Philip A.M. Rogers MRCVS

AP Analgesia


Chen_SC; Lu SN; Lai CT; Jean JY; Hsiao CL; Hsu PT (1991) Aqueous AP for postoperative pain: a matched controlled trial. Kaohsiung i Hsueh Ko Hsueh Tsa Chih Kaohsiung - J of Med Sci Sep 7(9):466-470. Dept of Int Med, Kaohsiung Med Coll, Taiwan, ROC. The analgesic effects of AP are well-documented. Aqueous AP, or point injection, is a conveniently modified modern AP method. This matched controlled trial was carried out to evaluate the effects of aqueous AP in postoperative pain control. A total of 12 patients were selected as age-, sex- and operative-style-matched controls. In the AP-treatment group when patients had regained consciousness after operative anaesthesia, 2-5 ml of 20% glucose solution was injected into LI04 and GB34. Pain intensity was scored on verbal assessment, sleep disturbance and use of narcotics. Compared with the control group, AP significantly reduced the intensity of postoperative pain, and the amounts and frequency of narcotics used, especially in the first 12 h post-op. Aqueous AP is a convenient and effective way to control postoperative pain.

Faure-Antonietti_F; Antonietti C; Estanove S; Ninet J; Vigneron M; Champsaur G (1991) Treatment using traditional AP of early scapulohumeral pains after heart surgery. Cahiers d' Anaesthesiologie 39(8):537-540. In French. Service de chirurgie thoracique et cardiovasculaire C, Hôpital cardiologique, Lyon. The purpose of this study was to test the efficacy of traditional Chinese AP to treat scapulohumeral pain during the early stage after heart surgery, by simple AP (without needle stimulation) of points not related anatomically or metamerically with the scapulohumeral joint. Reduction of pain and angular gain were almost immediate, durable, measurable and reproducible. This is explained by possible effects of AP on articular sympathetic mechanoreceptors, then suppressing reflex muscular contractions due to intraoperative postural constraints.

Gemma_M; Bricchi-M; Giannini-A; Coffano-B; Grandi-L; Quirico-P (1993) AP accelerates recovery from general anaesthesia [letter]. Can J Anaesth Dec 40(12):1224-1245.

Grabow_L (1994) Controlled study of the analgetic effectivity of AP. Arzneimittelforschung Apr 44(4):554-558. Zentrale Abteilung für Anästhesiologie und Intensivmedizin, Evangelische und Johanniter Krankenanstalten, Duisburg, Germany. 2 methods were used to test the analgesic effectivity of AP: 1. as a method of postoperative pain therapy several analgesic medications were compared with AP; 2. extracorporeal shockwave lithotripsy (ESWL) was used as a clinical algesimeter to test the analgesic effect of analgesic medications and AP to a controlled pain stimulus. In both groups the analgesic effectivity was placebo controlled. Both methods showed equally that the analgesic effect of AP is similar to that of the placebo group. Thus AP is not a generally useful form to treat acute pain. However, in every examined population, a minority is completely satisfied with AP as sole treatment of pain. The secret of AP probably lies in the selection of patients sensitive to AP. Under controlled conditions, postoperative wound pain may be an algesimeter analagous to ESWL. This may be important.

Lewis_SM; Clelland JA; Knowles CJ; Jackson JR; Dimick AR (1990) Effects of Ear-AP-like TENS on pain levels after wound care in patients with burns: a pilot study. J of Burn Care and Rehab Jul-Aug 11(4):322-329. This study tested the hypothesis that Ear-AP-like TENS would significantly reduce the pain experienced by patients with burns immediately after wound debridement, other wound care, and dressing changes. Subjects were 11 inpatients at the Univ of Alabama Hospital Burn Unit. A 2-period crossover design was used; each patient received one experimental treatment consisting of bilateral AP-like TENS to 6 Earpoints and one control treatment consisting of a placebo pill. The Visual Analogue Scale was used to measure pain and was used immediately before and after treatments and at 15, 30, and 60 min after treatment. A 2-factor repeated measures ANOVA indicated significant effects of measurement time (p<.001) and treatment by time (p=0.002). Post hoc analysis showed significant differences (p<.05) between experimental and control conditions at all times after treatment but not at pretreatment baseline. Ear-AP-like TENS was an effective pain management technique in patients with burns.

Moldovan_C1 et al (1986) EAP Treatment Method for Arm Oedema after Surgery for Breast Cancer. International Med AP Conference, London, UK, May 4-8. Inst of Oncology, Bucharest, Romania. Upper limb oedema (bloating from retention of water) occurs after surgery for breast cancer in circa 83% of the cases. Existing means have relatively limited efficiency. This study presents a treatment method with EAP (AP in which weak electrical currents are sent through the needles) on a group of 21 patients with upper limb oedema. Treatment response was based on objective criteria including clinical and thermoelectric measurements. Complete recovery from oedemas was obtained in 33% of the cases, while partial recovery was seen in 43% of the cases. No response was seen in 24%.

Tsibuliak_VN; Alisov AP; Shatrova VP (1995) [APA and analgesic TENS in the early postoperative period]. Anesteziol Reanimatol Mar-Apr 2:93-97. Efficacies of 2 methods of non-drug analgesia: AP- (1000 cases) and TENS- (91 cases) analgesia, as well as of narcotic analgesics omnopon and promedol (229 cases) were compared in the immediate and early postoperative period. In 229 cases AP was used to treat other functional complications of the postoperative period. The efficacies of the methods in question were assessed by formalized verbal estimation scales. Narcotic analgesics provided adequate analgesia in 75-79% of patients, TENS in 61-64%, AP in 50% of patients. AP, though less effective than narcotic analgesics, helped arrest or noticeably alleviate the severity of such postoperative complications as reflex retention of the urine, impairment of the drainage function of the bronchi, intestinal paresis, bronchial asthma, vomiting, nausea, pain or itching in the stoma, chill, hyperthermia in 43-81% of cases. Conclusion: An integrated approach (combined use of drugs and non-drug methods of analgesia) is desirable in the management of postoperative pain.