Surface electrostimulation of acupuncture points for sedation of critically ill patients in the intensive care unit--a pilot study.
BACKGROUND
This is a pilot study to investigate the effects of electrostimulation of acupuncture points on sedation and the dose of sedatives in the Intensive Care Unit.


METHODS
Electrostimulation of acupuncture points was performed on 12 critically ill patients requiring sedation for mechanical ventilation. Electrostimulation was applied by point surface electrodes at LI4, ST36, HT7 and LR3 points for 20 minutes every hour for 12 hours using dense dispersed mode with a current frequency of 10-100 Hz and maximum intensity of 10 mA. All patients were sedated with propofol and alfentanil as required. The dose of propofol was reduced by 10mg/hour provided the patient remained sedated according to our guidelines. Sedation and analgesia scores, dose of sedative and analgesics drugs, respiratory rate, heart rate, mean arterial blood pressure and compliance with the ventilator were recorded before electrostimulation of acupuncture points, and hourly thereafter for 12 hours.


RESULTS
There was significant reduction in the median propofol consumption from 145 mg/hour (range 30-250) to 15 mg/hour (range 0-250) (P<0.05), without any significant change in sedation scores or analgesia scores. The haemodynamic and respiratory variables remained stable. All patients were compliant with the ventilator.


CONCLUSIONS
This pilot study showed significant reduction in the dose of propofol required for sedation in critically ill patients following surface electrostimulation of acupuncture points, without any adverse effects. A randomised controlled trial is warranted.
Nayak
Sandeep
S
Intensive Care Unit, Royal Liverpool University Hospital, Liverpool, UK. drsnayak@yahoo.co.uk
Wenstone
Richard
R
Jones
Andy
A
Nolan
Jill
J
Strong
Ann
A
Carson
Jeff
J
D015669:Acupuncture Points; D000368:Aged; D000369:Aged, 80 and over; D015760:Alfentanil / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003422:Critical Care / Q000379:methods*; D015671:Electroacupuncture / Q000379:methods*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015742:Propofol / Q000008:administration & dosage; D012121:Respiration, Artificial / Q000379:methods*; D016896:Treatment Outcome
D006993:Hypnotics and Sedatives; D015760:Alfentanil; D015742:Propofol