Doctoral Thesis
Refine
Document Type
- Doctoral Thesis (3) (remove)
Has Fulltext
- yes (3)
Is part of the Bibliography
- no (3)
Keywords
- Akupunktur (3) (remove)
Institute
- Klinik für Anästhesiologie und Intensivmedizin (3) (remove)
Die vorliegende Arbeit bietet aus wissenschaftlicher Sicht zahlreiche Diskussionspunkte. Zum einen ist in der aktuellen Forschung ein wachsendes Interesse zum Thema chronische Schmerzen zu beobachten. Zum anderen steigen die Nachfrage und das Angebot an alternativen Heilmethoden, wie Akupunkturverfahren rasant an. Die Studie konzentriert sich auf die Indikation Akupunktur bei chronischen Rückenschmerzpatienten und bietet damit Anlass, auch den volkswirtschaftlichen Aspekt von chronischen Schmerzpatienten genauer zu beleuchten.
Der theoretische Teil der Arbeit soll neben definitorischen Aspekten und inhaltlichen Prinzipien vor allem einen Überblick über die aktuelle Literatur und die thematischen Gegenstandsbereiche geben, aus denen in den folgenden Kapiteln der Fragebogen abgeleitet wurde.
Zunächst werden im ersten Teil Aspekte zum Thema Schmerz genauer definiert und beleuchtet. Anschließend wird im zweiten Teil die Therapie bei chronischen Rückenschmerzen, der Themenbereich der Inanspruchnahme und das Ansehen alternativer Methoden in der Medizin diskutiert. Der letzte Abschnitt des theoretischen Hintergrundes wird der Akupunktur gewidmet.
Despite a plethora of therapeutic approaches, the injection of local anaesthetics itself remains one of the most painful and dreadful procedures among children. Stimulation of acupoint LI4 is associated with analgesic effects in dentistry. Goal of the study To investigate whether stimulation of LI4, added to standard therapy (ST), reduces pain and distress during injection of local anaesthetic (LA) in comparison with ST alone. Materials and Methods Children, scheduled for dental treatment in local anaesthesia on 2 separate days were enrolled in this trial, approved by local ethics commission. On one day each child received bilateral acupuncture of LI4 point, using indwelling fixed “New Pyonex” needles (0.2 x 1.5 mm; Seirin, Japan). The parents of the children were asked to stimulate the needles by massage. Standardized injection of LA was performed 5 min following acupuncture. The needles were withdrawn at the end of dental treatment. On the other day of treatment children received LA injection without acupuncture. The order of treatment days (acupuncture first or vice versa) was randomised. Primary endpoint was the pain intensity during LA injection reported by children on Visual Rating Scale from 0=no pain to 10=maximal pain imaginable (VRS-11). Secondary endpoints were parent- and dentist-assessed pain intensity (measured on Numeric Rating Scale 1-10), patients’ heart rate before and during dental treatment and satisfaction with received therapy (measured on Numerical Rating Scale 1-5.) Side effects of LI4 stimulation were also recorded. Results and Discussion The data of 49 children (22 females; age 10 ± 4 yrs; mean ± SD), who completed both visits, were analysed. Children reported less pain with than without acupuncture: 2.2 ± 2.5 vs. 3.9 ± 2.7; mean ± SD, p<0.001. Heart rate decreased after LI4 stimulation compared to ST alone throughout the dental treatment (p<0.05). LI4 stimulation was safe and raised better satisfaction with the treatment among children and parents, than ST alone (p<0.05). Other secondary endpoints were comparable between both sessions. Conclusion Stimulation of acupuncture point LI4 reduces pain and autonomous stress during injection of local anaesthetics in paediatric dentistry.