Philip A.M. Rogers MRCVS

AP Analgesia


Bihari_A2; Kumar A; Agarwal P (1995) Caprine and Canine Surgery of Abdomen and Limbs Under EAP. Indian Vet J Aug 72(8):849-854. Vas Dept Anim Husb, Udaipur, Rajasthan, India.

Bihari_A3; Kumar A (1995) Physiological and Clinical Effects of EAP Analgesia of Abdominopelvic Regions in Goats. Indian J of Animal Sci Feb 65(2):144-148. Govind Ballabh Pant Univ Agr & Technol, Pantnagar 263145, Uttar Pradesh, India. EAP at LI04, Lv14, GB34, BL30, GV20 and Tianping (group 1); LI11, LV14, GB34, BL30, GV20 and Tianping (group 2); and ST36, SP06, GB34, BL30, GV20 and Tianping (group 3) at a current of 3-5 volts in adjustable wave form and frequency of 130-150 Hz induced complete analgesia and good muscle relaxation at flank, ventrolateral abdominal region, pelvic and perineal regions, medial aspect of thigh, teats and udder in animals of group 3. A moderate degree of analgesia of flank, ventrolateral abdomen, medial aspect of thigh along with pelvic and perineal regions with poor analgesia of teat and udder was observed in other groups, The onset of analgesia occurred in 18.1+0.3 to 19.5+0.45 min. Analgesia persisted for the duration of EAP stimulation. After EAP in various groups of animals, heart rate increased (p<.05, significant) and respiration increased (p>.05, nonsignificant). Changes in rectal temperature, mean arterial blood pressure, central venous pressure, ECG and acid-base status were minor and not significant. No significant changes were seen between these groups of animals. Recovery occurred in 12.45+0.54 min after discontinuation of EAP.

Chen_P; Chen Y (1990) [Clinical approaches to improvement of appendectomy effects under APA]. Chen Tzu Yen Chiu 15(3):167-169. Dahua Hospital, Shanghai, PRC. Appendicitis is frequently encountered in a surgical Dept. Appendectomy under APA is safe and effective, easy and economical. It enhances the patient's recovery without side effects. APA is worth applying and popularizing. Though appendectomy is a minor operation in clinical practice, it has 3 crucial difficulties during surgery: incomplete analgesia, muscular tension and vagal reaction to traction on viscera. These difficulties must be researched and overcome before APA for appendectomy can be recommended with confidence internationally. Since 1970, we have used APA in circa 2000 cases of appendectomy, of which 1622 cases had detailed medical records. The clinical effects were analyzed and summarised from success and failure. The steps we conferred are as follows: 1. strict selection of the cases; 2. point selection and needle manipulation based on differentiation of symptoms and signs of TCM; 3. reasonable utilization of adjuvants; 4. maintenance of best needling sensation; 5. maintenance of relatively fixed groups of surgeons and assistants; and 6. improvement of operative technique. This is a valid way to have operative effect achieved. We have adhered to the 6 aspects mentioned above since 1982 and improved the success rate of appendectomy under APA. The rate of success reached 97% in which the rate of excellent result (Grade I) was 39% and the rate of good result (Grade II) 58%.

Kho_HG; Eijk RJ; Kapteijns WM; van Egmond J (1991) AP and transcutaneous stimulation analgesia in comparison with moderate-dose fentanyl anaesthesia in major surgery: Clinical efficacy and influence on recovery and morbidity [see comments]. Anaesthesia Feb 46(2):129-135. Inst for Anaesthesiol, Univ of Nijmegen, The Netherlands. The efficacy of AP and transcutaneous stimulation analgesia, supplemented by small doses of fentanyl (mean+SD 1.2+1.7 ug/kg) was compared with moderate-dose fentanyl anaesthesia (mean+SD 23+2.8 ug/kg) in 29 patients who underwent surgery for retroperitoneal lymph node dissection. The present study describes the anaesthetic techniques and comparison of haemodynamics, demand for analgesics after surgery, recovery and blood gases, restoration of urinary and bowel functions, convalescence in terms of self-reliance and the postoperative course in respect of fatigue and morbidity. A more rapid return of consciousness, an absence of hypercapnia and a smaller decrease in pH were observed in patients who received AP and transcutaneous stimulation (p <.05). No clinically relevant disadvantages attributable to the method were found.

Kolesnikov_BD; Artemenko LP; Kubikova IuI; Reznikov DB (1991) [The use of AP in the complex anaesthesiologic management of extracorporeal lithotripsy]. Anesteziol Reanimatol Sep-Oct 5:35-36.

Li_CK; Nauck M; Loeser C; Foelsch UR; Creutzfeldt W (1991) [AP to alleviate pain during colonoscopy]. Dtsch Med Wochenschr Mar 116(10):367-370. Abteilung fur Gastroenterologie und Endokrinologie, Universitõt Goettingen. 36 patients, 18 males and 18 females, mean age 51 (21-76) yr, being prepared for colonoscopy were assigned to 3 groups of 12 each: 1=AP at LI04, PC06, ST36 and SP04 bilaterally); 2=Control (no AP); 3=Sham AP at points not expected to induce pain relief. Pain sensitivity was estimated during the examination by means of a visual analog scale. Group 1 patients had mean pain sensitivity (1.4+0.4) significantly (p=.003) lower than in the groups without AP (2.7+0.3) or pretend AP (3.0+0.3). Also, Group 1 patients needed significantly less analgesics and sedatives (1 patient each; p=.005) than Group 2 (analgesics to 5, sedatives to 8 patients) or Group 3 (analgesics to 4, sedatives to 5 patients). Pain can be reduced by giving AP before colonoscopy.

Li_L; Jiang S; Zhong Y (1994) The application of APA in cystoscopy. JTCM Mar 14(1):30-31. People's Hospital, Dayu County, Jiangxi Province, PRC.

Li_L; Jian L; Chen Y; Chen X; Chen P (1992) [Influence of different types of syndrome on the rising of excellent response rate in hernia repair with APA]. Chen Tzu Yen Chiu 17(3):147-150. Shanghai Inst of AP and Channel, PRC. In order to raise the rate of excellent response in repair of hernia with APA, we valued individual difference in the light of basic theory of TCM. 70 cases were typed by symptoms and signs before hernia operation with APA in which 48 cases were Yang Xu type and 22 cases Yin Xu type, besides, 30 cases of peridural anaesthesia were as the controls. 1. AP Group: 1. Low-frequency EAP-needling (1 Hz) was applied to ST36 and SP06, while high-frequency EAP-needling (10 Hz) applied to the incisional edge. 2. The electrowaves and intension of stimulation were changed by regular time to maintain the best needling sensation. 3. Small doses of adjuvants were used together with AP, which shows synergism clearly (fentanyl, 2 ug/kg, fentanyl/droperidol, 1/50, the dose depending on the condition of patients in operation). 2. The Controls: Routine peridural anaesthesia and adjuvants were used. The same observation was given as the AP group. Results: I. the response rate of Yang Xu type was 97.9%, the excellent response rate 75%, while the response rate of Yin Xu type was 90.8% and its excellent response rate 45.4%. The response rate of the groups was no significant difference (p >.05), but the excellent response rate of the 2 differed significantly, the excellent response rate of Yang Xu type was better than that of Yin Xu type (p <.05). II. The total dose of adjuvants in the AP group was small.(ABSTRACT TRUNCATED AT 250 WORDS).

Sun_P; Li L; Si M (1992) [Comparison between AP and epidural anaesthesia in appendectomy]. Chen Tzu Yen Chiu 17(2):87-89. Alashan Meng Hospital, Inner Mongolia Autonomous region, PRC. Clinical effects of APA were compared with those of epidural anaesthesia in appendectomy. 80 patients with appendicitis were assigned randomly to 2 operative anaesthetic groups: 1=epidural anaesthesia (n=40); 2=APA (n=40). Both methods of anaesthesia gave similar surgical success. Compared with epidural anaesthesia however, APA at ST36 + LI04 gave less respiratory depression, hypotension, cardiac arrhythmia and less need for liquid infusion during surgery. Postoperatively, the APA group released intestinal gas earlier, needed less analgesics and antibiotics, and had lower rates of wound infection. These postoperative effects were significantly better than in the epidural group. AP at ST36 + LI04 gave clear-cut surgical analgesia and less interference with vital signs during surgery, and a more rapid and beneficial postoperative recovery. Thus APA is beneficial in appendectomy.

White_SS; Bolton JR; Fraser DM (1985) Use of EAP as an analgesic for laparotomies in two dairy cows. Aust Vet J Feb 62(2):52-54.