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Acupuncture transcutaneous electrical nerve stimulation reduces discomfort associated with barostat-induced rectal distension: a randomized-controlled study.
World J Gastroenterol. 2013 Jan 21; 19(3):381-8.WJ

Abstract

AIM

To explore the effectiveness of acupuncture transcutaneous electrical nerve stimulation (Acu-TENS), a non-invasive modality in reduction of rectal discomfort during barostat-induced rectal distension.

METHODS

Forty healthy subjects were randomized to receive 45 min of either Acu-TENS or placebo-TENS (no electrical output) over acupuncture points Hegu (large-intestine 4), Neiguan (pericardium 6) and Zusanli (stomach 36). A balloon catheter attached to a dual-drive barostat machine was then inserted into the subjects' rectum. A step-wise (4 mmHg) increase in balloon pressure was induced until maximal tolerable or 48 mmHg. Visual analogue scale and a 5-point subjective discomfort scale (no perception, first perception of distension, urge to defecate, discomfort/pain and extreme pain) were used to assess rectal discomfort at each distension pressure. Blood beta-endorphin levels were measured before, immediately after intervention, at 24 mmHg and at maximal tolerable distension pressure.

RESULTS

There was no difference in the demographic data and baseline plasma beta-endorphin levels between the two groups. Perception threshold levels were higher in the Acu-TENS group when compared to the placebo group, but the difference reached statistical significance only at the sensations "urge to defecate" and "pain". The distension pressures recorded at the "urge to defecate" sensation for the Acu-TENS and placebo-TENS groups were 28.0 ± 4.5 mmHg and 24.6 ± 5.7 mmHg, respectively (P = 0.043); and the pressures recorded for the "pain" sensation for these two groups were 36.0 ± 4.2 mmHg and 30.5 ± 4.3 mmHg respectively (P = 0.002). Compared to the placebo group, a higher number of participants in the Acu-TENS group tolerated higher distension pressures (> 40 mmHg) (65% in Acu-TENS vs 25% in placebo, P = 0.02). The plasma beta-endorphin levels of the Acu-TENS group were significantly higher than that of the placebo group at barostat inflation pressure of 24 mmHg (1.31 ± 0.40 ng/mL vs 1.04 ± 0.43 ng/mL, P = 0.044) and at maximal inflation pressure (1.46 ± 0.53 ng/mL vs 0.95 ± 0.38 ng/mL, P = 0.003).

CONCLUSION

Acu-TENS reduced rectal discomfort during barostat-induced rectal distension and concurrently associated with a rise in beta-endorphin level.

Authors+Show Affiliations

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong 999077, China. leungww@surgery.cuhk.edu.hkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

23372361

Citation

Leung, Wing-Wa, et al. "Acupuncture Transcutaneous Electrical Nerve Stimulation Reduces Discomfort Associated With Barostat-induced Rectal Distension: a Randomized-controlled Study." World Journal of Gastroenterology, vol. 19, no. 3, 2013, pp. 381-8.
Leung WW, Jones AY, Ng SS, et al. Acupuncture transcutaneous electrical nerve stimulation reduces discomfort associated with barostat-induced rectal distension: a randomized-controlled study. World J Gastroenterol. 2013;19(3):381-8.
Leung, W. W., Jones, A. Y., Ng, S. S., Wong, C. Y., & Lee, J. F. (2013). Acupuncture transcutaneous electrical nerve stimulation reduces discomfort associated with barostat-induced rectal distension: a randomized-controlled study. World Journal of Gastroenterology, 19(3), 381-8. https://doi.org/10.3748/wjg.v19.i3.381
Leung WW, et al. Acupuncture Transcutaneous Electrical Nerve Stimulation Reduces Discomfort Associated With Barostat-induced Rectal Distension: a Randomized-controlled Study. World J Gastroenterol. 2013 Jan 21;19(3):381-8. PubMed PMID: 23372361.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acupuncture transcutaneous electrical nerve stimulation reduces discomfort associated with barostat-induced rectal distension: a randomized-controlled study. AU - Leung,Wing-Wa, AU - Jones,Alice Y M, AU - Ng,Simon S M, AU - Wong,Cherry Y N, AU - Lee,Janet F Y, PY - 2012/05/29/received PY - 2012/09/05/revised PY - 2012/09/22/accepted PY - 2013/2/2/entrez PY - 2013/2/2/pubmed PY - 2014/1/5/medline KW - Acupuncture KW - Colonoscopy KW - Rectal discomfort KW - Transcutaneous electrical nerve stimulation KW - Visceral pain SP - 381 EP - 8 JF - World journal of gastroenterology JO - World J Gastroenterol VL - 19 IS - 3 N2 - AIM: To explore the effectiveness of acupuncture transcutaneous electrical nerve stimulation (Acu-TENS), a non-invasive modality in reduction of rectal discomfort during barostat-induced rectal distension. METHODS: Forty healthy subjects were randomized to receive 45 min of either Acu-TENS or placebo-TENS (no electrical output) over acupuncture points Hegu (large-intestine 4), Neiguan (pericardium 6) and Zusanli (stomach 36). A balloon catheter attached to a dual-drive barostat machine was then inserted into the subjects' rectum. A step-wise (4 mmHg) increase in balloon pressure was induced until maximal tolerable or 48 mmHg. Visual analogue scale and a 5-point subjective discomfort scale (no perception, first perception of distension, urge to defecate, discomfort/pain and extreme pain) were used to assess rectal discomfort at each distension pressure. Blood beta-endorphin levels were measured before, immediately after intervention, at 24 mmHg and at maximal tolerable distension pressure. RESULTS: There was no difference in the demographic data and baseline plasma beta-endorphin levels between the two groups. Perception threshold levels were higher in the Acu-TENS group when compared to the placebo group, but the difference reached statistical significance only at the sensations "urge to defecate" and "pain". The distension pressures recorded at the "urge to defecate" sensation for the Acu-TENS and placebo-TENS groups were 28.0 ± 4.5 mmHg and 24.6 ± 5.7 mmHg, respectively (P = 0.043); and the pressures recorded for the "pain" sensation for these two groups were 36.0 ± 4.2 mmHg and 30.5 ± 4.3 mmHg respectively (P = 0.002). Compared to the placebo group, a higher number of participants in the Acu-TENS group tolerated higher distension pressures (> 40 mmHg) (65% in Acu-TENS vs 25% in placebo, P = 0.02). The plasma beta-endorphin levels of the Acu-TENS group were significantly higher than that of the placebo group at barostat inflation pressure of 24 mmHg (1.31 ± 0.40 ng/mL vs 1.04 ± 0.43 ng/mL, P = 0.044) and at maximal inflation pressure (1.46 ± 0.53 ng/mL vs 0.95 ± 0.38 ng/mL, P = 0.003). CONCLUSION: Acu-TENS reduced rectal discomfort during barostat-induced rectal distension and concurrently associated with a rise in beta-endorphin level. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/23372361/Acupuncture_transcutaneous_electrical_nerve_stimulation_reduces_discomfort_associated_with_barostat_induced_rectal_distension:_a_randomized_controlled_study_ L2 - https://www.wjgnet.com/1007-9327/full/v19/i3/381.htm DB - PRIME DP - Unbound Medicine ER -