LightNeedle - RJ Laser

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Original Article G. Litscher European Journal of Anaesthesiology 2004; 21: 13-19 @ 2004 European Academy of Anaesrhesiology ISSN 0265-0215 University of Graz, Department of Biomedical Engineering and Research in Anesthesia and Intensive Care, Graz, Austria Summary Background and objective: The main purpose of this study was to investigate the effects of sensory (acupressure and acupuncture) and optical stimulation (Laserneedle@ acupuncture) on electroencephalographic bispectral index, spectral edge frequency and a verbal sedation score. Methods: Twenty-five healthy volunteers (mean age :!: SD: 25.5 :!: 4.0yr) were investigated during the awake state. The acupuncture point Yintang and a placebo control point were stimulated. The study was performed as a randomized, controlled and partly blinded cross-over trial. Results: Bispectral index and spectral edge frequency values both decreased significantly (P < 0.001) during acu- pressureonYintang tovalues of62.9 (minimum 35) :!: 13.9 bispectral indexand to 13.3 (minimum 2.9) :!: 8.1 Hz (spectral edge frequency right) and 13.8 (minimum 2.7) :!: 7.3 Hz (spectral edge frequency left), respectively. Bispectral index was also significantly (P < 0.05) affected by Laserneedle@ acupuncture and acupressure on the control point but the changes were not clinically relevant, 95.4 :!: 4 and 94.2 :!: 4.8, respectively. All interventions significantly (Yintang: p < 0.001; control point: p < 0.012) reduced verbal sedation score. Conclusions: The study highlights the electroencephalographic similarities of acupressure induced sedation and general anaesthesia as assessed by bispectral index and spectral edge frequency. Keywords: ACUPRESSURE; ACUPUNCTURE; ELECTROENCEPHALOGRAPHY, bispectral index, spectral edge frequency. Noninvasive bioelectrical neuromonitoring is gaining more and more attention in anaesthesia and critical care [1,2]. The bispectral index (BIS) and the spectral edge frequency (SEF) are important numerical descriptors of the electroencephalogram (EEG) and both are mainly used for assessing depth of anaesthesia [3]. If anaesthetists relyon BIS and SEF to detect awareness, then it is very important to Correspondence ro. Gerhard Lirscher, Departmenr of Biomedical Engineering and Research in Anesthesia and Intensive Care, University of Graz, Auenbruggerplatz 29, A-8036 Graz, Austria. E-mail: gerhard.litscher@ uni-grazat; Tel. +433163853907/83907; Fax. +433163853908 Accepted for publication August 2003 EJA 1537 exclude other influences that could give false readings. It is known that a number of environmental and physiological factors may affect BIS performance. Recently it has been reported that nonpharmacological interventions such as acupressure can also reduce BIS values significantly [4]. This study is a randomized, controlled and partly blinded (Laserneedle@ acupuncture; LASCO Int. Medical Mark. AG, Basel, Switzerland) cross-over trial intended to investigate the effects of three nonpharmacological interventions (acupressure, manual needle acupuncture and Laserneedle@ acupuncture) on two processed EEG variables (BIS and SEF) and a verbal sedation score (VSS) in healthy volunteers.
14 G. Litscher Methods Subjects The study was approved by the Ethics Committee of the University of Graz (13-048 ex 02/03). Written informed consent was obtained from each subject. We studied 25 healthy volunteers (mean age :!: SD: 25.5 :!: 4.0yr, range 21-39yr; 15 fernales, 10 males; height173.5 :!: 9.3cm;bodyweight69.1 :!: 16.1kg). None of the subjects had neurological or psychological disorders and they were not taking any medication. They were partly informed about the nature of the investigation and were paid for their participation. The investigators recording EEG and sedation data were blinded to the intervention applied to the volunteers. The subjects were not informed which of the four interventions was effectively a placebo control (acupressure on a control point). Procedure and study design The study was performed as a randomized, controlled cross-over trial. Four EEG electrodes (F7-Fpz, F8-Fpz' Fz = ground) and a noninvasive blood pres- sure cuff were attached to the volunteers after they arrived at the biomedical engineering laboratory. Two channels of spontaneous electrical activity were recorded from EEG electrodes (Zipprep@ selfprepping electrodes; Aspect Medical Systems Inc., Natick, MA, USA). The skin-electrode impedance was
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