Philip A.M. Rogers MRCVS


Cao_W; Wang Y; Lu Z (1990) Effects of AP on pain threshold and plasma corticosterone level at different times of the day. JTCM Jun 10(2):136-140. Inst of AP and Moxibustion, China Acad of TCM, PRC.

Chernilevskii_VE; Gudoshnikov VI; Mirkin AS; Sokolov PP (1992) [Possible interrelationship between the system of AP points and channels and mechanisms of endocrine regulation]. Fiziol Cheloveka Sep-Oct 18(5):171-173.

Kho_HG; Kloppenborg PW; van Egmond J (1993) Effects of AP and TENS analgesia on plasma hormone levels during and after major abdominal surgery. Eur J Anaesthesiol May 10(3):197-208. Inst for Anaesthesiology, Univ of Nijmegen, The Netherlands. The effects of AP and TENS on plasma adrenaline (A) and noradrenaline (NA), ACTH, beta-End, anti-diuretic hormone (FROMH) and cortisol were evaluated during and, for 4 d after surgery in 42 male patients submitted to a standardized major abdominal operation in a comparative study of 3 different anaesthetic techniques. Group 1 received AP and TENS as the main non-pharmacological analgesic during surgery. Group 2 received moderate-dose fentanyl (initial bolus of 10 ug/kg followed by continuous infusion of 5 ug/kg/h for the first h, and then 4 ug/kg/h. Group 3 received a combination of both methods. In all 3 groups analgesia was supplemented, if necessary, by small bolus injections of 50 ug fentanyl. Anaesthesia was induced in all groups with thiopentone 5 mg/kg and vecuronium 0.1 mg/kg and patients were ventilated (N2O:O2=2:1) to achieve normocapnia without the use of a halogenated agent. Pre-operatively AP plus TENS in Groups 1 and 3 led to a rise in beta E without changes of haemodynamics. After intubation beta E did not increase further. Intubation in Group 2 led to an increase of beta E (p <.05) also, and to a rise in pulse rate and blood pressure (p <.05) in all 3 groups. Per-operatively AP plus TENS in Group 1 showed a response of circulating NA and cortisol similar to that in Groups 2 and 3, whereas the responses of the circulating A, ACTH, beta E and ADH in Group 1 were more pronounced (p <.01). Post-operatively no differences in hormonal profiles occurred between the groups with or without AP plus TENS (Group 2 v Group 3) nor between those with or without moderate-dose fentanyl anaesthesia (Group 1 v Group 3). AP and TENS had no effect on the cardiovascular response to laryngoscopy and intubation. They can replace moderate-dose fentanyl anaesthesia in major abdominal surgery at the cost of a more enhanced per-operative neuroendocrine stress response, which does not, however, influence postoperative hormonal profiles nor the rapidity of return to pre-operative values.

Kho_HG; van Egmond J; Zhuang CF; Zhang GL; Lin GF (1990) The patterns of stress response in patients undergoing thyroid surgery under APA in China. Acta Anaesthesiol Scand Oct 34(7):563-571. Inst for Anaesthesiol, Univ of Nijmegen, The Netherlands. The patterns of catecholamines (adrenaline and noradrenaline), peptide hormones (ACTH, antidiuretic hormone, beta-End, growth hormone and prolactin), cortisol and those of immunoglobulins (IgA, IgG and IgM) and total and differential leucocyte counts in the peripheral blood were investigated during and for 6 d after thyroid surgery in 20 patients (F/M: 18/2) performed under APA, supplemented by small doses of pethidine (mean+sd 45+8.9 mg). Throughout surgery the patients remained conscious. During surgery the level of catecholamines and the above-mentioned circulating hormones increased significantly and immunoglobulins decreased, whereas leucocytosis due to lymphocytosis occurred; % eosinophils decreased and % neutrophils decreased remarkably. In the postoperative phase, levels of noradrenaline and beta-End remained elevated, whereas the other circulating hormones gradually returned to normal values. Immunoglobulin levels and eosinophil counts returned to the preinduction values within 24 h, and those of neutrophil and lymphocyte counts within 2 d. Changes in monocyte and basophil numbers were not detected peri- and post- operatively.

Liu_J (1994) Clinical observations on treatment of hyperprolactinemia by AP. JTCM Jun 14(2):121-12. Xuanwu Hospital of TCM, Beijing, PRC.