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OBJECTIVE: The objective of this study was to compare trigger point (TrP) dry needling, TrP electroacupuncture and motor point electroacupuncture of the trapezius muscle for the treatment of myofascial pain syndrome (MPS). METHODS: This randomised clinical trial included 90 patients divided into three groups. Group 1 was treated with dry needling of TrPs, group 2 with intramuscular electrical stimulation of TrPs, and group 3 with electroacupuncture of motor points and/or the spinal accessory nerve. Each group received seven treatment sessions. The outcomes were the pain score measured by visual analogue scale (VAS) and quality of life evaluated by the 12-item short form (SF-12) health questionnaire. We compared the pain outcome over serial time points using growth curve analysis methods. RESULTS: Participants in the three groups experienced significant improvements in pain scores over time. The average pain level of participants in group 3 across the repeated assessments was 0.98 units lower than in group 1 (mean difference (95% confidence interval (CI) = 1.74-0.23)), p = 0.012). There were no significant differences in pain scores between participants in groups 1 and 2, and there were no significant differences in quality of life across the three groups at the end of the treatment period. CONCLUSION: Our results provide evidence that electrical stimulation of motor points and/or of the spinal accessory nerve may be superior in terms of pain relief (but not quality of life) to dry needling and possibly electrical stimulation of trigger points for the management of MPS involving the trapezius. TRIAL REGISTRATION NUMBER: TRIAL-RBR-43R7RF (Brazilian Clinical Trials Registry).

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ABSTRACT BACKGROUND AND OBJECTIVES: Angina is a clinical syndrome characterized by pain or discomfort, considered stable when it occurs for several weeks without progressing to an acute coronary event. Anginal pain management can be performed with pharmacological and non-pharmacological treatments, among which acupuncture is a non-pharmacological option. The aim of this study was to carry out an integrative review of the analgesic effect of acupuncture in patients with stable angina. CONTENTS: An integrative review was carried out in April 2021 in databases: Pubmed, Scopus, Cinahl and Bireme. Controlled descriptors "angina pectoris", "angina stable", "acupuncture", "acupuncture therapy", "acupuncture analgesia" were used. After screening and analyzing the manuscripts, seven experimental studies of the randomized controlled trial type were selected. The results suggest that acupuncture in patients with stable angina can promote an analgesic effect with clinical improvement of symptoms. CONCLUSION: Acupuncture can be an adjuvant therapeutic alternative for the treatment of patients with stable angina, since it can promote an analgesic effect with clinical improvement of symptoms.

RESUMO JUSTIFICATIVA E OBJETIVOS: A angina é uma síndrome clínica caracterizada por dor ou desconforto, considerada estável quando ocorre por várias semanas sem evoluir para um evento coronariano agudo. O manejo da dor anginosa pode ser realizado por meio de tratamentos farmacológicos e não farmacológicos, incluindo a acupuntura como uma opção não farmacológica complementar. O objetivo deste estudo foi realizar uma revisão integrativa sobre o efeito analgésico da acupuntura em pacientes com angina estável. CONTEÚDO: Foi realizada uma revisão integrativa no mês de abril de 2021 nas bases de dados: Pubmed, Scopus, Cinahl e Bireme. Foram utilizados os descritores controlados "angina pectoris", "angina stable", "acupuncture", "acupuncture therapy", "acupuncture analgesia". Após triagem e análise dos manuscritos, foram selecionados sete estudos experimentais do tipo ensaio controlado randomizado. Os resultados sugerem que a acupuntura pode promover efeito analgésico com melhora clínica dos sintomas em pacientes com angina estável. CONCLUSÃO: A acupuntura pode ser uma alternativa terapêutica complementar para tratamento de pacientes com angina estável, uma vez que pode promover efeito analgésico com melhora clínica dos sintomas.

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Disfunção Temporomandibular (DTM) apresenta-se como principal causa de dores orofaciais de origem não dentária. A acupuntura é indicada para o alívio de da dor em casos de DTM muscular, baseada em propriedades anti-inflamatórias com efeitos neuro-hormonais. Objetivou-se nesta pesquisa a avaliação da eficácia da acupuntura como um método válido para redução imediata da sintomatologia dolorosa e limitação de abertura bucal nos casos de DTM. Realizou-se terapia acupuntural em 30 pacientes com DTM, avaliando-se a dor, a partir da Escala Verbal (EV) e da Escala Analógica Visual (EAV) e a limitação de abertura bucal com o auxílio de paquímetro digital antes e após a terapia para registro da análise. O aumento da média de abertura bucal foi de 9,2% no total de participantes. Quanto à sintomatologia dolorosa, apresentou redução média em 63%. Na EV, 27 dos pacientes tiveram resposta "moderada" e "intensa" para sensação dolorosa. Contudo, após a terapia, observou-se ausência de sensação dolorosa intensa. Os dados apontaram significância da terapia acupuntural para redução dor e limitação de abertura bucal, de forma imediata, em pacientes com DTM... (AU)

Temporomandibular Disorder (TMD) is the main cause of orofacial pain of non-dental origin. Acupuncture is indicated for pain relief in cases of muscle TMD, based on anti-inflammatory properties with neuro hormonal effects. The aim of this research was to evaluate the effectiveness of the acupuncture as a valid method for immediate reduction of painful symptoms and mouth opening limitation in TMD cases. Acupuncture therapy was performed in 30 patients with TMD, evaluating pain from the Verbal Scale (VE) and Visual Analog Scale (VAS) and mouth opening limitation with the aid of a digital caliper before and after therapy to record the analysis. The increase in the average mouth opening was 9.2% in the total number of participants. As for painful symptoms, an average reduction of 63%. In IV, 27 of the patients had "moderate" and "intense" responses to painful sensation. However, after therapy, the absence of intense painful sensation was observed. The data showed the significance of acupuncture therapy for immediate pain reduction and mouth opening limitation in patients with TMD... (AU)

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OBJECTIVE: To compare differences in self-reported musculoskeletal pain before and after receiving rapid acupuncture for pain at an outpatient emergency department. METHODS: Exactly 102 patients presenting to the emergency room of the Hospital Servidor Publico Estadual in Sao Paulo, Brazil, participated in this before-and-after study. All participants had musculoskeletal pain and were treated with the technique proposed by Marques Filho. This emergency acupuncture involved inserting a needle at a point defined by traditional Chinese medicine and applying intense stimulation for 10 s; no more than two points were used on any individual patient. Pain was measured using a numerical visual scale before and immediately after the procedure. RESULTS: Participants in this study were mostly women (78%), had a college degree (47%) and were below the age of 60 (56%). The most common region of pain was the lower back (31%), and the most common type of pain was acute and exacerbated chronic pain. The meridians most commonly involved were the eight extra meridians (40%), and the points most often used for treatment were Houxi (SI3), Shenmai (BL62) and Zulinqi (GB41). Almost all participants reported a decrease in pain intensity, independent of sex, education level, pain site and pain type (acute/chronic; P < 0.05). At the end of the session, only 4% of the participants reported a desire for allopathic medication. CONCLUSION: This emergency acupuncture technique for analgesia appears to reduce musculoskeletal pain. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (http://www.ensaiosclinicos.gov.br/) with No. RBR-8dmfjf.

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RESUMEN Introducción: la analgesia por acupuntura produce una estimulación mecánica o eléctrica en diferentes puntos del cuerpo, provocando un aumento del umbral del dolor y ayuda al paciente a soportar diversos tipos de intervención quirúrgica. Objetivo: evaluar la aplicación de analgesia acupuntural en cirugía inguino genital urológica en el Hospital Pediátrico Provincial Docente Pepe Portilla. Métodos: se realizó un estudio observacional, descriptivo y transversal de 260 pacientes operados con analgesia acupuntural entre 2011 y 2017. Los datos se obtuvieron a partir de las historias clínicas de los pacientes. Las variables (edad, sexo, área quirúrgica, eficacia del tratamiento, complicaciones, recuperación anestésica, tiempo de uso de analgésicos y gasto económico) se analizaron mediante estadística descriptiva. Resultados: predominó el sexo masculino (78,1 %) y las edades comprendidas entre 13 - 18 años. La región inguinal fue el área más intervenida (76,1 %). El 93,9 % de los pacientes presentó buena respuesta al tratamiento, el 2,7 % mostró respuesta regular en cirugía genital y el 3,4 % respuesta mala en cirugía inguinal. Solo 19 pacientes (7,3 %) presentaron algún tipo de complicación, siendo el dolor la más frecuente (10 casos). La recuperación anestésica fue favorable en 241 pacientes (92,7 %). El valor de los recursos materiales usados representa $0,99 por cada cirugía, lo cual asciende al monto de $257,4 en las 260 intervenciones realizadas. Conclusiones: el uso de analgesia acupuntural en cirugía uropediátrica presentó buena respuesta al tratamiento, aparición escasa de complicaciones, recuperación anestésica favorable y amplio valor científico y socioeconómico.

ABSTRACT Introduction: acupuncture analgesia produces mechanical or electrical stimulation in different points of the body, increasing the pain threshold and helping the patient to support different types of surgical intervention. Objective: to assess the application of acupuncture analgesia in urinary genital inguinal surgery at Pepe Portilla Provincial Pediatric Teaching Hospital. Methods: an observational, descriptive and cross-sectional study that included 260 patients undergoing surgeries applying acupuncture analgesia between 2011 and 2017 was conducted. The data were obtained from the patient's medical records. The variables were: age, gender, surgical area, effectiveness of treatment, complications, anesthetic recovery, duration of the analgesic action and economic expenses; which were analyzed by descriptive statistics. Results: male sex predominated (78,1 %), the ages comprised between 13 - 18 years. The inguinal region was the most intervened area (76,1 %); 93,9 % of the patients showed good outcomes, 2,7 % had a regular response in genital surgery and 3,4 % a poor outcome in inguinal surgery. Only 19 patients (7,3 %) presented some type of complications, pain was the most frequent (10 cases). Anesthetic recovery was favorable in 241 patients (92,7 %). The cost of the surgical materials used represents $ 0,99 for each surgery, which amounts of $ 257,4 in a total of 260 surgical interventions performed. Conclusions: the application of acupuncture analgesia in pediatric urinary genital inguinal surgery presented a good response to this treatment, observing infrequent complications, favorable anesthetic recovery and an ample scientific value, as well as low socioeconomic expenses.

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RESUMEN Fundamento: la analgesia quirúrgica acupuntural permite realizar el tratamiento quirúrgico sin el uso de anestésicos convencionales, pues la acupuntura y la electroterapia, logran un aumento del umbral doloroso en el paciente, y producen una disminución o pérdida de la percepción del dolor. Este proceder combinado con otras técnicas bioenergéticas afines es más efectivo. Objetivo: divulgar información actualizada sobre el uso de la analgesia quirúrgica acupuntural y las técnicas bioenergéticas afines, en profesionales dela estomatología. Método: se realizó una revisión bibliográfica desde enero hasta marzo de 2017, en las bibliotecas de la facultad de Estomatología y Medicina, de la Universidad de Ciencias Médicas de la provincia Camagüey. Se consultó la bibliografía impresa, libros clásicos revistas y la información disponible en internet, que aparece escrita en los idiomas español, inglés y portugués. La búsqueda se realizó en bases de datos como: Medline, Lilacs, Dialnet, Redalyc, Hinari, Doyma, SciELO. De los 90 artículos encontrados, se incluyen 47 en la investigación, un alto porcentaje de ellos fue publicado en los últimos cinco años. Desarrollo: la revisión bibliográfica muestra la importancia de combinar la acupuntura con técnicas eléctricas, terapias psicológicas, la hipnosis, la homeopatía y la auriculopuntura; al realizar exodoncias. Se mencionan los antecedentes históricos, conceptos, indicaciones, precauciones, contraindicaciones, equipo e instrumental, aspectos que garantizan el éxito del tratamiento. Se señalan los puntos acupunturales más útiles, ventajas de su uso, iatrogenias y eventos adversos frecuentes. Conclusiones: la analgesia quirúrgica acupuntural es un procedimiento con bases científicas en continuo desarrollo. Su indicación para exodoncias en estomatología es favorable y su eficacia es mayor al combinarla con terapias bioenergéticas afines, por tanto es necesario potenciar y desarrollar estudios rigurosos sobre este tema, para estimular y divulgar su uso entre los profesionales de la estomatología.

ABSTRACT Background: the surgical acupunctural analgesia allows accomplishing the surgical treatment without the use of conventional anesthetics, because acupuncture and electrotherapy achieve an increase of the painful doorstep in the patient and they produce a decrease or loss of the perception of the pain. This action combined with other techniques related bioenergetics is more effective. Objective: to popularize updated information on the use of the surgical acupunctural analgesia and techniques related to bioenergetics in stomatology. Methods: a bibliographic revision was carried out from January to March 2017, at the libraries of Dentistry's and Medicine´s faculty of Medical Science's University of Camagüey´s province. It was consulted the printed bibliography, classical books, magazines and the available information in internet, which appear written in the Spanish, English and Portuguese languages. The search was carried out in databases like Medline, Lilacs, Dialnet, Redalyc, Hinari, Doyma and SciELO. Of the 90 articles found, 47 are included in the investigation; a high percentage of them were published in the last five years. Development: the bibliographical review shows the importance of combining the acupuncture with electrical techniques, psychological therapies, hypnosis, homeopathy, and auriculopuncture; when performing exodontias. There are mentioned the historic background, concepts, indications, precautions, contraindications, equipment and instruments, aspects that guarantee the success of treatment. It is pointed out the most useful acupuncture points, advantages of its use, iatrogenic and frequent adverse events. Conclusions: the surgical acupunctural analgesia is a procedure with scientific bases in continuous development. Its indication for exodontias in dentistry is clearly favorable and its efficacy is higher when combining with bioenergetics therapies, therefore it is necessary to encourage and to develop rigorous studies on this theme to stimulate and to promote its use among the professionals of dentistry.

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ABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorder is defined as a set of clinical problems involving masticatory muscles, temporomandibular joint and associated structures. For having multifactorial etiology, several treatments are proposed and successfully used. However, most recommended therapies are those reversible and noninvasive, which should be the first choice to treat temporomandibular disorders. This study aimed at discussing acupuncture to treat temporomandibular disorders and associated symptoms. CONTENTS: This is a review of 34 articles published between 1983 and 2015. Since acupuncture aims at returning balance to body and harmony between physical and psychical parts by stimulating specific points, it may be considered therapy of choice to treat temporomandibular disorders. In TMD patients, evidences have shown efficacy in increasing temporomandibular joint movement amplitude, accelerating serotonin, encephalin and endorphin release, thus favoring masticatory muscles relaxation and pain relief. According to recent articles, most commonly used points for this purpose are: ST6, ST7, SJ21, SJ17, SI18, Taiyaing and Yintang (face and head) and LI4 (extrafacial). CONCLUSION: Acupuncture is as effective to control facial pain as conventional Western therapies. It is considered useful, of low cost and provides better quality of life to patients treated with this technique.

RESUMO JUSTIFICATIVA E OBJETIVOS: A disfunção temporomandibular é definida como um conjunto de problemas clínicos que envolvem os músculos mastigatórios, a articulação temporomandibular e estruturas associadas. Por serem de causa multifatorial, diversas modalidades de tratamento são propostas e utilizadas com êxito. Contudo, as terapias mais recomendadas são as reversíveis e não invasivas, as quais devem ser a primeira opção de escolha no tratamento das disfunções temporomandibulares. O objetivo deste estudo foi discorrer sobre o uso da acupuntura no tratamento da disfunção temporomandibular e sintomas associados. CONTEÚDO: Compuseram essa revisão 34 artigos, publicados entre os anos de 1983 e 2015. Uma vez que a acupuntura busca devolver o equilíbrio do organismo e harmonia entre as partes física e psíquica por meio de estímulos em pontos específicos, pode ser considerada uma terapia de eleição para o tratamento da disfunção temporomandibular. Em pacientes com disfunção temporomandibular evidências demonstraram eficácia no aumento da amplitude de movimento da articulação temporomandibular, acelerando a liberação de serotonina, encefalina e endorfina, e favorecendo assim o relaxamento dos músculos mastigatórios e a redução da dor. Segundo os artigos recentes, os pontos mais comumente empregados para esse fim são: E6, E7, TA21, TA17, ID18, Taiyaing e Yintang (face e cabeça) e IG4 (extrafacial). CONCLUSÃO: A acupuntura tem se mostrado tão eficiente no controle de dores faciais quanto as terapias ocidentais convencionais. É uma terapia considerada útil, de baixo custo e que proporciona uma melhor qualidade de vida aos pacientes tratados com essa técnica.

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Background: There is evidence that acupuncture may relieve pain. Aim: To assess the evidence about the effectiveness of acupuncture to relieve postoperative pain. Material and Methods: A systematic review of the literature selecting controlled clinical trials and systematic reviews comparing acupuncture with standard pain management. The value and quality of reports were evaluated using Jadad scale and STRICTA protocol. Pain intensity and analgesic consumption were the primary endpoints sought. Results: Five controlled trials and two systematic reviews were selected. A meta-analysis was not feasible due to the heterogeneity of studies. In the postoperative period of tonsillectomy, acupuncture reduced pain by 36 and 22% at 20 minutes and two hours, respectively. In knee replacement, acupuncture reduced pain by 2% and analgesic consumption by 42%. In the postoperative period of dental interventions, acupuncture reduced pain by 24% at two hours. Conclusions: Acupuncture may be useful to manage postoperative pain, but more controlled studies are required.

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BACKGROUND AND OBJECTIVES: For most cases, temporomandibular disorders should be treated by a non-invasive, interdisciplinary and integrative process. In traditional Chinese medicine, acupuncture is an excellent tool aiming at treating and healing this disease. This study was a critical literature review to observe the efficacy of traditional Chinese acupuncture to treat muscular temporomandibular disorders and to identify primary acupoints. CONTENTS: Pubmed, LILACS, Scielo and Cochrane databases were queried to identify scientific articles relevant for the study. Articles were selected from January 2000 to May 2013. A total of 125 articles were found and 21 were included. Acupuncture treatment alone or as additional therapy, or even compared to other techniques, was superior and effective to improve pain and function of patients with temporomandibular disorders and most commonly used acupoints were IG4, E6, E7 and F3. CONCLUSION: This study has shown that acupuncture is a technique recommended by national and international literature to treat muscular temporomandibular disorders, promoting pain relief and/or total intensity, improvement of joint movements and oral function and decrease of masticatory muscles hyperactivity. .

JUSTIFICATIVA E OBJETIVOS: Na grande maioria dos casos, o tratamento das disfunções temporomandibulares deve ser um processo não invasivo, interdisciplinar e integrativo. Dentro da medicina tradicional chinesa, a acupuntura é uma ótima ferramenta que visa a terapia e cura dessas doenças. O objetivo deste estudo foi conduzir uma revisão crítica da literatura para verificar a eficácia da acupuntura tradicional chinesa no tratamento da disfunção temporomandibular do tipo muscular, bem como identificar os principais acupontos. CONTEÚDO: Foi realizada uma pesquisa nas bases de dados Pubmed, LILACS, Scielo e Cochrane para identificar artigos científicos relevantes para o estudo. Os artigos foram selecionados no período de janeiro de 2000 a maio de 2013. Encontrou-se um total de 125 artigos, sendo que 21 foram incluídos. O tratamento de acupuntura isolado ou como terapia complementar, ou ainda comparado com outras técnicas, se mostrou superior e eficiente na melhora da dor e da função de pacientes com disfunção temporomandibular, e os pontos de acupuntura mais citados foram IG4, E6, E7 e F3. CONCLUSÃO: Este estudo demonstrou que a acupuntura é uma técnica recomendada pela literatura nacional e internacional para o tratamento de disfunções temporomandibulares de origem muscular, promovendo alivio e/ou redução total da intensidade dolorosa, melhora nos movimentos mandibulares e na função oral e diminuição da hiperatividade muscular dos músculos da mastigação. .

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FUNDAMENTO: la terapia ortodóncica provoca períodos variables de dolor que no pueden tratarse de manera convencional por las negativas influencias de los analgésicos en el movimiento dentario, lo que motiva a buscar otras alternativas para la sedación de estos pacientes. OBJETIVO: evaluar la acción analgésica de la auriculopuntura en el dolor pos- instalación de técnicas ortodóncicas fijas. MÉTODO: se realizó un estudio de intervención terapéutica a corto plazo en el servicio de ortodoncia de la Clínica Estomatológica Docente Previsora desde enero de 2010 a enero de 2011. El universo y muestra lo conformaron 31 pacientes. Se determinó la percepción del dolor inmediato y mediato a través de la escala visual analógica, se precisó el estado de satisfacción de cada paciente y se identificaron las posibles reacciones adversas. RESULTADOS: más de la mitad de la muestra refirió dolor moderado inmediatamente de instalada la técnica, al tercer día de evolución casi la totalidad de los pacientes no presentó dolor. El total de la muestra estuvo satisfecho con el tratamiento. CONCLUSIONES: el método resultó eficaz con un mínimo de complicaciones.

BACKGROUND: orthodontic therapy causes different periods of pain that can not be treated conventionally because of the negative influence of analgesics in the dental movement; this motivates looking for other alternatives for the sedation of patients. OBJECTIVE: to asses the analgesic action of auriculoacupuncture in the pain that appears after the installation of fixed orthodontic techniques. METHOD: a short-term study of therapeutic intervention was conducted in the orthodontic department of the Previsora Teaching Stomatological Clinic from January, 2010 to January, 2011. The universe and sample were composed of 31 patients. The perception of immediate and mediate pain was determined by means of the analogical visual scale; the satisfaction state of every patient was specified and the possible adverse reactions were identified. RESULTS: more than the half of the sample expressed feeling a moderate pain immediately after the technique was installed; the third day of evolution almost all the patients did not presented pain. The whole sample was satisfied with the treatment. CONCLUSIONS: the method resulted to be effective with a minimum of complications.

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OBJECTIVE: This study aimed to evaluate the analgesic efficacy of systemic acupuncture therapy on the pain caused after orthodontic adjustments. METHODS: An initial sample of 30 orthodontic patients with fixed appliances monthly adjusted was selected; however, only 11 participants completed the study. For this reason, final sample comprised these patients' data only. Initially, average pain levels were assessed at different periods by means of an analogue visual scale (VAS) for three months without acupuncture. In the following three months, the volunteers were submitted to systemic acupuncture sessions on Hegu (LI4) and Jiache (St6) points, before orthodontic adjustments were carried out. RESULTS: Results revealed statistically significant reduction in pain level indexes both for men (P = 0.030) and women (P = 0.028) when acupuncture therapy was performed prior to orthodontic adjustment. Patients did not present any side effects. CONCLUSION: Acupuncture is a safe and effective method in reducing orthodontic post-adjustment pain.

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OBJECTIVE: This study aimed to evaluate the analgesic efficacy of systemic acupuncture therapy on the pain caused after orthodontic adjustments. METHODS: An initial sample of 30 orthodontic patients with fixed appliances monthly adjusted was selected; however, only 11 participants completed the study. For this reason, final sample comprised these patients' data only. Initially, average pain levels were assessed at different periods by means of an analogue visual scale (VAS) for three months without acupuncture. In the following three months, the volunteers were submitted to systemic acupuncture sessions on Hegu (LI4) and Jiache (St6) points,before orthodontic adjustments were carried out. RESULTS: Results revealed statistically significant reduction in pain level indexes both for men (P = 0.030) and women (P = 0.028) when acupuncture therapy was performed prior to orthodontic adjustment. Patients did not present any side effects. CONCLUSION: Acupuncture is a safe and effective method in reducing orthodontic post-adjustment pain. .

OBJETIVO: o presente trabalho objetivou avaliar a eficácia analgésica da acupuntura sistêmica, realizada previamente, sob a dor oriunda pós-ajuste ortodôntico. MÉTODOS: uma amostra de 30 indivíduos usuários de aparelhos fixos foi selecionada, os quais tinham de ser ajustados mensalmente. Contudo, somente 11 participantes completaram o estudo, e somente os seus dados foram coletados e analisados. A princípio, foi realizada uma média do índice de dor, em diferentes períodos, por meio de uma escala analógica visual (EAV), por três meses, sem a utilização da acupuntura. Nos três meses seguintes, os voluntários foram submetidos a sessões de acupuntura sistêmica nos pontos Hegu (IG4) e Jiache (E6), previamente ao ajuste ortodôntico. A média dos resultados do índice de dor com e sem acupuntura foram comparados. RESULTADOS: os resultados demonstraram que houve redução estatisticamente significativa no índice geral de dor, tanto para os homens (p = 0,030) quanto para as mulheres (p = 0,028), após a utilização da acupuntura previamente ao ajuste, e nenhum voluntário apresentou efeitos adversos. CONCLUSÃO: conclui-se que os pontos de acupuntura utilizados são eficientes e seguros na redução da dor pós-ajuste ortodôntico. .

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Acute dental pain is the main reason for seeking dental services to provide urgent dental care; there is consensus about the use of alternative therapies, such as acupuncture, to control dental pain in pre-dental care. This study aimed to evaluate the use of acupuncture in reducing the intensity of acute dental pain in pre-dental care in patients waiting for emergency dental care, and was conducted at the After-Hours Emergency Dental Clinic of Piracicaba Dental School, and at the Emergency Center Dental Specialties I in Piracicaba, São Paulo, Brazil. The sample consisted of 120 patients. The Visual Analog Scale (VAS) was used to measure pain intensity. All patients underwent one session of acupuncture; the points LI4, ST44 and CV23 were selected and were used alone or in combinations. Reduction in pain was observed in 120 patients (mean initial VAS=6.558±1.886, p<0; mean final VAS=0.962±2.163, p<0.00001). The results of this study indicate that acupuncture analgesia could be a technical adjunct to pain control in patients with acute dental pain, contributing to the restoration of health with social benefit.

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JUSTIFICATIVA E OBJETIVOS: A acupuntura é um método terapêutico utilizado há aproximadamente 5.000 anos que promove a harmonização e o fortalecimento do corpo. A cervicalgia atinge 28% da população. A Organização Mundial da Saúde de 2004 afirma que dores cervicais melhoram em 67% através do tratamento com acupuntura. A técnica Canal Unitário harmoniza e trata as dores. A técnica Flor de Liz alivia a dor crônica e aguda através do tratamento direto sobre as vértebras. O objetivo deste estudo foi verificar qual dos métodos produziu melhor efeito em relação à dor e qual deles manteve seus efeitos por maior tempo. MÉTODOS: Dois grupos foram criados. Um dos grupos tratado com Flor de Liz (G1) e o outro com Canal Unitário (G2). Os pacientes foram avaliados por um questionário e pela escala analógica visual de dor. O tratamento foi realizado em 10 sessões, de 40 minutos cada, uma vez por semana. Após uma, duas, três e quatro semanas os pacientes foram reavaliados. RESULTADOS: Foram incluídos 20 pacientes dos quais 10 receberam Canal Unitário e 10 receberam a técnica Flor de Liz. Pela técnica Flor de Liz, a média de dor inicial foi de 5,6 e após 10 sessões foi de 0,1; enquanto com o Canal Unitário foi de 6,36 e 2,54, respectivamente. Após quatro semanas do fim do tratamento a graduação de dor diminuiu. Através da técnica de Canal Unitário observou-se que os meridianos mais acometidos foram triplo aquecedor (35%), intestino delgado (20%) e bexiga (20%), seguidos por vesícula biliar (15%) e intestino grosso e estômago com 5% cada um. Ao comparar ambos os grupos após aplicação das técnicas, verificou-se de uma maneira geral que o G1 apresentou valores inferiores aos obtidos pelo G2. Após o tratamento, ambos os grupos permanecem com intensidade inferior a zero. CONCLUSÃO: A técnica Flor de Liz obteve melhores resultados após as 10 sessões e manteve os resultados após quatro semanas.

BACKGROUND AND OBJECTIVES: Acupuncture is a therapeutic method used for approximately five thousand years which promotes body harmonization and strengthening. Cervical pain affects 28% of the population. In 2004, the World Health Organization stated that cervical pain improves 67% when treated with acupuncture. The Unitary Channel technique harmonizes and treats pain. The Fleur de Lis technique relieves chronic and acute pain by directly acting on vertebrae. This study aimed at verifying which method had the best effect on pain and which has kept its effects for a longer time. METHODS: Two groups were created. One group was treated with Fleur de Lis (G1) and the other with Unitary Channel (G2). Patients were evaluated with a questionnaire and the visual analog scale. Treatment consisted of 10 sessions of 40 minutes each, once a week. Patients were revaluated after two, three and four weeks. RESULTS: Participated in the study 20 patients of whom 10 have received Unitary Channel and 10 have received the Fleur de Lis technique. With the Fleur de Lis technique, mean initial pain was 5.6 and after ten sessions it was 0.1. For the Unitary Channel it was 6.36 and 2.54, respectively. Four weeks after treatment pain scores had decreased. With the Unitary Channel technique it was observed that most affected meridians were triple burner (35%), small intestine (20%) and bladder (20%), followed by gallbladder (15%), and large intestine and stomach, with 5% each. When comparing both groups after the application of the techniques, it was observed that, in general, G1 had lower scores as compared to G2. After treatment, both groups have remained with pain intensity below zero. CONCLUSION: Fleur de Lis technique had better results after 10 sessions and has maintained results after four weeks.

RESUMO

Se efectuó un estudio descriptivo y transversal de 60 pacientes, atendidas en la consulta de regulación menstrual del Policlínico Universitario "Josué País García" de Santiago de Cuba, desde abril hasta junio del 2009, con vistas a evaluar los resultados de la analgesia acupuntural empleada para tratar a estas féminas. Entre las variables analizadas figuraron: edad, escolaridad, ocupación, intensidad del dolor percibido, complicaciones y grado de satisfacción. Para resumir la información se emplearon las frecuencias absolutas y relativas (porcentaje). En la serie predominaron el grupo etario de 15-19 años, el nivel escolar preuniversitario, las estudiantes, el sangrado como la complicación más frecuente y el dolor moderado como el de mayor intensidad. Asimismo, prevaleció el tratamiento efectivo y existió una adecuada satisfacción por parte de las pacientes en cuanto al uso de la citada técnica.

A descriptive and cross-sectional study was carried out in 60 patients attended in the menstrual regulation department of "Josué País García" University Polyclinic of Santiago de Cuba, from April to June 2009, with the purpose of evaluating the results of acupuncture analgesia used to treat these females. Among the analyzed variables were age, education, occupation, severity of perceived pain, complications and satisfaction. To summarize the information the absolute and relative frequencies were used (percentage). The age group of 15-19 years, high school level, students, and bleeding as the most frequent complication and moderate pain as that of more severity predominated in the case material. Also, the effective treatment prevailed and there was an adequate satisfaction of the patients in the use of that technique.

RESUMO

La enfermedad carotídea aumenta significativamente el riesgo de tener el tipo más común de ataque isquémico cerebral (ictus). Son sobradamente conocidos los elevados procesos isquémicos cerebrales que tienen su origen en lesiones estenosantes (ulceradas o no) de las arterias extracraneales, fundamentalmente en la bifurcación carotídea. Dado que estas lesiones tienen acceso quirúrgico, el tratamiento de rutina desde hace años es la endarterectomia carotídea. El efecto analgésico de la acupuntura permite realizar cualquier tipo de operación en la región anatómica seleccionada, conservando el paciente su lucidez mental, algo oportuno para determinar qué pacientes necesitarán de shunt intraluminal después del clampeo de las arterias durante esta operación. Con el objetivo de asociar estos criterios, a un paciente masculino de 76 años que había sufrido cuatro ataques cerebrales de isquemia, producto de placa de ateroma complicada y estenosante de la bifurcación carotidea izquierda, se le realizó una endarterectomía con analgesia acupuntural sin complicaciones transoperatorias ni postoperatorias, por lo que se propone que es una alternativa lógica, económica y segura de realizar la desobstrucción carotídea.

Carotid disease increases the risk of having the most common brain-ischemic stroke significantly. The elevated brain ischemic processes havig their origin in lesions caused by stenosis (ulcerous o non-ulcerous) of the extracranial arteries, mainly in the carotid bifurcation are well-known. As these lesions are surgically accessible, for long years the routine treatment is the Endarterectomy of carotids. The analgesic effect of the acupuncture permits any types of surgery in the chosen anatomic region, preserving mental lucidity in patient, something very significant to determine the patients needing intraluminal shunt after campling the arteries during this surgical procedure. Aimed at associating these criteria, a 76-year-old-male patient who had suffered from four ischemic brain strokes as a consequence of a complicated atheromatous plaque and stenosis of left carotid bifurcation, an Endarterectomy of carotids with acupunctural analgesia was performed without trans-operative or post-operative complications, therefore it is proposed as a logic, economic and secure alternative to remove the carotid obstruction.

RESUMO

Objetivou-se avaliar o efeito analgésico da farmacopuntura com meloxicam e da aquapuntura preemptivas em gatas submetidas à OSH. Foram utilizados 29 animais considerados sadios após exame clínico e laboratorial com idade de 11,59±6,21 meses e peso de 2,50±0,58kg distribuídos em quatro grupos: aquapuntura (GA; n=7; 0,1ml de solução fisiológica nos acupontos BP6, VB34, F3 e E36 bilaterais), meloxicam (GM; n=8; 0,1mg kg-1 de meloxicam por via subcutânea), farmacopuntura (GMFV; n=7; 0,01mg kg-1 de meloxicam, diluído em 0,8ml de solução fisiológica, distribuído nos acupontos BP6, VB34, F3 e E36 bilaterais) e subdose de meloxicam (GMFF; n=7; 0,01mg kg-1 de meloxicam diluído em solução fisiológica por via SC na região interescapular). Os animais foram submetidos à OSH por meio de técnica cirúrgica minimamente invasiva. Os momentos de avaliação pós-cirúrgica foram 1h, 2h, 6h, 8h, 12h e 24h após o término da cirurgia por avaliador encoberto. Todos os parâmetros avaliados no dia anterior à cirurgia foram considerados como valores basais. Para a avaliação da sedação, utilizou-se a escala analógica visual e o escore do grau de sedação. Para a avaliação da dor, foram utilizadas a escala analógica visual (EAV), a escala descritiva de dor (EDD) e o grau de hiperalgesia com o auxílio dos monofilamentos de Von Frey. O resgate analgésico foi realizado com morfina na dose de 0,2mg kg-1 por via intramuscular (IM), quando a pontuação na EDD ultrapassava 33% da total. A análise estatística foi realizada por meio do programa Sigma-Stat 3.1, utilizando-se a análise de variância paramétrica e não paramétrica e respectivos teste de Tukey e de Dunn para as comparações, com significância de 5% (P<0,05). Não houve diferenças estatísticas na comparação entre os grupos quanto às variáveis fisiológicas, sensibilidade quanto aos monofilamentos de Von Frey, EAV para dor e sedação e EDD. Quatro resgates do grupo GM foram realizados, contra três resgates dos grupos GA e GMFF e dois resgates do grupo GMFV. Os tratamentos apresentaram semelhante eficácia analgésica em gatas submetidas à OSH.

The aim of this study was to evaluate the analgesic effect of preemptive pharmacopuncture with meloxicam or aquapuncture in cats undergoing ovariohysterectomy. Twenty-nine healthy animals, aged 11.59±6.21 and weighing 2.50±0.58kg were used and assigned to four groups: aquapuncture (GA; n=7; 0.1mL of saline solution in the SP6, GB34, LIV3 and ST36 acupoints bilaterally), meloxicam (GM; n=8; 0.1mg kg-1 of meloxicam subcutaneously), pharmacopuncture (GMFV; n=7; 0.01mg kg-1 of meloxicam, diluted to 0.8ml of saline solution, equally distributed in the SP6, GB34, LIV3 and ST36 acupoints bilaterally) or subdose of meloxicam (GMFF; n=7; 0.01mg kg-1 of meloxicam diluted in saline subcutaneously, at the interscapular region). The animals were submitted to OVH by minimally invasive surgical technique. Animals were evaluated at 1h, 2h, 6h, 8h, 12h and 24h postoperatively by a blind assessor. All measurements were assessed the day before surgery and were considered as baseline. Postoperative pain and sedation were evaluated by visual analogue scale in both cases and sedation score and descriptive pain scale (DPS), respectively, as well as hyperalgesia was assessed by the Von Frey monofilaments. The analgesic rescue was performed with 0.2mg kg-1 of morphine intramuscularly, when the DPS score was above 33% from the total score. Statistical analysis were performed with the Sigma-Stat 3.1 program using parametric and nonparametric analyses of variances and respective Tukey´s and Dunn´s test for post hoc comparisons. The level of statistical significance was set at 5% (P<0.05). There was no statistical difference between groups for the physiological variables, Von Frey sensitivity, VAS for pain and sedation and DPS. Four analgesic rescues were performed in GM group, three in GA and GMFF groups and two in GMFV group. All treatments showed similar analgesic effect in cats undergoing OVH.

RESUMO

JUSTIFICATIVA E OBJETIVOS: As doenças cerebrovasculares são responsáveis por grande parte das mortes no mundo. Entre os sobreviventes, a maioria das sequelas limitantes encontradas nos pacientes é motora, mas quando vias ou centros sensitivos são afetados os pacientes podem evoluir com alterações de sensibilidade na região corpórea representada pela área encefálica atingida. Quando a região acometida relaciona-se com o tálamo pode ocorrer síndrome talâmica. O objetivo deste relato de caso foi demonstrar o uso da eletroacupuntura como coadjuvante no tratamento de dor central, diagnosticada como síndrome talâmica de difícil controle com tratamento farmacológico. RELATO DO CASO: Paciente do sexo feminino, 46 anos, com história de acidente vascular encefálico isquêmico que acometeu região temporoparietal esquerda em abril de 2003, evoluiu com hemiparesia e hemitaxia à direita. Após um ano, iniciou-se quadro doloroso insidioso, contínuo, difuso em hemicorpo direito, acompanhado de alodínea e hiperalgesia, diagnosticado como síndrome talâmica. Em janeiro de 2006, deu entrada no serviço de terapia da dor e medicina paliativa da Santa Casa de Misericórdia de São Paulo e iniciou tratamento farmacológico com resposta ruim, sendo programada para abordagem neurofuncional. Em julho de 2009, propôs-se à paciente tratamento com eletroacupuntura na tentativa de melhor controle de quadro álgico. Foram realizadas sessões de eletroacupuntura em pontos em couro cabeludo e membros. Após a décima primeira sessão, a paciente encontrava-se com quadro álgico controlado, sem uso de opioides e amitriptilina tópica, sensação de bem-estar elevada, maior coordenação motora, diminuição global da dor, sendo completa em mão e face. CONCLUSÕES: A eficácia da eletroacupuntura no controle do quadro álgico e no aumento do bem-estar encontra-se em concordância com estudos modernos, os quais demonstraram ativação de vias antinociceptivas encefálicas pela eletroacupuntura. Estudos clínicos prospectivos controlados são necessários para reafirmar e consolidar a eletroacupuntura como um importante instrumento no controle da dor central.

BACKGROUND AND OBJECTIVES: Cerebrovascular diseases are responsible for a large proportion of deaths in the world. Among survivors, the majority of limiting sequelae observed is motor in origin; but when sensorial pathways or centers are affected patients can evolve with sensorial changes in the body region represented by the area of the brain affected. When the affected area is related to the thalamus the patient might develop thalamic syndrome. The objective of this report was to demonstrate the use of electroacupuncture as adjuvant in the treatment of central pain, diagnosed as thalamic syndrome difficult to control with pharmacologic therapy. CASE REPORT: This is a 46 year-old female with history of ischemic stroke in the left temporoparietal region in April 2003 that evolved to right hemiparesis and hemitaxia. One year later, the patient developed continuous, insidious pain on the right side of the body with allodynia and hyperalgia, diagnosed as thalamic syndrome. In January 2006, she was admitted to the department of pain therapy and palliative care of Santa Casa de Misericórdia de São Paulo where pharmacologic treatment was instituted with poor response; she was scheduled for neurofunctional surgery. In July 2009, electroacupuncture, in an attempt to obtain better pain control, was proposed to the patient. Electroacupuncture was done on points in the scalp. After the 11th session, her pain was controlled, with no use of opioids or topical amitriptyline, her well-being had increased, her motor coordination improved, she presented global pain reduction, complete in hand and face. CONCLUSIONS: The efficacy of electroacupuncture in pain control and well-being are in agreement with modern studies which demonstrated activation of antinociceptive pathways in the brain. Controlled prospective studies are required to reaffirm and consolidate electroacupuncture as an important technique in controlling central pain.

JUSTIFICATIVA Y OBJETIVOS: Las enfermedades cerebrovasculares son las responsables de una gran parte de las muertes en todo el mundo. Entre los sobrevivientes, la mayoría de las secuelas limitantes encontradas en los pacientes es motora, pero cuando se afectan vías o centros sensitivos, los pacientes pueden evolucionar con alteraciones de sensibilidad en la región corporal representada por el área encefálica afectada. Cuando la región acometida se relaciona con el tálamo, puede ocurrir el síndrome talámico. El objetivo de este relato de caso fue demostrar el uso de la electroacupuntura como coadyuvante en el tratamiento del dolor central, diagnosticado como síndrome talámico de difícil control con un tratamiento farmacológico. RELATO DEL CASO: Paciente del sexo femenino, 46 años, con historial de accidente vascular encefálico isquémico, que le acometió la región temporoparietal izquierda en abril de 2003, evolucionando con hemiparesia y hemitaxia a la derecha. Después de un año, se inició el cuadro doloroso insidioso, continuo, difuso en el hemicuerpo derecho, seguido de alodínea e hiperalgesia, diagnosticado como síndrome talámico. En enero de 2006, se presentó en el servicio de terapia del dolor y medicina paliativa de la Santa Casa de Misericordia de São Paulo y empezó el tratamiento farmacológico con una mala respuesta, siendo programada para el abordaje en la neurofuncional. En julio de 2009, se le propuso el tratamiento con electroacupuntura en un intento de mejorar el control del cuadro álgico. Se realizaron sesiones de electroacupuntura en puntos en el cuero cabelludo y en los miembros. Después de la décima primera sesión, la paciente estaba con un cuadro álgico controlado, sin uso de opioides y amitriptilina tópica, una sensación de bienestar elevada, una mayor coordinación motora, y la disminución global del dolor verificada ya en la mano y la cara. CONCLUSIONES: La eficacia de la electroacupuntura en el control del cuadro álgico y en el aumento del bienestar, está a tono con los estudios modernos, que demuestran una activación de las vías antinociceptivas encefálicas por la electroacupuntura. Estudios clínicos prospectivos controlados son necesarios para reafirmar y consolidar la electroacupuntura como un importante instrumento en el control del dolor central.

Assuntos

RESUMO

Los pacientes con pulpitis aguda, producto al dolor que las caracteriza, en ocasiones no permiten realizar un tratamiento endodóntico de urgencia satisfactorio. Objetivo: evaluar la acción analgésica de la digitopuntura previo al tratamiento estomatológico convencional en las pulpitis agudas. Método: se realizó un estudio de evaluación, cuasi-experimental de tipo antes y después, en la consulta de urgencias estomatológica del policlínico Previsora desde septiembre de 2008 hasta abril de 2009, el universo de estudio se conformó por los pacientes que acudieron a la consulta con dolor producido por pulpitis aguda, la muestra quedó se integró por 40 pacientes que no habían recibido tratamiento previo. Se evaluó la intensidad del dolor a los 30min y se valoró la cooperación del paciente durante el tratamiento convencional. Resultados: en el 90 por ciento de los casos se evaluó como eficaz el tratamiento realizado y los pacientes refirieron sentirse satisfechos.

Patients with acute pulpitis caused to the pain that characterizes it, in occasions allow carrying out a satisfactory endodontic treatment of urgency. Objective: to evaluate the analgesic action of digitopuncture previous to the conventional stomatological treatment in acute pulpitis. Method: a before and after type quasi-experimental, evaluation study was performed, in the stomatological urgency consultation at Previsora polyclinic from September 2008 to April 2009, the study universe was conformed by patients that came to the consultation with pain caused by acute pulpitis and the sample was integrated by 40 patients who had not received previous treatment. The intensity of pain was evaluated to 30 minutes and patient's cooperation was valued during the conventional treatment. Results: in 90 percent of cases was evaluated as effective the treatment carried out and patients referred to feel satisfied with the treatment received (90 percent).

Assuntos

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Introducción: La enfermedad litiásica renoureteral es muy común en nuestro medio y es causa de cuadros disímiles donde predomina fundamentalmente el dolor, Desde 1991 se viene realizando en el Hospital Universitario "Arnaldo Milián Castro" de Villa Clara la Litotricia Extracorpórea renal, proceder no invasivo, pero doloroso, sobre todo en el momento de fragmentación del cálculo. Este proceder se realiza sin aplicar ningún método de alivio del dolor. Objetivo: Evaluar los efectos de la analgesia acupuntural con electroestímulo para el alivio del dolor en la realización de la Litotricia Extracorpórea renal. Materiales y Método: Se realizó un estudio comparativo entre dos grupos de 50 pacientes cada uno: el Grupo I con Analgesia Acupuntural con electroestímulo y el Grupo II se realizó convencionalmente, sin ningún método de alivio del dolor, que es como se realiza el proceder en el presente. Resultados: Se pudo comprobar que los pacientes a los cuales se les aplicó acupuntura presentaron dolor de ligero a moderado, con calidad de la analgesia buena, los parámetros hemodinámicos se mantuvieron más estables y con un mínimo de complicaciones. Conclusiones: La Analgesia Acupuntural con electroestímulo en los puntos IG4 y V57 fue satisfactoria como método de alivio del dolor durante la realización de Litotricia Extracorpórea renal, pues se logró excelente analgesia, estabilidad hemodinámica y un mínimo de complicaciones.

Introduction: Renoureteral-lithiasis is very common in our practice and it is the cause of dissimilar pictures where mainly predominates the pain. From 1991, in "Arnaldo Milián Castro" University Hospital of Villa Clara province, the renal extracorporeal lithotripsy is performed. It is a non-invasive, but painful procedure mainly at moment of calculus fragmentation. This procedure is performed without pain relief method. Aim: To assess the effects of acupuncture analgesia on electrical stimulation to pain relief in performing of renal extracorporeal lithotripsy. Materials and Methods: A comparative study was conducted between two groups of patients (50 each): Group I using acupuncture analgesia with electrical stimulation and the Group II where it was used in a conventional way without pain relief method that is the current procedure. Results: It was confirmed that patients in which acupuncture was applied had a slight to moderate pain with a good quality of analgesia and the hemodynamic parameters remained more stable and with a minimum of complications. Conclusions: Acupuncture analgesia with electrical stimulation in IG4 and V57 points was satisfactory as method to pain relief during performing of renal extracorporeal lithotripsy since there was an excellent analgesia and a hemodynamic stability, as well as a minimum of complications.