Effect of electroacupuncture in postanesthetic shivering during regional anesthesia: a randomized controlled trial

Abstract

BackgroundShivering during regional anesthesia is a common complication and is related to a decrease in the patient’s core body temperature. Previous studies have shown that acupuncture on specific acupoints can preserve core body temperature. The present study evaluated the effect of electroacupuncture in preventing the shivering caused by regional anesthesia.MethodsThis prospective and randomized controlled study analyzed the data from 80 patients undergoing urological surgery, who were classified as ASA I or II. Spinal anesthesia was performed in all patients using 15 mg of bupivacaine. The patients were randomly allocated to receive either placebo acupuncture (Group P, n = 40) or electroacupuncture (Group A, n = 40) for 30 min before administration of spinal anesthesia. Shivering score was recorded at 5 min intervals, with 0 representing no shivering and 4 representing the most severe shivering possible. Heart rate, blood pressure, and tympanic temperature were recorded before the intrathecal injection, and again every 5 min thereafter until 30 min.ResultsAfter spinal anesthesia, the decrease in tympanic temperature was less for Group A patients than Group P, with the difference being statistically significant. After 15 min, 13 patients in Group P attained a shivering score of 3 or more, compared with 3 patients in Group A. Significantly more patients in Group P attained a shivering score of at least 1.ConclusionsThe prophylactic use of electroacupuncture might maintain core body temperature, and may effectively prevent the shivering that commonly develops during regional anesthesia.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12612000096853.

Comparison of effect of electroacupuncture and nefopam for prevention of postanesthetic shivering in patients undergoing urologic operation under spinal anesthesia

“…Stener-Victorin et al [24] proposed that the low frequency (below 10 Hz) EA, at acupoints of lower extremities, attenuates sympathetic nerve activity, which may mediate muscle shivering. EA also leads to peripheral vasoconstriction and interrupts the core-to-peripheral redistribution of heat that results from spinal anesthesia [12]. Furthermore, several experimental studies describe the effects of acupuncture for the prevention and treatment of shivering.…”

“…Furthermore, several experimental studies describe the effects of acupuncture for the prevention and treatment of shivering. Yeh et al [12] stated that when EA is performed at low frequency (3 Hz) on ST 36 and ST 37, the core temperature is elevated and the redistribution of heat is inhibited, resulting in a reduced incidence of postanesthetic shivering. Lin et al [13] reported that when ST 36 was stimulated, oral temperature was increased, while cutaneous temperature of the limbs was reduced.…”

“…A non-pharmacological treatment for the prevention of postanesthetic shivering is electroacupuncture (EA) [121314]. EA has been used in many anesthesia studies because, unlike manual acupuncture, it is easier to control and provides better replication of results, which is needed for the scientific approach [15].…”

“…EA has been reported to be effective in controlling postoperative nausea, vomiting [16], and pain [17]. Recent studies have reported that EA reduces postanesthetic shivering by preventing hypothermia [12131417]. To date there have been no studies comparing the efficiency of EA with pharmacological treatments for prevention of postanesthetic shivering.…”

Acupuncture in ambulatory anesthesia: a review

“…These involved therapeutic modalities including acupuncture injection, 38,39 electroacupuncture, 40,41 transcutaneous electro acupoint stimulation, 42,43 auricular acupuncture, 44,45 Korean hand acupressure, 46,47 and capsicum plaster used on acupuncture points. 48,49 These studies were excluded as they did not meet the selection criteria.…”