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ACUPUNCTURE ANALGESIA FOR

SURGERY IN ANIMALS
Part 1
Philip A.M. Rogers MRCVS
e-mail : progers@grange.teagasc.ie
1980, 1982, updated 1993, 1995
Postgraduate Course in Veterinary AP, Sydney, 1991

SUMMARY
Surgical analgesia can be produced by methods involving peripheral or central stimulation,
such as acupuncture (AP) analgesia (AA). The most common method is Electro-Acupuncture
Analgesia (EAA), using a special electrostimulator attached to needles in AP points.
The major advantages of AA or EAA are its safety in high-risk patients and excellent postoperative pain relief, freedom from complications and enhanced healing which follows
surgery under AA. The major disadvantages are the long induction period (10-40 minutes)
and variable degrees of analgesia, even in skilled hands.
Many combinations of AP points can be used to induce EAA in large and small animals and
there is no agreement on which combination is best for which operation. However, certain
points have marked analgesic effects. They are LI04,11; TH08; PC06; points along the GV
Channel; (BaiHui, WeiGan, TianPing, SanTai; ChihYi points); points between the digits
(BoKoKu, InKoTen in dogs; second interdigital space in rabbits), certain Earpoints; the Root
of the Ear; LU01; BL23,30; ST25,36,44; SP06; GB34; and X 35. Sometimes needles are
inserted parallel to (or at both ends of) the incision, together with some of those points.
The choice of point combinations depends largely on the personal preference and experience
of the operator. However, it is useful to consider the Channels in relation to the operation site
and to choose points from (a) distant points on Channels whose superficial, deep, collateral
or other branches pass through the operation site, plus (b) local points near the operation
site, plus (c) points along nerves supplying the operation site or related to the operation site
by spinal reflexes.
There is no agreement on the choice of stimulation parameters, although work by Toda et al,
Matsumoto and others show that these can be critical. Further research in this area is needed.
The mechanisms of AA involve stimulation of peripheral sensory nerves, spinal cord and
supraspinal areas (thalamus, midbrain and hypothalamus). Release of endorphin and serotonin
activates a descending pain-inhibition mechanism. ACTH release assists healing. Extra-spinal
and autonomic transmission may also be involved in AA mechanisms.
Stimulation-Produced Analgesia (SPA) and Transcutaneous Electro-Stimulation Analgesia
(TESA) are closely allied with EAA and involve endorphin release. Vaginal Stimulation

Analgesia (VSA) appears to use different mechanisms. Electro-restraint ("Stockstill") appears
to be quite a different phenomenon and may have little analgesic effect.
Electro-Narcosis, Electro-Anaesthesia and Electro-Sleep (Cerebral Electro- Therapy) differ
from the other techniques, as they cause unconsciousness during Electro-Stimulation (ES).
Combining AP and western concepts, as in combination anaesthesia, will lead to development
of safer and more reliable methods of surgical anaesthesia.
INTRODUCTION
Acupuncture (AP) can be used to obtain pain relief in clinical disorders or as an alternative or
complementary method of inducing pain control during surgical procedures.
AP analgesia (AA) is a misnomer. It should really be called AP hypoalgesia. It is a pain
inhibition phenomenon caused by stimulation of peripheral nerves via certain AP points. The
degree of pain inhibition may be complete or partial.
In vet surgery, the AA technique, if applied carefully, often is sufficient to allow surgery
without the use of other anaesthetics. Consciousness is retained throughout the operation but
many animals become slightly drowsy (as if slightly sedated) during and for a short time after
AA stimulation. All other sensations (touch, traction, pressure, tickle etc) and reflexes (to
sight or sound stimuli, fear, traction etc) are intact.
AA can be induced by simple AP (manual twirling of the needles) but it is more common to
use electrical stimulation (ES) via the needles. In this case the technique is called Electro-AP
analgesia (EAA).
In emergencies a slight degree of hypo-algesia can be obtained in humans and animals by
heavy digital pressure over the correct AP/nerve points. This method may have application
in time of war or national disasters, when anaesthetists and anaesthetics may not be available.
AA also can be induced by other stimuli, such as injection or electro-static fields applied to
the points. Since the late 1980s, research on uses of low-power (cold) Laser as an AA
stimulus is ongoing, with some positive results. However, it is too early to attempt to assess
that method.
Stimuli via the AA points are carried in the peripheral sensory nerves to the spinal cord. They
reach the midbrain via the ascending spino-thalamic tracts. In the midbrain the ascending
signals cause release of endorphin, serotonin and other neurotransmitters which activate a
"descending inhibition mechanism" and prevent the "pain signals" from the surgical area from
reaching the cerebral cortex. Thus, AA can be said to "close" various "pain gates" in the
nervous system. These gates are thought to be located in the spinal cord, thalamus and
possibly other areas. The result is that the human (and, presumably, the animal) patient can
feel the knife, the touch and traction etc but does not "feel pain".
Stimulation-Produced-Analgesia (SPA): Since the 1970s, western researchers, working
independently of the Chinese, found that various types of stimuli applied indirectly or directly
to the nervous system can reduce or abolish clinical and operative pain. Transcutaneous
Electro-Stimulation Analgesia (TESA) has been used in childbirth in the human female and
is somewhat comparable to EAA. Dorsal Column Stimulation (DCS) of the spinal cord has

surgery on the lip. incision. rats. Austria. ES via electrodes implanted in specific sites in human or animal brain can induce a high degree of analgesia. USA. The choice of points will be discussed later. This paper will discuss the following topics: 1. EQUIPMENT AND METHODS OF RESTRAINT FOR AA Equipment: Most AA is done using electrostimulation (ES) through needles in the correct points (Electro-AP analgesia = EAA). cattle. Many . Westermayer's method for reposition of the prolapsed uterus has been mentioned already. monkeys. 2. advantages and disadvantages of AA in animals 5. These include France. types of operation successfully done under AA 2. trachea. See also the paper on the integration of AP into routine vet practice). joints). limbs and teats. thoracotomy. mechanisms of AA 6. cavies. usually involving the entire body. laparotomy. removal of parotid and submaxillary glands. as has AP therapy for the relief of dystocia. electro-narcosis and electro-sleep) 1. ear. Experimental surgery under AA includes: pain responses to towel clips. other methods of SPA (vaginal stimulation analgesia. gastric and intestinal surgery. rumen. oesophagus. The main difference between these methods is that SPA tends to cause "whole body" analgesia. techniques in large and small animals 4. mules. frontal sinuses. Japan. whereas the area of analgesia is much more localised in AA and is related to the site of the AA stimulation. Canada and Australia. inguinal hernia. orthopaedic surgery (bones. Germany. Vaginal stimulation (electrical or mechanical) can cause potent whole-body analgesia in rats. nephrectomy. Taiwan etc have used the method for many years. castration. SPA has some similarities to AA. anal and vaginal region. goats. donkeys. surgery on the bladder and urethra. (See the paper on AP effects on the body's defence systems. navel hernia repair. TYPES OF OPERATIONS UNDER AA Since the mid 1970s. Types of surgery successfully done in animals include: caesarean section. equipment and methods of restraint used 3. ovariohysterectomy. guinea pigs and mice. The animal species involved include horses. limb and skin surgery. cats. major surgery has been done in animals under AA as the sole analgesic agent in many countries in the West. orchidopexy. Workers in Eastern countries such as China. thermal and electrical stimuli. Belgium. removal of mammary and skin tumours. The late Dr.been used in intractable pain in humans. electro-restraint. pigs. dogs. sheep. surgery of the eye. Direct ES of human thalamic or spinal areas can abolish clinical pain.

Small animals are normally operated on in lateral. as in prolonged surgery. USA. It is safer to use models which deliver a bipolar waveform. The apparatus used does not appear to have been tested in Europe or America. Some are made in China. Newer models for human use would be adequate for EAA in animals. It should have outputs for at least 8 electrodes. My dentist told me that most patients could not have had the tooth removed unless they had general anaesthesia. Extraction was painless or caused minimal pain in 5/8 cases but 3/8 extractions caused moderate to severe pain but were completed without the use of drug analgesia. If a special operation-harness is not available they are restrained by tying bandages from the hocks and . Voltage was increased slowly to maximum tolerance (anaesthesia mode. operations under AA may be performed with the animal in the standing position or in dorsal. lateral or ventral recumbency. TESA does not appear to have been tested in animals. Caesarean section has been done in Japan using electro-static or electromagnetic fields around the hands and feet. the output was usually at a setting of 4-5 on a 10 point scale. Occasionally adjustable waveform at 5-10 Hz was used. Childbirth has been helped in 60-80% of women treated by transcutaneous ES analgesia (TESA) of the thoraco-lumbo-sacral region. at each electrode. This prevents the development of serious electrolytic lesions which could arise if a monopolar waveform was used for long periods. A blindfold over the animal's eyes helps to avoid fright by visual stimuli. I used mainly ChiaChe (ST06) plus Earlobe "Dental Analgesia Point" on the affected side. Needles were inserted 12-20 mm in the points. Recumbent animals should be roped securely and an attendant should ensure that the head is kept down. portable and battery-operated. movement and fuss should be kept to a minimum. In large animals. or ropes may be used through rings in the wall to keep the animal in one position. Europe and Australia etc. Sweden. Nervous animals may be given a tranquilliser i/v. The standing position may be used for surgery in quiet cattle. There is little standardization of equipment. If "nerve pain" arose. dense-disperse waveform). When heavy needle-probing of the gum caused no pain. Canada. The Model 71-3 General Purpose Electro-AP Apparatus is suitable for AA as well as AP therapy. Unnecessary noise. Dental fillings under EAA were uneventful except in deep root fillings. dorsal or ventral recumbency. Kicking may be prevented by the usual methods as applied in operations under local anaesthesia. The apparatus used was the Travisens. Horses and nervous cattle should be knocked by ropes or a short-acting knock-down anaesthetic.different types of electrostimulator are on the market. An attendant may hold the nose and the animal should be restrained in a suitable cattle crate. others in Japan. Box 144-17224. I had 8 teeth extracted and 8 teeth filled under EAA with the Model 71-3. depending on the type of operation and whether or not the animal is quiet. An impacted wisdom-tooth required 10 minutes of very strong rocking to remove it from its socket. In human patients. available from Dan Sjo Elektronik AB. There was rather severe pressure-pain with that attempt but I was able to tolerate it without asking for another anaesthetic. The equipment should be strong. After 30 minutes of induction. Restraint for AA in animals: Surgery under AA requires adequate restraint because consciousness and all sensations and reflexes (except those of pain) are retained. turning up the voltage usually controlled it. dentistry could begin. (+) and (-). Sundbyberg.

Dogs are excellent subjects for AA but it is advisable to tie a tape bandage around the jaws to prevent biting. the animal indicates a degree of discomfort or pain (restlessness. As long as one of a pair is twitching. towel clip. If output voltage is too high at such points. the animal makes no response to strong pain stimuli in and around the operation site. When the animal is properly restrained. the output controls are checked to ensure they are set at zero. reduce the output to the tolerance of the patient. Otherwise. AP needles are placed to the correct depth in the AA points related to the operation site. and should remain at this level during . pleura etc) and incision of periosteum and nerves. Needles may not twitch in points such as GV26. Occasionally (in those animals which respond poorly to AA) it may be necessary to use small volumes of local anaesthetic injection or spray at these stages. increased blood pressure. Turn up the output controls slowly until the needles begin to twitch in time with the frequency of the stimulator. defensive reaction. When the needles are in position. Note: A needle can not twitch unless it is embedded in reactive muscle. as indicated by local muscle twitch or guarding. or by struggling in nervous animals. the operation site is tested for analgesia using rattooth forceps. Every 5 minutes or so. In the first few minutes after stimulation begins it is usual for the animal to show a mild stress reaction (dilated pupils. After 5-10 minutes. the paired needle is also receiving a similar stimulus. faster respiration and heart rate). Pain stimuli may exceed the hypoalgesia (thereby inducing pain response by the animal) at certain stages of the operation. in successful cases. on rare occasions. This is especially advisable if the instrument uses (+) and (-) electrodes. After 20-40 minutes. The operation may then commence. An output circuit placed across the thorax may interfere with cardiac function and may. Reduce the output to a "strong but acceptable level" (that which can be tolerated without obvious discomfort). At that point.elbows to suitable anchor-points on the operating table. Excessive stimulation reduces the EAA effect and to weak a stimulus may induce little or no analgesia. vocalisation or defence reactions/struggling. These quickly return to normal or near normal levels. It helps if the owner or an attendant talks to the dog and comforts the animal from time to time during surgery. vocalisation etc). Increase the output voltage from each control to the maximum tolerance of the patient. Initially. Attach the leads and turn on the power switch. In this case the correct connection would be as in the diagram on the next page. after switch-on. This is normally sufficient to counteract the pain. especially during incision and suturing of the skin. the animal will indicate discomfort. Tape or suture the needles firmly in position. clamp or pin prick. serosa (peritoneum. AA TECHNIQUES IN LARGE AND SMALL ANIMALS Electro-AP analgesia (EAA) is the most common method used. Do not connect the leads from one output across the thoracic or posterior cervical region. the response to pain stimulus decreases. full sensitivity to pain is present. cause cardiac arrest. During these stages of the operation the frequency or output voltage should be increased. The stimulator is checked to ensure that the power switch is off. In that case. The output leads are then connected to the needles. they are liable to become dislodged by muscle twitches induced by the stimulation. struggling. Cats are difficult animals to handle and some vets who have tried AA in cats have ceased to use the technique in this species. 3.

.. This may be partly counteracted by increase in frequency or output of the AA stimuli.. this usually indicates that excessive traction on mesentery/internal organs is the cause. which links up with its Mate Channel) and other connections linking to every part of the body. similar to those of drowsiness or light sleep. Thus in eye operations... In human EAA. the LV Channel (big toe to chest.. Other operators prefer faster or slower frequencies.. (Discussion of the deep. increasing to 30-50 Hz at the start of operation in dogs. unnecessary noise should be avoided and a blindfold may be desirable.the operation..... Matsumoto found that frequencies of less than 200 or greater than 10000 Hz were less satisfactory in rabbits than frequencies within this range.e. such as those of Van Nghi and Mann). These points are similar in position to points of the same name and code in HUMAN AP. the operation site and personal preference/experience. Earpoint LU.. this rule is not always obeyed. Because sight and hearing are unaffected (pupil reflex is also intact)... a deep course (going to the organ of the Channel and possibly linking to other organs and deep regions).. 25 cm long. If salivation is excessive or retching/vomiting occurs. a collateral course (Luo... a LV point might be included. In general. As will be seen from some point prescriptions below.. For instance.e. interior and exterior.. The general rule is to use Local Points (near the operation site)... However... The diagram shows 2 needles. _ _ _ _ _ _ _ _ _ _ _ _ _ needle 2 (25 cm) . For instance. Studies of EEG patterns in animals under AA indicate that brain waves are in the alpha range (8-13 cycle per second) i. . in ear and bone operations a KI point might be included... The following table lists the points by authors whose work is discussed later. buried parallel to the incision: . Pupillary dilation and salivation occurs in some animals. for appendectomy.. Classic AP teaches that the Channels have a superficial course (Jing. collateral and other connections is not included in this seminar. Other workers pay particular attention to the points or nerves supplying the operation site.. Earpoint LI.... same workers add two needles.... The choice of points for AA depends on the species of animal.. Examples of point combinations are given later.. Ishizaki recommended a frequency of 10 Hz. For instance. from the first to the last point on the Channel). one on each side of the incision. These concepts are covered in certain classic texts.. Many different combinations are effective and there is no one combination which is agreed by all authors. in tongue operations a HT point might be included. needle 1 (25 cm) 25 cm incision Some workers prefer to use AP stimulation at a low frequency and to increase the frequency gradually during the induction period. Points used in AA in animals: Many different workers have used many different combinations of points in various animal species..... In man. or Appendix etc.. i. under the nipple) also sends a branch to the eye... for lung operations... the animals are still conscious and can eat or drink and (in dogs) wag the tail if petted by someone they know.... or related to it.. points are chosen according to Channel theory of human AP. AA sometimes uses Earpoints for the organ or region being incised.

SanTai is equivalent to GV11 (Shen Tao). They are local points at each end of the incision. These are also described in recent human texts. On the GV Channel: BaiHui: In the dorsal midline of the lumbo-sacral space. There is no direct equivalent in human AP.6.Other points used in AA in animals are: 1. ChihYi Points are on the course of the GV Channel but are not classic GV points. at 90 degrees to the surface). Depth 1-1. depth 3-5 cm in horse/ox. as the needles may impede access to the site. between the GV and inner line of the BL Channel. 5. TianPing : In the dorsal midline.5. These points are located on the paravertebral line from the first cervical to the last sacral vertebra. One pair of points is located beside each vertebra. 4.5 cm in horse/ox. in the thoraco-lumbar space. to react the dura mater. SanTai: In the dorsal midline. Depth 2-4 cm in horse/ox. 2. X 35 points lying nearest to spinal nerves which supply the operation site may be added as secondary points. Points UNDERLINED: used in AA or EAA: The most commonly used Point Point name Point Point name Point Point name LU01 CHUNGFU SP03 TaiPai TH03 ChungChu LU02 YunMen SP04 KungSun TH05 WaiKuan LU03 TienFu SP06 SANYINCHIAO TH08 SANYANGLO LU05 ChihTse HT03 ShaoHai TH13 NaoHui LU06 KungTsui HT05 TungLi TH14 ChienLiao LU10 YuChi BL22 SanChiaoShu TH17 YiFeng LI04 HOKU BL23 SHENSHU TH23 SsuChuKuan points are . WeiGan: In the dorsal midline between coccygeal vertebrae 2-3. They have been described recently in relation to human AA.11 and Lumbar 1. The main ones used in vet AA are over the dorsal spines of vertebrae: Dorsal 3. Depth 6-8 cm antero-ventrally in horse/ox. ChiehKou points. between the spines of thoracic vertebrae 4-5 (some texts say T5-6). Para-incisional points are not often used in vet AA. HuaToChiaChi Points (X 35 in my coding system). There is no direct equivalent in human AP. 3. There is no direct equivalent in human AP.

Set 2: SP06 (positive) with ST36 (negative). on the lateral side). Horse: In navel hernia operation. altered to spike wave during surgery. GeiKo (on the lateral margin of the naso-labial fold in mice and rats).5). The frequency was 200 Hz. a. Humphries used 4 needles: Set 1: LU01 (positive) with TH08 penetrating to PC04. unnamed point (in the second interdigital space in rabbits on the hindlimb (this may correspond with ST44 (NeiTing)).5 YIEYEN LV14 ChiMen ST40 FengLung PC05 ChienShih GV03a BAIHUI ST44 NeiTing PC06 NEIKUAN GV26 JenChung 6. It was used especially in thoracic and abdominal surgery. It is driven medially and downwards behind the radius/ulna to reach YieYen (PC04. yet the operation went perfectly and no signs of pain were detected at any stage in the operation. Horse: LU01 (ChungFu) with TH08 (SanYangLo penetrating to YieYen) was one of the first combinations used in large animals ln China (Niboyet). which lasted 4 hours. BoKoKu (between metatarsal bones 3 and 4 in small animals). The needles are inserted on the uppermost limb (horse in lateral recumbency). square wave. The Japanese points do not appear to have equivalents in Chinese human or vet texts. b. This horse was very ill and was a high anaesthetic risk. EXAMPLES OF POINT SELECTION IN LARGE ANIMALS: Points used for AA in horses and cattle.LI10 SanLi BL40 YiHsi GB01 TungTzuLiao LI11 ChuChih BL49 ChihPien GB30 HuanTiao LI14 PiNao BL54 WeiChung GB34 YangLingChuan LI15 ChienYu BL57 ChengShan GB36 WaiChiu LI17 TienTing BL59 FuYang GB38 YangFu LI18 FuTu BL60 KunLun GB39 HsuanChung ST06 ChiaChe KI03 TaiHsi GB40 ChiuHsu ST25 TienShu PC04 HsiMen GB43 HsiaHsi ST36 TSUSANLl PC04. . A needle is inserted to a depth of 3-5 cm in LU01 (behind the shoulder in the second intercostal space). just under the skin above the "chestnut". Points described by Japanese workers also include: InKoTen (between metacarpal bones 3 and 4 in small animals). A second needle is inserted at TH08 (about 1 handsbreadth below the elbow. c. Horse or ox: Sun et al used traditional Chinese vet AP points on hundreds of large animals (horses and cattle).5 (negative).

ST36.5). in general. but EAA of this point occasionally caused convulsions. for operations on the head. Cattle: Kothbauer did many Caesarian sections in cows using EAA. between metacarpals 3 and 4) plus ST36 plus BoKoKu (Japanese point. Kitazawa (Gifu Veterinary Faculty.25. d. Manual AA was also successful. 4 points. The best combination for surgery in all areas was BL23 bilateral. EAA was given at 40 Hz. For operations on the abdomen and hindlimbs. plus para-incisional needles for ovariohysterectomy. Japan) did dozens of operations in which he compared the efficiency of various point combinations. EXAMPLES OF POINT SELECTION IN SMALL ANIMALS Dog: a. c. he had no simple combination of points. Voltage (output) was increased if the animals were recumbent. at a level with the shoulder joint) with BL30. between metatarsals 3 and 4). out the other) behind the radius and ulna. . Equally good was SP06 bilateral. with the needles penetrating completely through the limb (in one side. Ishizaki (Japan) did over 50 major operations in dogs with 95% success. For anal surgery he added points lateral to the anus.5 Hz during operation. neck. They used 30 Hz. Ox. as in combinations (c) above. one in each point on each limb: LI11 plus InKoTen (Japanese point. rising to 3. EAA was given at 2. thorax and upper limb he used points PC06 and TH08 bilateral. The next best combination was 8 needles. They concluded that the best effective points in cattle and pigs were Tenpei (TianPing) and Hyahai (BaiHui). In his first 2 cases he used LV14 (8th intercostal space. The late Dr. These points are located in the midline at the thoraco-lumbar space and the lumbo-sacral space. as he chose points according to Channel Theory and also points near the operation site. i. b. Arambarri and Cazieux in the Toulouse Vet School used AA at points SP06. LI11 (negative poles). they used SanTai. pig: In Japan. In a large series of toxic pyometra cases. Ralston reported uneventful removal of bladder calculi and Caesarean section in high-risk dogs using needles bilaterally in LI04 and ST36 (positive poles) and SP06. Unfortunately. penetrating almost to the dura mater. e. vaginal and hindlimb operations were : BaiHui (main point) plus WeiGan (secondary point) plus TianPing (minor point). bilateral = 8 needles. he used SP06 (penetrating completely through the limb) and ST36. In chest operations.Points for abdominal. This point is paravertebral between the transverse processes of lumbar vertebrae 2-3.5 Hz.5-4.e. both points on the left side. the Akita Veterinary AP Research Unit tested many point combinations (including the classic LU01 with TH08 penetrating to PC04. However. He also examined other combinations but his preference was for 2 needles in BL23 (left and right). Not one case died and all recovered uneventfully. output causing marked muscle twitch. To each of these points they added points on or near the spinal nerves supplying the operation site + points from the attached charts nearest the incision site. The depth of needle insertion would be similar to that in combination (c) above (the Chinese combination). d. Induction time was 20 minutes.

ST36. Lambardt used EAA at 2.5 +/. Bilateral electrostimulation of ST36 gave marked hypo-algesic effects.03. Other workers have used cats very successfully in experimental work on EAA (confirmation that the limbic and cortical potentials elicited by pain stimuli were suppressed by EAA) and Still (1987) claimed very good surgical analgesia in cats. splenectomy. gastric and intestinal surgery and ovariohysterectomy. Cats: The cat is difficult to work with and resents needles placed in the feet. Monkeys respond similarly to man in many aspects of AP. KI03. removal of abscessed mammary tumour. ChihYi points (main point in midline over the 6th thoracic vertebra and secondary point over 1st lumbar vertebra. 0. depending on site of surgery. lower abdomen: add point at T11).59.44.43.11. The operations (all of which were done successfully without other anaesthetics) included Caesarean section.e.4.4. TH14 (or) LI04.05. O'Boyle and Vajda used SP06 and ST36 (bilateral) in 15 dogs.6. The ones listed below are only a few of the combinations listed in texts on human EAA. TH17 Abdominal surgery: SP06.38.10. PC06 (or) LI10.5 Hz on 4 cats (3 ovariohysterectomies.13. LV02. X 35 in region lumbar 1 to sacrum 2. Dorso-lumbar surgery: LI04.36.54. LU01. BL49. Monkeys: Many combinations can be used in monkeys.39.17. 2 seconds on/2 seconds off. HT03.and post- .34. square wave. PC04. Thus one should expect the following points to be effective: Dental surgery: LI04 plus ST06 or Ear Root (Dental) point plus ST06 Oral plus lip surgery: ST44 plus LI04 (Jacobs: 15 minutes at 100 Hz gave excellent results).06. Thoracic surgery: TH08 penetrating to PC04.18. Channels near the operation site and the nerve supply. His points were: ST36. TH08 (bilateral).5. ST36 (or) ChihYi points (main point in midline at vertebra T6 plus secondary point at T3. Upper abdominal surgery: add point at T5. LU02. Three assistants were needed to restrain the animals! He concluded that cats are not the best subjects for EAA.40. Vierck applied an electrical pain stimulus to the gastrocnemius area of monkeys. using EAA at pre.6. He used 200 Hz monophasic square wave.PC06 (or) TH05 penetrating to PC06 (or) LI14.60. depending on site of surgery.49.40. Upper limb surgery: Choose points from LI04.57. GB30. 1 Caesarean section). Lower limb surgery: Choose points from SP03. Channels near site and nerve supply. ChihYi points.15. TH05 plus ChiehKou (local points at each end of the incision). They used 125 Hz.5 msec. TH03. BL40. The results were not satisfactory and he noted much struggling.

auricular points. for 20 minutes. Rabbits: Matsumoto reported the best analgesia from ES of a single needle placed to a depth of 3 cm in the second interdigital space. lumbo-sacral space (GV03a) and SP06. When the animal lost its reaction to pinprick etc. especially in cats. The analgesic effect crossed the midline. a left needle gave left and right analgesia.23a. 0. diprenorphine) but not by dextro-naloxone (which has little opiate. The pulse duration had little effect on efficiency of analgesia. The choice of points and frequency of stimulation are important to good success. 1.5 to 500 Hz but the best analgesia was given by frequencies between 30 and 150 Hz. Under experimental conditions this had analgesic effects on the nose. All points were needled bilaterally and the needles were left in position.0 msec.22. naltrexone. abdomen and thigh. upper limb. A lateral incision through skin and muscle layers was used in all animals. cyclazine. experimented with a "standard surgical incision and suturing" applied to the upper lateral abdomen.e. square wave.1-5.30.100. The GeiKo point was stimulated at 45 Hz. . Texas. Chinese workers have also used AA on Earpoints alone for abdominal surgery in rabbits. KI06. 4 Hz. He used only simple insertion of needles (no ES) in the following points GB01. They tested various points and concluded that the most effective points for dental analgesia were LI04 (bilateral) or needle cathode at GeiKo (Japanese points on the lateral margin of the nasolabial fold) and a 3 x 4 cm silver plate anode placed on the centre of the abdomen. HT05. Rats: Toda et al have done many years of research with EAA in rats to study the mechanisms of EAA in the treatment of dental pain and as a preparation for dental surgery. until the nose twitched in frequency with the stimulator. cats. TH23.300.1000 Hz). the incision was made and was then sutured. They found that some analgesia occurred at all frequencies from 0. monkeys. 1000 Hz was unsatisfactory.10. They also tested stimulation patterns using pulse durations between 0. In the experiments with LI04. 5 msec. plus GV06b. i. The negative electrode was a needle placed in the thigh muscles or at the vertex of the head. BL23. they did extensive trials to examine various frequencies (0. Dogs.150. cavies and rats: Lynd in the San Antonio Medical School.5.antagonist effect) (Cheng & Pomeranz 1980).1 msec. Induction was about 15 minutes. The effects were reversed by opiate antagonists (levo-naloxone. Output level was adjusted until muscular contraction occurred and was increased to just below the level which caused the mice to vocalise (squeak). Analgesia occurred on both sides of the mouth from stimulation of GeiKo on one side but was better on the side opposite to the needle.500.45. thorax. This technique at 200-10000 Hz sine wave gave powerful analgesia of ventral aspects of the neck. He reported excellent analgesia but gave no statistics.24. BL23. Mice: EAA at LI04.

activity in the EEG and with less time-space-disorientation on waking up than in the control group. EAA combined with diazepam was successful in surgery for fracture of the femoral head in elderly high-risk patients (Glennie-Smith 1986). especially if combined with tranquilliser or drug anaesthesia. It may be the only method of surgical analgesia which might be available in wartime. cortisol and aldosterone during surgery did not differ between groups. If they occur. AP at the AA sites or at other points for the pain site can control the pain quickly. less nausea etc). These cases include shock (post trauma. It is well known that AA . pulmonary or cardiac cases. The dogs are given a tranquillizer (i/v) and small doses of general anaesthetic (much smaller than would be successful without EAA). as may occur under general anaesthesia or spinal block. a. The EAA-drug group had less deviations from the baseline in heart rate. Operative haemorrhage is also decreased. Post-operative benefits: Because consciousness and reflexes (other than pain response) are retained under EAA. Post-operative pain and discomfort are almost totally absent. lung. The AP-drug anaesthesia was associated with minimal depression of vital functions and maintained good adaptive reactions (Ponomarenko 1987). kidney or liver disease). EEG and body heat loss than the controls during surgery. who might NOT tolerate general or local anaesthesia. less urine retention. the animal can walk unaided to the recovery area immediately after surgery. BP. b. malnut-rition or cruelty). together with EAA. report far fewer postoperative complications after AA (less ileus. cheap and effective preparation for surgery. hepatic. and in operations lasting up to 10 hours. They confirmed that the amounts of narcotic and barbiturate drugs needed to maintain adequate anaesthesia were reduced. Combination anaesthesia: In humans.4. Per-operative benefits: AA can be used in high-risk patients. The effect of AA on the autonomic nervous system prevents shock during the operation so that deaths during or immediately after operation under AA are extremely rare. It can also be used on very young and very old animals. struggling or falling. haemorrhage). heart. toxic pyometra etc). obstetric surgery (Caesarean section etc). toxaemia (renal. Recovery of consciousness in the EA-drug group was associated with more alpha. It is common practice to offer cattle some hay or concentrates during operations and many dogs will placidly accept bits of meat during major surgery. Many authors. severe debilitation (after chronic disease. faster return to normal appetite.and less beta. Defecation and urination occur very quickly after EAA and the animal will eat and drink immediately after operation (if it is hungry or thirsty). operating on animals as well as human patients. national disasters and other emergency situations. especially in allergic or high-risk patients (circulation. Results were compared with control patients operated under drug anaesthesia alone. Some vet acupuncturists combine EAA with drug analgesia. ADVANTAGES AND DISADVANTAGES OF AA ADVANTAGES OF AA AA is a simple. The results are very good and post-operative recovery is faster and less troublesome than after surgery under conventional anaesthesia. a combination of EAA and tranquilliser or anaesthetic drugs is used in thoracic or abdominal surgery. There is no risk of self-injury due to ataxia. Blood levels of ACTH.

Failure: Western vets can expect a failure rate of 20-50% in the beginning. muscle tremor. The operation can still proceed. Analgesia is inadequate in some patients. Local muscle tremor or guarding is noted at intervals but the operation can proceed without other anaesthetics. An extraordinary finding in monkeys is that peaks of powerful analgesia (interspersed with periods of normal pain sensitivity) can continue for up to 70 hours afterwards (Vierck). direction. DISADVANTAGES OF AA a. intermittent struggling may arise. However. Species differences: among farm animals cattle and sheep are the best reactors. followed by pigs and horses. Marked local tremor and guarding may arise.effects last for up to 20. with failure rates of zero. intestine or bladder may be less than for other body regions. Fair some pain reactions are noted at intervals during the operation and frequent. restraint. suturing of sensitive structures etc. expert technique can obtain a success rate of 90-100% between different operators but the success rate has 3 categories: Excellent results are defined as no indications of pain at any stage in the operation (struggling and vocalising because of physical discomfort. with less oedema. incorrect needle depth. Some of the effects can be relieved by increasing the frequency or voltage or by relocating the needles. despite much experience in general AP therapy have not had such good success with AA. Dogs are very good reactors but cats are difficult subjects to handle and their intolerance of morphine may be related to their poor response to AA. Temperament differences: nervous. vocalisation. incorrect location of points. these success rates are seldom obtained by Western operators in the first year or two of their use of the technique. In animals. Skilled operators may have excellent. This finding demands further research. Vets who specialise in limb surgery might not get success rates as high as those who specialise in intestinal surgery. After AA. animal factors and surgical technique. less wound infection and less wound breakdown. The operation proceeds smoothly at all stages and no other anaesthetic method is required. strong reaction and impossible to proceed with the operation without some other form of anaesthesia. and many western operators. 19 and 3% respectively. Slight muscle tremor or local guarding may occur. Good is defined as short intervals of restlessness or mild struggling during traction of internal organs. oesophagus. Animal factors which may reduce the success rate: Regional variation in EAA: Certain body regions are more difficult to render insensitive to pain than other regions. Success rates for surgery on the frontal sinus. This is due mainly to incorrect choice of points.60 minutes after stimulation is ended. excitable animals . Failure is defined as pain reactions (fierce struggling. Sex and breed effects may interfere: female cattle respond slightly better than male cattle and domestic cattle may respond better than buffaloes. good and fair rates of about 78. surgical incisions heal much faster. b. fear etc must be distinguished from pain reaction). incorrect or inadequate methods of stimulation.

The hands usually are more sensitive than instruments and are less likely to cause unnecessary trauma/stimulation during surgery. not sensory inhibition. If needles fall out. There are marked differences between the physiological effects and mechanisms of human and animal hypnosis and those of EAA. clamps. movement or touch. Where possible. Restraint must be good: This usually needs the presence of at least one assistant at all times after the start of induction. forceps. These may lower pain threshold and reduce the success rate. hypnosis or self-hypnosis (deep relaxation) can induce surgical analgesia in sensitive subjects and can be used to treat certain disorders associated with stress. shock. Needle dislodgement: Occasionally one or more needles become dislodged. f. Although AA has anti-shock effects. EAA demands skilled surgery. "Animal hypnosis" (the Still Reaction) is not fully analogous to human hypnosis. as should handling of organs and viscera. g. animals may tolerate mildly painful stimuli (pinprick. Struggling against discomfort needs to be distinguished from possible pain reactions to the surgery. It is a reversible and involuntary "Tonic Immobility" (TI). induced in many species as a defensive reaction to sudden fright or pain. In TI. use the hands. The special EAA harnesses tend to reduce this problem in small animals. who may also complain about "electric wires all over the place". This may cause ballooning of intestines through abdominal incisions. noise. clumsy surgical technique etc). 5. Surgical technique must be deft. c. vomiting. by tying them in dorsal or dorsolateral recumbency. fast and unhesitating. MECHANISMS OF AA EAA is not hypnosis: In humans. This is due to descending motor inhibition. probes etc. Dislodgement may occur (despite good restraint of the animal) due to strong muscle twitch induced by EAA. despite good analgesia. Prolonged probing or manipulation of organs and slow uncertain incision reduce the success rate. may cause them some discomfort. Voltage should be increased in recumbency. TI is disrupted easily by noise. depressed animals may appear to be easy to handle but their reaction to AA may be sluggish and not of a high degree.may be good responders to AA but are easily frightened by noise. . Appendix 1 compares and contrasts TI and AA. Traction on mesentery or ligaments should be kept to a minimum. When reconnecting a replaced needle. Restraint of small animals. proprioceptive stimuli/physical discomfort. sight stimuli and may be hard to restrain. fearful sights. smell. They feel the stimulus (as assessed by neuronal discharges in the cerebral cortex) but do not appear to react. d. Induction time (10-40 minutes) may be inconvenient for some surgeons. excitement. electric shock) without somatic (muscular) reaction. light. Dull. sound. Recumbency: Large animals in the recumbent position need a more expert AA technique than those which are standing. especially if they had not been taped or sutured securely in position. the output voltage should be set to zero and then restored gradually after reconnection. heavy traction during EAA can cause autonomic (vagal) reflexes (nausea. e. collapse etc). they must be replaced or the analgesia may be poor or absent. rather than surgical retractors. External and other stimuli: Animals with an elevated pain threshold under AA can still react to disturbance by environmental stimuli (smell of blood. Muscle relaxation may be inadequate if the EAA technique is not expert.

Experimental electrolytic lesions placed around the 3rd ventricle (midbrain) or surgical hypophysectomy completely abolish AA effects. direct EAA of the isolated nerve gives the same analgesic effect as EAA of the AP point. Thus far. This evidence is strengthened by the following observations: AA stimulation causes release of endorphins. 4. GB34 etc) relieves the symptoms of narcotic and alcohol withdrawal within 10-30 minutes in human addicts and in laboratory animals addicted experimentally to morphine or heroin. naltrexone and other opiate antagonists prevent and abolish much of the analgesic effect of AP in humans and animals. other sites also. AP stimulation of certain points (especially Earpoint "Lung". especially the midbrain and hypothalamus. Many of the most active AA points are directly over. (Certain strains of mice. rats and other laboratory animals. these facts indicate that the signals generated by needling or ES of the AA points are transmitted via the peripheral sensory nerves to the spinal cord and that they activate a descending brain-based pain-inhibition mechanism. Levo-naloxone. In monkeys. This activity can be monitored by electrodes placed directly into specific neuronal centres of the brain or by surface electrodes at specific regions of the head. In animals. pain stimuli applied at distant regions (for example. enkephalins (endogenous morphine compounds) and ACTH. the hind limbs) evoke electrical activity in cortical and thalamic neurons. ST36. If the nerve is transected. Thus. The midbrain and hypothalamic areas are rich in opiate receptors.Sensory inhibition in EAA: Modern theories attribute the effects of EAA to inhibition of the ascending (sensory) pain signals at three levels: peripheral. . This has been demonstrated in many species (including humans) by local anaesthesia (procaine infiltration etc) of the AA point. This has been confirmed by chemical analysis of tissues. EAA at points which cause analgesia of the pain zone suppress or abolish completely the evoked potentials in the brain. probably. There are also "pain inhibition gates" in the spinal cord. spinal and central. There is very strong evidence that the pain inhibition mechanism involves activation of opiate and serotonin (5HT) receptors in the brain and. 2. cats. or very close to. stimulation of the proximal cut end produces AA but stimulation of the distal cut end produces no effect. LI04. by nerve block above the point and by spinal block above the entry point of the nerve into the spinal cord. (There is also experimental evidence that transmission of pain signals is inhibited by AA at peripheral and spinal levels. Some recent research findings which support this theory are as follows: 1. the "ascending pain signals" are blocked at spinal and midbrain level and fail to reach the cerebral cortex. rabbits. 3. Interruption of the sensory nerve supply proximal to the AA needle site abolishes the EAA effect. These points have major AA effects (Patterson). main nerve trunks and branches of peripheral nerves. which have no opiate receptors because of a genetic abnormality can not respond to AA).

there is some specificity between the anatomical location of the point and the area of analgesia. Recent research has also shows that serotonin (5HT) is involved in EAA and that oral administration of 5HT precursors. biphasic pulses. by the same method but at non-points 5 cm below GB30. PC09. BL13. An extraordinary finding was that if the donor had a localised analgesia (specific to one side or one region).39. whole blood or serum was perfused directly or indirectly into animals (of the same species) which had received no AP. not over the nerve trunk). Analgesia developed in the recipients but was not as marked as in the donor animals. the Chinese had evidence that a morphine-like analgesic factor was released into the blood and cerebro-spinal fluid by AA (Niboyet et al).65. . the stronger analgesia is usually on the same side as the needles.25 msec duration for 30 minutes. BL13. It appears that endorphin release in these specific areas is the main mechanism of AA. This suggests that the AA signals are going to specific sites in the brain. Chinese and Western workers have confirmed that release of endorphin is involved in AA. Although ES of single points such as ST06. The difference between real and false EAA was highly significant. Many years before the endorphins were discovered. However. Cross-perfusion studies were conducted in rats.47 and the needles were inserted subcutaneously only (not to the deeper levels as in the active points). KI01. It is known already that the brain contains 3-dimensional projection areas (both sensory and motor) for all body regions. which increases the cortisol levels in blood. Many neurophysiologists find it difficult to accept that such specificity can exist. needling the "false points" is usually not effective). EAA was given at 4-5 points to above the threshold of muscle twitching.e. GB26.18. The points were chosen from points effective in treating limb pain in horses. In the past few years. EAA increased cortisol by 40% above pretrial values but "false EAA" had little effect. whereas SP06 or ST36 will give better analgesia of the leg and abdomen than of the arm. As well as releasing endorphins. The needles were 10 cm long and were inserted to a depth of 3-5 cm. AA or EAA was established in experimental animals and cerebro-spinal fluid. TH08 etc may cause analgesia over a wide area. 5 Hz. dogs. Also. If the "false points" are lateral or medial to the "real points" (i.Stimulation of AA points on one side of the body may have analgesic effects on the opposite side. the recipient also developed analgesia on the same side and in the same region as the donor. even though the false points can be quite near the correct points. such as d-phenyl alanine. EAA also releases ACTH. This was proved in horses by Cheng et al (1980). Cortisol levels before and after AP were measured. needling of "false points" usually fails to produce AA. (Note: If "false points" above or below the "real points" are used. A control group of horses received "false" AP. This suggests that humoral factors are released by EAA and that they activate specific receptors (now known to be opiate receptors) in specific regions of the brain and spinal cord of both donor and recipient animal. LI04. rabbits and monkeys in China. greatly enhances AA and can turn "non-responders" into "responders". Toda et al found a stronger effect on the opposite side when the GeiKo point was used in rodents. In most species of animal. .02. For instance point PC06 or TH08 will give better analgesia of the arm and thorax than of the leg. In these experiments. A certain degree of side-to-side and region-to-region specificity exists between the AA point and "target zone of analgesia". some hypoalgesia may occur because the same nerve trunk may be stimulated.

It involves endorphin release but over a wider area of the brain than EAA. via the ascending tracts (spino-thalamic tracts. The endorphin activates the opiate receptors. serotonin (5HT) and other neurotransmitters not discussed in this paper. TENS etc were more effective if the electrodes were applied to the affected local areas plus (AP points. These signals stimulate the local (and systemic) release of endorphin. Spinal signals are also transmitted to specific sites in the thalamus. Some AA signals can reach the pain inhibition centres by routes outside of the spinal cord. researchers began to examine the possibility of indirect stimulation of the nervous tissue. which "switch on" the pain inhibition mechanism specific for those areas related to the needle site and its projections at brain level. transcutaneous nerve stimulation (TNS). OTHER METHODS OF STIMULATION-PRODUCED ANALGESIA (SPA) SPA originally referred to analgesia produced by direct stimulation of specific brain sites. surgical intervention has been done in animals under SPA but the main use of SPA and TESA has been in the control of clinical pain. especially the area around the 3rd ventricle. hypothalamus and midbrain. This probably explains the more localised analgesia of EAA. This led to the development of various forms of transcutaneous ES analgesia (TESA). Release of ACTH by EAA could be important in treating allergies. Long-term direct stimulation of brain or cord sites involves some risks (possible electrolytic lesions in brain/nerve tissue. transcutaneous electro-neural stimulation (TENS) etc. Because direct methods were effective but risky. SPA is abolished by opiate antagonists (naloxone etc). (b) by the autonomic nervous system and (c) by release of some (yet unknown) substances from the needle-site into the bloodstream. Analgesia occurred above the transection. via peripheral nerves. The mechanisms of AA can be summarised as follows: Signals caused by stimulation of AA points are carried in the peripheral sensory nerves to the spinal cord. thus preparing the animal to withstand the surgical stress and to assist (antiinflammatory effect) in wound healing. ventro-lateral funiculi). He confirmed that EAA released a humoral analgesic factor in rabbits even when the spinal cord was severed behind the medulla oblongata. Workers familiar with the AP system found that TESA. TESA mechanisms are not fully researched yet but there is strong evidence that they are similar to those of EAA. It has many parallels with EAA. Direct stimulation of the thalamus or dorsal spinal cord roots also produces potent analgesia and ES of permanently implanted electrodes in these sites has been used in treating severe intractable pain in humans. At this level they may activate local (spinal) pain inhibition gates. this produces powerful analgesia over the whole body. These methods are widely used internationally in physiotherapy and for personal use by outpatients of pain clinics. 6. Simultaneous ACTH release from hypothalamic areas induces cortisol secretion by the adrenal. possibly by (a) cell-to-cell transmission through the skin and soft tissues (as in a beecolony). Terral repeated the Chinese cross-perfusion EAA studies in rabbits. organ reflex points etc). inflammation and shock. Under experimental conditions. . risk of infection etc). Trigger Points. the periaquaductal grey matter (PAG).Frost reported 3 cases of human AA following needling of points below a traumatic transection of the spinal cord in the region cervical vertebrae 1-6. In humans and animals. arthritis.

Consciousness returns immediately stimulation ceases. The induction period in humans and animals is very short. To knock the animal. Electro-narcosis and electro-anaesthesia are terms used for another type of electrically induced anaesthesia which uses indirect electrical stimulation of the thalamus to produce unconsciousness and total anaesthesia. It is also interesting that stimulation of the nasal area (the simple tongs or fingers in cattle. Electro-restraint: Reports from Poland claimed that positive clamp electrodes fastened to the ear and a negative tongs electrode fastened to the nose gives excellent restraint in cows. Its tradename is STOCKSTILL. vertex. Anaesthesia produced by these techniques is sufficient for major surgery in man and animals. Kano et al have done many experiments with the method in monkeys.Other types of SPA include vaginal stimulation analgesia. needle electrodes were used in various sites on the head: temples. electro-restraint electroanaesthesia/electro-narcosis and electro-sleep. Using this technique in 58 cows. They found that needle electrodes could produce third degree burns. Unconsciousness and anaesthesia can be maintained for long periods while stimulation continues. i. In early trials. They proved that the stimuli are transmitted to the brain by these nerves by a local ring-block around the scalp. using 0. VSA is mediated by mechanisms different from SPA.e. a similar instrument has been available commercially in Australia and the USA.25% lidocaine. current is applied to the cheek and lumbar area. Since the Polish report. Margaret Patterson traces the history of . Details of induction time are not available in the English summary of the article but I believe that induction was probably very short. mastoid area. usually 1-5 minutes. forehead etc. TESA and EAA. as required. It applies a strong electrical stimulus to the cheek/mouth/nose and the base of the tail or other area. where electrodes B and B1 are over the greater occipital nerves and C and D are over the greater auricular nerves. The animal falls to the ground immediately and simple surgery can be done with great ease. However. the author (Szczerbac) was able to pare the hooves with no difficulty and no defence reaction from the cows. The Ear roots and the nose (especially GV25 and 26) are used as EAA points in some Chinese prescriptions for humans and animals. The frequency of stimulation was 160-200 Hz and the current was 4-16 mA. the rope "twitch" in horses) and of the ear-root (in both cattle and horses) has been used internationally for many centuries as a method of restraint in large animals. In her book on AP in the treatment of drug addicts. such as sponges soaked in saline or metal disc electrodes were used later. It seems that this method of electro-restraint has little analgesic power but rather that it acts by a type of spinal shock which induces spastic paralysis of the motor nerves from the spinal cord. Thus. I suspect that the Polish instrument is used as a method of restraint rather than a true analgesia. More research is required on this method but it appears to have little or no similarity in its effects or mechanisms of action to EAA or SPA. occipital area. However. The local anaesthetic blocked the phenomenon. stretching between the electrodes but that contact electrodes did not produce tissue damage. opposite ends of the spinal cord. Their suggestion for best results was to use high frequency current passed between B-C and B1-D. Vaginal Stimulation Analgesia (VSA): Mechanical (glass probe) or electrical stimulation of the vagina in rats produces a powerful analgesia over the whole body but the mechanism does not involve the opiate receptors in the brain because opiate antagonists (naloxone etc) do not interfere with the analgesia. the British Veterinary Association has not accepted that this technique is humane and painless. Contact electrodes.

lasting 6-48 hours. abscesses etc are rare (3%) as compared with operations under general anaesthesia (17% abscesses) in the same hospital. One Russian worker (Sergeer . A course of treatment lasted 20-25 sessions. It is used in therapy of various diseases with underlying disturbances of cortical regulation of somatic function and in all disorders with psycho-autonomic manifestations.25" X 4. Reversibility: TI is easily disrupted by stimuli and care must be taken to avoid disruption of the trance by stimuli . sudden moves or accidental blows to the animal's legs or body. as compared with 0. 80-100 Hz. This also parallels the EAA effect but loss of consciousness during electro-anaesthesia indicates that the mechanisms differ from those in EAA. Electro-Sleep or Cerebral Electro-therapy (CET) has some parallels with electroanaesthesia but it differs in other respects. constant polarity. (b) pressure on parts of the body.2-0. It was widely used in the old USSR and in Austria but there is no agreement on the mechanism of the effects or on the stimulation parameters used to induce electrosleep.see Patterson for other details) used rectangular pulse.0 minutes induced by restraint on a table. Other hospitals in France are also using the method. urological and intestinal surgery) have been done using that method in the hospital. The animal may be alert or drowsy. Electro-anaesthesia has a long history in western medicine dating back to 1902 (long before the development of EAA. It was discovered by Francois Luduc in 1902. for 30-120 minutes per day. current intensity 15-20 mA. Tactile and proprioceptive stimuli are the most important inducers but other stimuli. The first human operations using the method were in 1972 in the Necker Hospital.5" high. or of electrodes placed across the head. unidirectional high frequency current (See Patterson for details). such as loud noise.3 msec. TESA etc). more than 400 operations (including arterial grafting.2-8. (The chicken/rabbit "freezes" at the sight of the hawk/weasel). APPENDIX ANIMAL HYPNOSIS AND AA EFFECTS Definition: "Animal hypnosis" is also called the "Still Reaction". with involuntary but reversible inhibition of spinal reflexes. Paris. Post-operative analgesia is marked. (d) forcible restraint until struggling ceases. Since then.these techniques. The electrode placement is: 2 electrodes (anodes) behind the mastoids (one each) and one cathode between the eyebrows. such as intense fear can trigger TI spontaneously. In this discussion it is called TI. kidney transplants. duration of TI was 15-60+ minutes. SPA. Visual stimuli are most important in chickens. such as visual and auditory inputs. It is a specific tonic immobility. (c) inversion. Post-operative infection. . "Tonic Immobility (TI)" or the "Immobility Reflex". The effect is enhanced by inserting a block to press slightly against the head. Using this method. enhance the effect. depending on the nature of the induction of TI and the sensory stimulation during the trance. It involves the selective loss of placing. as in EAA. "Death Feint". TI can be enhanced greatly in duration and depth by low-level ES of certain subcortical brain sites. Experimental induction involves one or more of four main techniques: (a) repetitive stimulation. Enhancement and duration of TI in rabbits 2-4 kg weight is most marked if they are restrained for 5 seconds on their backs in a holder with inside measurements: base 18" X 3. righting and supporting reflexes. Induction of TI: Strong emotions. pulse duration 0.

brainstem and cerebellum. The difference in susceptibility between intact and decorticated adult rats suggests that. enhance depth & duration of TI enhance AA mild electrical stimulation enhances enhances motor reaction to mild pain applied anywhere on the body absent absent if AA points with wide analgesic effect are used drowsiness sometimes often noise.Human hypnosis can induce surgical analgesia in some subjects. Opiate antagonists (naloxone etc) do not inhibit the lack of motor response to mild painful stimuli in TI. Removal of the cerebral cortex in adult rats makes them very susceptible to TI. Motor centres in the brain are inhibited but sensory cortical centres are fully active. there is a cortical centre which inhibits a hypnogenic centre elsewhere and that the cortical centre may be underdeveloped in young rats. The lack of response to mild stimuli is due to motor inhibition and not to sensory inhibition (analgesia). atropine scopolamine. sudden movement. Similarities between "Animal Hypnosis" (TI) and Acupuncture Analgesia (AA) TI premedication. use different neurotrans-mission mechanisms. TI mechanisms: TI is associated with sympathetic arousal. meperidine tranquillisers AA tranqs. In contrast. AA is inhibited by opiate antagonists. Animals in TI are less responsive than when awake to mild stimuli. the loci of descending inhibition on spinal motor neurons are located in the medullary reticular formation (MRF). electric shock. indicating that sensory information is received. such as sound. Decerebration does not inhibit TI in guinea pigs and rabbits. cause motor response autonomic effect sympathetic mild sympathetic to neutral Differences between "Animal Hypnosis" (TI) and Acupuncture Analgesia (AA) physiological response inhibition TI AA motor inhibition. In TI of rabbits and frogs. Young rats (up to 3 weeks of age) are good subjects but TI is difficult or impossible to induce in adult rats. controlled by different parts of the nervous system. TI and AA activate clearly different responses. Arousal responses are elicited readily and cerebral-evoked potentials to applied pain stimuli are intact. strong pain stimuli disrupt TI. in that species. no sensory inhibition no motor . sensory inhibition. cause motor response may disrupt AA. pinprick.

analgesia sufficient for major surgery generalised response 10% of selected cases in humans. mainly response induction time 5-30 seconds 10-40 minutes duration of effect usually < 3 minutes. < 20% of selected cases in animals yes local 80-90% of selected cases in humans and animals only if points with generalised response used. up to 10+ hours post-effect analgesia no yes naloxone no effect inhibits/abolishes AA . up to 60 minutes in optimal conditions as long as needed.