture-related technique that has been used to amplify the therapeutic effects of different medications.Objectives: To investigate the analgesic efficacy of a lidocaine injection at acupoints in cats undergoing ovariohysterectomy.Methods: Thirty cats were randomly distributed into two groups (n = 15, per group). The experimental group received a bilateral administration of lidocaine at the following acupoints: Stomach 36 (ST-36) and Spleen 6 (SP-6) (Lido group). The control group did not receive lidocaine (Control group). All cats were sedated with dexmedetomidine and anesthesia was induced with propofol and maintained with isoflurane. Intraoperatively, fentanyl was given to control cardiovascular responses to surgical stimulation. Postoperative pain was assessed at various time points, up to 24 hours after extubation, using the UNESP-Botucatu multidimensional composite pain scale (MCPS) and Glasgow feline composite measure pain scale (CMPS-Feline). Sedation scores were measured at the same time points. Morphine/meloxicam was administered as rescue analgesia. Data were analyzed using t-tests, Fisher´s exact test, the Mann-Whitney test, and the Friedman test (p < 0.05).Results: Intraoperatively, more cats in the Control group required analgesic supplementation than those in the Lido group, but the difference was not significant (p = 0.65). Postoperative pain, sedation scores, and analgesic requirements did not differ between groups. Rescue analgesia was given to 67% (10/15) of the cats in each group.Conclusion: The administration of lidocaine at ST-36 and SP-6 acupuncture points did not provide significant perioperative analgesic benefits in healthy cats undergoing ovariohysterectomy.

Exploring Acupuncture Actions in the Body and Brain

In-Seon Lee, Younbyoung Chae^*

J Acupunct Meridian Stud 2022; 15(3): 157-162 https://doi.org/10.51507/j.jams.2022.15.3.157

Acupuncture’s actions have been explained by biomedical research. However, the meridian system used in acupuncture needs further clarification. This review describes how acupuncture affects the body and brain. From the perspective of traditional East Asian medicine, the meridian system is closely connected with acupuncture’s treatment effects. In the body, the indications of acupoints, primarily established based on the meridian system, have spatial symptom patterns. Spatial patterns of acupoint indications are distant from the stimulated sites and strongly associated with the corresponding meridian’s route. Understanding how acupuncture works based on the original meridian system is important. From a neuroscience perspective, an acupuncture-induced sensation originates from the bottom-up action of simple needling in the peripheral receptor and the reciprocal interaction with top-down brain modulation. In the brain, enhanced bodily attention triggered by acupuncture stimulation can activate the salience network and deactivate the default mode network regardless of the actual stimulation. The application of data science technology to acupuncture research may provide new tools to uncover the principles of acupoint selection and enhance the clinical efficacy of acupuncture treatment in various diseases.

Warm Cupping of the Posterior Thorax in Combination with Standard Conventional Therapy for ARDS in COVID-19 Patients in ICU: a Case Series

Mehrdad Karimi¹, Amir Hooman Kazemi^1,2, Asma Asadi³, Azadeh Zarei¹, Arman Zargaran⁴, Seyed Ali Al-hadi Moravej⁵, Seyede Ferdos Jazayeri⁵, Omid Nabavian⁶, Seyedeh Aida Ahmadi⁶, Reihane Alipour^1,*

J Acupunct Meridian Stud 2022; 15(3): 194-200 https://doi.org/10.51507/j.jams.2022.15.3.194

Acute respiratory distress syndrome (ARDS) is commonly found in critically ill patients with coronavirus disease 2019 (COVID-19). As a non-pharmacological treatment of complementary and alternative medicine (CAM), cupping has been clinically used for respiratory symptoms. We sequentially identified a series of patients with COVID-19 with ARDS who were admitted to the intensive care unit (ICU). Warm cupping of the posterior thorax was performed for seven days. We collected longitudinal severity scores on cough, breathlessness, chest tightness, type of oxygen therapy, and oxygen saturation (SpO₂). We hereby report the changes in the severity scores in a series of eight patients who received 21 sessions of cupping in addition to conventional treatments. All patients reported improvement in symptom scores that was matched by an increase in SpO₂ by as much as 3.16%. All patients were discharged and did not require the use of a mechanical ventilator. The results suggest that combining cupping with conventional treatment may provide a good prognosis for patients with COVID-19 with ARDS.

Acupuncture for the Elsberg Syndrome Secondary to Varicella-Zoster Virus Infection: a Case Report and Brief Review

Lian-Sheng Yang^1,*, Kun Zhang¹, Dan-Feng Zhou¹, Shu-Zhen Zheng¹, Jin Zhang²

J Acupunct Meridian Stud 2022; 15(2): 152-156 https://doi.org/10.51507/j.jams.2022.15.2.152

Elsberg syndrome (ES) is an infectious syndrome presenting with variable signs of acute lumbosacral radiculomyelitis. Its low recognition rate leads to misdiagnosis and incorrect treatment. Thus, some ES patients may develop neurological sequelae. This case described a 74-year-old woman complained of urinary retention, constipation, and sacral numbness after herpes zoster in the perianal area. She was diagnosed with ES and accepted conventional drug treatments and urethral catheterization. The treatment was ineffective; therefore, she accepted electroacupuncture six times and her symptoms completely disappeared, with no recurrence of neurological disorders during 1-year follow-up. This shows that acupuncture is a safe and effective alternative therapy for ES. Nonetheless, further prospective studies are necessary to prove its efficacy in ES.

Effect of Acupuncture on Physical Symptoms and Quality of Life in Treatment-Resistant Major Depressive Disorder and Bipolar Disorder: a Single-Arm Longitudinal Study

Yuto Matsuura^1,*, Seiji Hongo², Hiroshi Taniguchi¹, Fumiko Yasuno¹, Tomomi Sakai¹

J Acupunct Meridian Stud 2022; 15(6): 336-346 https://doi.org/10.51507/j.jams.2022.15.6.336

Background: Acupuncture is a non-pharmacological therapy used clinically for mood disorders. Relief of physical symptoms with acupuncture treatment may lead to relief of depressive symptoms and improvement of quality of life (QoL). Few studies have examined the effect of acupuncture on the physical symptoms and QoL of patients with mood disorders.Objectives: To examine the effect of acupuncture on physical symptoms and QoL of patients with treatment-resistant major depressive disorder (MDD) and bipolar disorder (BD).Methods: This prospective, single-arm, longitudinal study included patients with MDD and BD from an outpatient psychiatric clinic. Acupuncture was performed weekly for 12 weeks in combination with regular treatment, with fixed acupoints and individualized treatment for each patient. Psychiatric symptoms were evaluated using the Himorogi Self-Rating Depression Scale (HSDS) and Himorogi Self-Rating Anxiety Scale (HSAS). Physical symptoms such as physical pain, gastrointestinal symptoms, and sleep disorders were evaluated using the Japanese version of the Somatic Symptom Scale-8 (SSS-8) and Visual Analog Scale (VAS). QoL was evaluated using the 8-item Short-Form (SF-8) Health Survey.Results: A total of 36 patients (15 MDD and 21 BD patients) were analyzed. After 12 weeks of acupuncture, HSDS and HSAS scores significantly decreased (p < 0.05). Physical symptoms evaluated using SSS-8 and VAS scores also significantly improved (p < 0.05). In particular, neck pain and insomnia improved at an early stage. Among the SF-8 subscales, scores of bodily pain, general health perception, role limitations due to emotional problems, and mental health significantly increased (p < 0.05).Conclusion: Acupuncture may improve not only psychiatric symptoms but also physical symptoms and QoL in patients with treatment-resistant mood disorders. Further studies are required for confirmation of the preliminary data collected thus far.

The Adjunctive Effects of Acupuncture for Hospitalized COVID-19 Patients: a Single-Blinded Randomized Clinical Study

Dwi Rachma Helianthi¹, Atikah C. Barasila^1,2, Salim Harris³, Robert Sinto⁴, Yordan Khaedir², Irman^1,*

J Acupunct Meridian Stud 2022; 15(4): 247-254 https://doi.org/10.51507/j.jams.2022.15.4.247

Background: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a coronavirus (SARS-CoV-2) that can induce cytokine storm. To this point, no specific drug has been effective for curing COVID-19.Objectives: The aim of this study was to determine the effects of a combination of acupuncture intervention and pharmacologic treatment in hospitalized COVID-19 patients with mild-moderate symptoms.Methods: A single-blinded randomized controlled clinical trial of hospitalized COVID-19 patients confirmed by RT-PCR examination with mild-moderate symptoms was conducted from August to September 2020. Participants were assigned to the treatment group (receiving pharmacologic treatment and manual acupuncture intervention) or the control group (receiving only pharmacologic treatment). Laboratory outcomes, including complete blood count, C-reactive protein (CRP) and ferritin levels, and erythrocyte sedimentation rate (ESR), were measured before and after the intervention. For clinical outcomes, we evaluated the duration of the cough symptom.Results: We found that participants in the treatment group had a shorter duration of the cough symptom compared to the control group, and the difference was statistically significant. In the treatment group, we found an increase in the percentage of lymphocyte count and ESR, while in the control group, both parameters were decreased; however, the differences were not statistically significant. There was a decrease in the mean of CRP and ferritin levels in both groups, and the differences were not statistically significant.Conclusion: Our study has shown promising results for the effects of combined treatment of acupuncture and pharmacologic treatment on the duration of the cough symptom in hospitalized COVID-19 patients with mild-moderate symptoms. Further large-scale studies with rigorous design are needed to examine these preliminary results.