Acupuncture Continuing Education

Acupuncture Helps Stanford Intensive Care Infants

A Stanford University study finds acupuncture effective for reducing the need for sedative medications for neonates and infants undergoing treatments in the intensive care unit. Dr. Golianu, MD (Department of Anesthesiology, Stanford University), Christina Almgren, PNP (Stanford Children’s Health, Stanford University), et. al., note that high doses of opioids and benzodiazepines are often required for neonates and infants for the purposes of pain management and sedation. Cessation from medications lead to withdrawal symptoms and irritability. The researchers cite acupuncture’s documented ability to reduce pain, irritability and withdrawal symptoms in adults. Infants benefit from acupoint therapy at Stanford.

The research team applied acupuncture in the pediatric setting to see if the therapeutic effects known to help adults also applies to neonates and infants. They concluded that the pediatric patients “tolerated acupuncture well and required a decreased amount of pain medication for treating agitation and withdrawal.” The study concludes, “Acupuncture may be a useful adjunct for managing agitation and withdrawal in neonates and infants in the intensive care unit, and may lead to a decreased need for sedative medications.” Acupuncture points used in the study were Yin Tang, ST36, and PC6 plus acupuncture point protocols developed by the National Acupuncture Detoxification Association.

In a related study, doctors from the University of Washington School of Medicine (Seattle, Washington) conclude, “Our experience suggests that acupuncture therapy is a safe, non-pharmacological option for prevention of emergence delirium in children undergoing general anesthesia.” The doctors note that delirium occurs in approximately 12 - 50% of pediatric patients receiving general anesthesia. They add that pharmaceutical drugs used to manage delirium often produce unwanted adverse effects including “sedation and longer recovery time from anesthesia.”

The study came up with some very interesting findings. All children in the study receiving intravenous anesthesia plus acupuncture required less quantities of propofol, an amnestic-hypnotic drug. A total of 83% of patients did not get delirium. An additional 17% had relatively mild cases of delirium and were able to “communicate the source of distress.” The acupuncture points used in the study were SP8, HT7, and LR3. Needle stimulation was applied to the three acupuncture points. Magnet therapy was applied to ear Shenmen. No complications occurred demonstrating that acupuncture is both safe and effective in the prevention of pediatric emergence delirium. 

Acupuncture Points Close-Up
Some of the acupuncture points used are highlighted here.

Yintang (M-HN-3, Hall of Impression)
This acupoint is located in the glabella and is at the midpoint between the medial extremities of the eyebrows. Yintang activates the channels, stops pain and calms the shen (spirit). This point is especially useful for children because it is classically indicated for the treatment of childhood fright, both chronic and acute. A doctor with nurses.

ST36 (Zusanli, Leg Three Measures)
This point is located 3 cun below ST35 and is one fingerbreadth from the anterior crest of the tibia. There is a notch in the tibia to which this point is directly level to and lateral from. ST36 benefits the spleen and stomach qi and blood. It strengthens weak and deficient conditions and is used to benefit digestion. ST36 finds use for these investigations and is indicated for the treatment of mania and neurasthenia.

PC6 (Neiguan, Inner Pass)
This acupoint is located 2 cun above the transverse wrist crease between PC3 and PC7 between the tendons of the palmaris longus and flexor carpi radialis. PC6 calms the shen and heart, regulates qi and stops pain. It is useful for many conditions including vomiting, nausea, palpitations and mental disorders. The traditional designations of PC6 are as follows: Luo Point, Confluent Point of the Yin Wei channel (paired to SP4).


References:
Golianu, Brenda, Jeannie Seybold, and Christina Almgren. "Acupuncture Helps Reduce Need for Sedative Medications in Neonates and Infants Undergoing Treatment in the Intensive Care Unit: A Prospective Case Series." Medical Acupuncture 26, no. 5 (2014): 279-285.
Authors:
Dr. Golianu, MD. Department of Anesthesiology, Stanford University, Stanford, California.
Christina Almgren, PNP. Stanford Children's Health, Stanford University, Palo Alto, California.

Kundu, Anjana, Nathalia Jimenez, and Anne Lynn. "Acupuncture therapy for prevention of emergence delirium in children undergoing general anesthesia." Medical Acupuncture 20, no. 3 (2008): 151-154.
Authors:
Dr. Anjana Kundu, MD. Dr. Nathalia Jimenez, MD. Dr. Anne Lynn, MD. University of Washington School of Medicine, Seattle, Washington.


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