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BJA Advance Access originally published online on October 24, 2007
British Journal of Anaesthesia 2008 100(1):78-81; doi:10.1093/bja/aem306
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Transcutaneous electrical nerve stimulation at the PC-5 and PC-6 acupoints reduced the severity of hypotension after spinal anaesthesia in patients undergoing Caesarean section

Y. C. P. Arai1,*, N. Kato2, M. Matsura2, H. Ito2, N. Kandatsu2, S. Kurokawa2, M. Mizutani2, Y. Shibata2 and T. Komatsu2

1 Multidisciplinary Pain Centre
2 Department of Anaesthesiology, Aichi Medical University School of Medicine, 21 Karimata, Nagakutecho, Aichigun, Aichi 480-1195, Japan

* Corresponding author. E-mail: arainon{at}aichi-med-u.ac.jp

Background: Despite prophylactic measures, hypotension remains a common side-effect of spinal anaesthesia for parturients. Electroacupuncture at the Neiguan (PC-6) and Jianshi (PC-5) points influences haemodynamics. We thus hypothesized that transcutaneous electrical nerve stimulation (TENS) at traditionally used acupuncture points would reduce the severity of hypotension after spinal anaesthesia in patients undergoing Caesarean section.

Methods: After obtaining approval from the local ethics committee and written informed patient consent, 36 singleton parturients undergoing Caesarean section under spinal anaesthesia were randomized into three groups. The control group received no treatment, and the acupoint and non-acupoint groups received TENS at the PC-5 and PC-6 points of both arms and non-acupoints of both shoulders, respectively.

Results: The median (range) of the lowest recorded systolic blood pressure was significantly higher in the acupoint group compared with the other groups and that of the non-acupoint group was higher than that of the control group [control, 70 (68–82) mm Hg; acupoint, 94 (84–109) mm Hg; non-acupoint, 81 (70–92) mm Hg: P<0.001]. Significantly more parturients in the control and non-acupoint groups experienced hypotension [control, 10 (83%); acupoint, 4 (33%); non-acupoint, 10 (83%): P=0.013]. More ephedrine was required to maintain arterial blood pressure in the control and non-acupoint groups.

Conclusions: TENS on the traditional acupuncture points reduced the severity and incidence of hypotension after spinal anaesthesia in parturients.

Keywords: acupuncture; anaesthesia, obstetric; anaesthetic techniques, subarachnoid; complications, hypotension; surgery, LSCS; TENS


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