Investigating the Effects of Three Needling Parameters (Manipulation, Retention Time, and Insertion Site) on Needling Sensation and Pain Profiles: A Study of Eight Deep Needling Interventions

Introduction. In traditional Chinese acupuncture, needle sensation (deqi) is purported to contribute to a therapeutic outcome. While researchers have attempted to definedeqiqualitatively, few have examined the effects of needling parameters on its intensity.Methods. 24 healthy subjects completed eight interventions scheduled at least one week apart, which involved manual acupuncture to LI4 or a designated nonacupoint (NAP) on the hand, with real or simulated manipulation each three minutes and needle retentions of one or 21 minutes. Intensities of needling sensation and pain were reported every three minutes and sensation qualities were reported post-intervention.Results. Immediately after needle insertion, similar levels of mean needle sensation and of pain were reported independent of intervention. At subsequent measurement times, only two interventions (one at LI4 and one at NAP) maintained statistically significantly elevated needle sensation and pain scores and reported higher numbers of needle sensation descriptors. For both, the needle was retained for 21 minutes and manipulated every three minutes. Neither intervention differed significantly in terms of levels of pain, and needle sensation or numbers and qualities of needle sensation described.Conclusion. In this group of healthy subjects, the initial needling for all eight interventions elicited similar levels of needle sensation and pain. These levels were only maintained if there was ongoing of needle manipulation and retention of the needle. By contrast, the strength of needle sensation or pain experienced was independent of insertion site.

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SWE and SMI ultrasound techniques for monitoring needling treatment of ankylosing spondylitis: study protocol for a single-blinded randomized controlled trial

Trials ◽

10.1186/s13063-021-05344-z ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Mengyu Wang ◽

Wen Fu ◽

Lingcui Meng ◽

Jia Liu ◽

Lihua Wu ◽

...

Keyword(s):

Quality Of Life ◽

Blood Flow ◽

Ankylosing Spondylitis ◽

Outcome Measures ◽

Healthy Subjects ◽

Acupuncture Group ◽

Musculoskeletal Ultrasound ◽

Sham Control ◽

Post Intervention

Abstract Background Ankylosing spondylitis (AS) is a high-incidence disease in young men that interferes with patients’ physical and mental wellbeing and overall quality of life (QoL). It is often accompanied by arthralgia, stiffness, and limited lumbar flexibility. Acupuncture is safe and effective for reducing the symptoms of AS, but the underlying mechanisms by which it does so are not fully understood. Therefore, to objectively assess acupuncture efficacy, which is critical for patients making informed decisions about appropriate treatments, we will use shear-wave elastography (SWE) and superb microvascular imaging (SMI) ultrasound techniques to evaluate elasticity of lumbar paraspinal muscles and blood flow to the sacroiliac joint (SIJ) in AS. Methods We will recruit a total of 60 participants diagnosed with AS and 30 healthy subjects. Participants will be randomly allocated 1:1 to either an acupuncture group or a sham control acupuncture group. Primary-outcome measures will be musculoskeletal ultrasound, Ankylosing Spondylitis Quality of Life Scale (ASQoL), Bath Ankylosing Spondylitis Metrology Index (BASMI), and the Visual Analogue Scale (VAS) for pain. Secondary outcome measures will be the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Function Index (BASFI), and Fatigue Scale-14 (FS-14). We will monitor the effect of acupuncture or sham acupuncture on blood flow and SIJ inflammation using SMI, lumbar-muscle stiffness using SWE and the lumbar paraspinal-muscle cross-sectional area (CSA) using a two-dimensional (2D) grayscale imaging. QoL, physical function, and fatigue will be assessed using an evaluation scale or questionnaire developed for this study, with outcomes measured by the ASQoL, BASMI, BASDAI, BASFI, and FS-14. Healthy subjects will not receive acupuncture but undergo only musculoskeletal ultrasound at baseline. Acupuncture and sham control acupuncture interventions will be conducted for 30 min, 2–3 times/week for 12 weeks. Musculoskeletal ultrasound will be conducted at baseline and post-intervention, while other outcomes will be measured at baseline, 6 weeks, and post-intervention. The statistician, outcome assessor, and participants will be blinded to treatment allocation. Discussion The results of this single-blinded, randomized trial with sham controls could help demonstrate the efficacy of acupuncture and clarify whether musculoskeletal ultrasound could be used to evaluate AS. Trial registration ClinicalTrials.gov ChiCTR2000031476. Registered 3 April 2020.

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Comparison of historical anatomic landmarks vs. ultrasound guidance for the selection of a needle insertion site for jugular central venous access

Resuscitation ◽

10.1016/j.resuscitation.2012.01.005 ◽

2012 ◽

Vol 83 (4) ◽

pp. e113-e114 ◽

Cited By ~ 1

Author(s):

Michel Galinski ◽

Jean Catineau ◽

Karim Tazarourte ◽

Nicole Dardel ◽

Philippe Bertrand ◽

...

Keyword(s):

Ultrasound Guidance ◽

Central Venous Access ◽

Insertion Site ◽

Venous Access ◽

Needle Insertion ◽

Central Venous ◽

Anatomic Landmarks ◽

Selection Of

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Vibrio vulnificus necrotizing fasciitis associated with acupuncture

Infectious Disease Reports ◽

10.4081/idr.2015.5901 ◽

2015 ◽

Vol 7 (3) ◽

Cited By ~ 4

Author(s):

Yael Kotton ◽

Soboh Soboh ◽

Naiel Bisharat

Keyword(s):

Necrotizing Fasciitis ◽

Unusual Case ◽

Vibrio Vulnificus ◽

Needle Insertion ◽

Infectious Complications ◽

Alcoholic Fatty Liver ◽

Acupuncture Needle ◽

Life Threatening ◽

Subcutaneous Tissues ◽

Alcoholic Fatty Liver Disease

Necrotizing fasciitis is a severe life-threatening infection of the deep subcutaneous tissues and fascia. Infection with Vibrio vulnificus, a halophilic Gram-negative bacillus found worldwide in warm coastal waters, can lead to severe complications, particularly among patients with chronic liver diseases. We herein present an unusual case of necrotizing fasciitis caused by V. vulnificus triggered by acupuncture needle insertion. The patient, who suffered from diabetes mellitus and non-alcoholic fatty liver disease and worked at a fish hatchery, denied any injury prior to acupuncture. This is the first ever reported case of V. vulnificus infection triggered by acupuncture needle insertion, clearly emphasizing the potential hazards of the prolonged survival of V. vulnificus on the skin. The potential infectious complications of acupuncture needle insertion are discussed.

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Ultrasonographic Evaluation of Needle Insertion Site for the Flexor Pollicis Longus

Annals of Rehabilitation Medicine ◽

10.5535/arm.2013.37.2.215 ◽

2013 ◽

Vol 37 (2) ◽

pp. 215 ◽

Cited By ~ 2

Author(s):

Seung Min Lee ◽

Kihoon Kim ◽

Sang Min Lee ◽

Hyun Seok Lee

Keyword(s):

Insertion Site ◽

Needle Insertion ◽

Flexor Pollicis Longus

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Ankle Blockade

Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade ◽

10.1093/med/9780199743032.003.0028 ◽

2010 ◽

pp. 443-454

Author(s):

Adam K. Jacob ◽

James R. Hebl

Keyword(s):

Side Effects ◽

Insertion Site ◽

Needle Insertion ◽

Clinical Applications ◽

Foot And Ankle ◽

Patient Position ◽

Ankle Surgery

Ankle blockade is a safe, efficacious, and well-tolerated anesthetic for foot and ankle surgery The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications.

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Sciatic Nerve Blockade

Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade ◽

10.1093/med/9780199743032.003.0026 ◽

2010 ◽

pp. 405-422

Author(s):

Adam K. Jacob

Keyword(s):

Side Effects ◽

Sciatic Nerve ◽

Lower Extremity ◽

Ultrasound Guidance ◽

Insertion Site ◽

Needle Insertion ◽

Clinical Applications ◽

Nerve Blockade ◽

Patient Position ◽

Ankle And Foot

Sciatic nerve blockade is performed to achieve anesthesia and analgesia of the distal lower extremity, including the anterior and posterolateral leg, ankle, and foot. The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications. Use of ultrasound guidance is also discussed.

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Wrist Blockade

Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade ◽

10.1093/med/9780199743032.003.0018 ◽

2010 ◽

pp. 303-310

Author(s):

David E. Byer

Keyword(s):

Side Effects ◽

Insertion Site ◽

Needle Insertion ◽

Clinical Applications ◽

Patient Position

Wrist blockade anesthetizes the median, ulnar, and radial nerves at the level of the wrist. The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications.

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Intersternocleidomastoid Blockade

Mayo Clinic Atlas of Regional Anesthesia and Ultrasound-Guided Nerve Blockade ◽

10.1093/med/9780199743032.003.0012 ◽

2010 ◽

pp. 215-224

Author(s):

Michelle A. O. Kinney

Keyword(s):

Side Effects ◽

Insertion Site ◽

Needle Insertion ◽

Clinical Applications ◽

Upper Arm ◽

Patient Position

The intersternocleidomastoid block is indicated for procedures of the shoulder, upper arm, and forearm. The following aspects of the procedure are reviewed: clinical applications, relevant anatomy, patient position, technique (including neural localization techniques, needle insertion site, and needle redirection cues), and side effects and complications.

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Measurement of Acetate in Aqueous Solutions and Plasma by Gas Phase Chromatography using a Porous Polymer Stationary Phase

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/000456327801500149 ◽

1978 ◽

Vol 15 (1-6) ◽

pp. 228-232 ◽

Cited By ~ 3

Author(s):

M. F. Laker ◽

M. A. Mansell

Keyword(s):

Fatty Acids ◽

Stationary Phase ◽

Gas Phase ◽

Retention Time ◽

Healthy Subjects ◽

Volatile Fatty Acids ◽

Reference Range ◽

Porous Polymer ◽

Plasma Samples ◽

Apparently Healthy

Summary A method of acetate determination by gas phase chromatography using a porous polymer stationary phase is reported that is suitable for use with aqueous and plasma samples. It is linear up to 100 mmol/l and has a coefficient of variation of less than 4 % for acetate values of greater than 1 mmol/l. The recovery of acetate from plasma is 92 % and sample retention time is 3 minutes. The reference range of plasma acetate in a group of 40 apparently healthy subjects was from less than 0·1 to 0·35 mmol/l. The frequently encountered problem of adsorption and ghosting of volatile fatty acids is overcome without the addition of formic acid vapour to the carrier gas.

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Skin Disinfection and Acupuncture

Acupuncture in Medicine ◽

10.1136/aim.19.2.112 ◽

2001 ◽

Vol 19 (2) ◽

pp. 112-116 ◽

Cited By ~ 27

Author(s):

Peter Hoffman

Keyword(s):

Needle Insertion ◽

Host Immunity ◽

Contaminated Site ◽

Risk Of Infection ◽

Foreign Material ◽

Acupuncture Needle ◽

Skin Disinfection ◽

Micro Organisms ◽

Good Analogy

The need for skin disinfection before insertion of an acupuncture needle is controversial and there is no specific research on this topic. However research and observations on the effect of, and the need for, skin disinfection before injections forms a good analogy of acupuncture. Whilst micro-organisms present on the surface of the skin are accessible to disinfection, those located under the surface in ducts, glands and follicles are out of reach and can be inoculated into the sterile tissues below by needle insertion. Fortunately, the bacteria resident on the skin have a low potential to cause infection if host immunity is not severely impaired or compromised by the long-term presence of foreign material, such as a surgical stitch. Disinfection of clean skin before injection is not generally considered necessary and observations of lack of infection following injections without prior skin disinfection support this; however, contamination by micro-organisms not normally resident on skin can pose a higher risk of infection. If skin is visibly soiled, it should be washed and if needle insertion is near an infected or contaminated site, it should be disinfected with alcohol. Practitioner hand hygiene between patients is important, even if gloves are worn. Hands should be washed with soap or detergent and water, or an alcohol handrub can be used if hands are physically clean.

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