Effects of acupuncture at Pericardium-6 and Stomach-36 on nausea, sedation and gastrointestinal motility in healthy dogs administered intravenous lidocaine infusions

Autoři: Mariko L. St. James aff001;  DeAnna L. Kosanovich aff001;  Lindsey B. Snyder aff001;  Qianqian Zhao aff002;  Brian G. Jones aff003;  Rebecca A. Johnson aff001
Působiště autorů: Department of Surgical Sciences, University of Wisconsin, Madison, Wisconsin, United States of America aff001;  Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, United States of America aff002;  Antech Imaging Services, Fountain Valley, California, United States of America aff003
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0226065


The objectives of this study were to assess gastrointestinal transit times, sedation, and signs of nausea associated with intravenous lidocaine infusions in dogs following targeted acupuncture at Pericardium-6 (PC6) and Stomach-36 (ST36). In a randomized, blind crossover design, 6 healthy, adult Beagles were fed thirty 1.5 mm barium-impregnated polyethylene spheres (BIPS), then were subject to 30 minutes of: 1) no acupuncture, 2) bilateral targeted acupuncture at PC6 and ST36, or 3) bilateral non-target acupuncture at Lung-5 (LU5) and Bladder-55 (BL55). Lidocaine was immediately administered at 1 mg/kg intravenously followed by 50 μg/kg/min. BIPS were tracked radiographically; sedation and nausea were scored at baseline (Time 0) and for 11 hours during lidocaine infusions. Transit times and sedation and nausea scores were analyzed with a linear mixed-effects model; the number of BIPS at defined time points was analyzed with a piecewise linear mixed-effects model. All P values were two-sided and P < 0.05 was considered significant. Sedation and nausea scores did not differ between treatments at any time point (all P > 0.05). However, nausea scores in all groups were significantly greater at Times 5 through 7 and at Time 11 compared to Time 0 whereas sedation scores in all groups were significantly greater at Times 2 through 11 compared to Time 0 (all P < 0.05). The number of BIPs found out of the stomach, the number found in the large intestine, gastric emptying and gastrointestinal transit times did not differ between treatments (all P > 0.05). Acupuncture at PC6 and ST36 did not alleviate nausea and sedation associated with lidocaine infusions in clinically normal animals or affect gastric emptying and gastrointestinal transit.

Klíčová slova:

Acupuncture – Body limbs – Dogs – Nausea – Sedation – Stomach – Vomiting – Large intestine


1. Malone E, Ensink J, Turner T, Wilson J, Andrews F, Keegan K, et al. Intravenous continuous infusion of lidocaine for treatment of equine ileus. Vet Surg. 2006;35(1):60–6.

2. Cook VL, Blikslager AT. Use of systemically administered lidocaine in horses with GI tract disease. J Am Vet Med Assoc. 2008;232(8):1144–8. doi: 10.2460/javma.232.8.1144 18412523

3. Doherty TJ. Postoperative ileus: pathogenesis and treatment. Vet Clin North Am Equine Pract. 2009;25(2):351–62. doi: 10.1016/j.cveq.2009.04.011 19580945

4. Torfs S, Delesalle C, Dewulf J, Devisscher L, Deprez P. Risk factors for equine postoperative ileus and effectiveness of prophylactic lidocaine. J Vet Intern Med. 2009;23(3):606–11. doi: 10.1111/j.1939-1676.2009.0311.x 19422470

5. Li J, Wang G, Xu W, Ding M, Ding M, Yu W. Efficacy of intravenous lidocaine on pain relief in patients undergoing laparoscopic cholecystectomy: a meta-analysis from randomized controlled trials. Int J Surg. 2018;50:137–45. doi: 10.1016/j.ijsu.2018.01.001 29331604

6. Lamont LA. Adjunctive analgesic therapy in veterinary medicine. Vet Clin North Am Small Anim Pract. 2008;38(6):1187–203. doi: 10.1016/j.cvsm.2008.06.002 18954680

7. Smith LJ, Bentley E, Shih A, Miller PE. Systemic lidocaine infusion as an analgesic for intraocular surgery in dogs: a pilot study. Vet Anaesth Analg. 2004;31(1):53–63. doi: 10.1111/j.1467-2995.2004.00142.x 14756754

8. Valverde A, Doherty TJ, Hernández J, Davies W. Effect of lidocaine on the minimum alveolar concentration of isoflurane in dogs. Vet Anaesth Analg. 2004;31(4):264–71. doi: 10.1111/j.1467-2995.2004.00165.x 15509291

9. Ortega M, Cruz I. Evaluation of a constant rate infusion of lidocaine for balanced anesthesia in dogs undergoing surgery. Can Vet J. 2011;52(8):856–60. 22294791

10. Tsai TY, Chang SK, Chou PY, Yeh LS. Comparison of postoperative effects between lidocaine infusion, meloxicam, and their combination in dogs undergoing ovariohysterectomy. Vet Anaesth Analg. 2013;40(6):615–22. doi: 10.1111/vaa.12064 23837712

11. Guimarães Alves IP, Montoro Nicácio G, Diniz MS, Alves Rocha TL, Prada Kanashiro G, Navarro Cassu R. Analgesic comparison of systemic lidocaine, morphine or lidocaine plus morphine infusion in dogs undergoing fracture repair. Acta Cir Bras. 2014;29(4):245–51. doi: 10.1590/s0102-86502014000400005 24760025

12. MacDougall LM, Hethey JA, Livingston A, Clark C, Shmon CL, Duke-Novakovski T. Antinociceptive, cardiopulmonary, and sedative effects of five intravenous infusion rates of lidocaine in conscious dogs. Vet Anaesth Analg. 2009;36(5):512–22. doi: 10.1111/j.1467-2995.2009.00480.x 19709055

13. Johnson RA, Kierski KR, Jones BG. Evaluation of gastric emptying time, GI transit time, sedation score, and nausea score associated with intravenous constant rate infusion of lidocaine hydrochloride in clinically normal dogs. Am J Vet Res. 2017;78(5):550–7. doi: 10.2460/ajvr.78.5.550 28441056

14. Mittleman E, Gaynor JS. A brief overview of the analgesic and immunologic effects of acupuncture in domestic animals. J Am Vet Med Assoc. 2000;217(8):1201–5. doi: 10.2460/javma.2000.217.1201 11043693

15. Cheong KB, Zhang J, Huang Y, Zhang ZJ. The effectiveness of acupuncture in prevention and treatment of postoperative nausea and vomiting–a systematic review and meta-analysis. PLoS ONE. 2013;8(12):e83474. doi: 10.1371/journal.pone.0083474

16. Acar HV. Acupuncture and related techniques during perioperative period: A literature review. Complement Ther Med. 2016;29:48–55. doi: 10.1016/j.ctim.2016.09.013 27912957

17. Gouveia F, Oliveira C, Losa N. Acupuncture in the management of intraoperative nausea and vomiting. J Acupunct Meridian Stud. 2016;9(6):325–9. doi: 10.1016/j.jams.2016.09.005 28010836

18. Matić Z, Bojić T. Acupuncture, autonomic nervous system and biophysical origin of acupuncture system. Vonjnosanitetski pregled. 2008. [cited 2019 May 3]. Available from: https://doi.org/10.2298/VSP170818016M.

19. Kotani N, Hashimoto H, Sato Y, Sessler DI, Yoshioka H, Kitayama M, et al. Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses. Anesthesiology 2001;95(2):349–56. doi: 10.1097/00000542-200108000-00015 11506105

20. Ouyang H, Yin J, Wang Z, Pasricha PJ, Chen JD. Electroacupuncture accelerates gastric emptying in association with changes in vagal activity. Am J Physiol Gastrointest Liver Physiol. 2002;282(2):G390–6. doi: 10.1152/ajpgi.00272.2001 11804862

21. Jin H, Liu J, Foreman RD, Chen JD, Yin J. Electrical neuromodulation at acupoint ST36 normalizes impaired colonic motility induced by rectal distension in dogs. Am J Physiol Gastrointest Liver Physiol. 2015;309(5):368–76.

22. Li H, He T, Xu Q, Li Z, Liu Y, Li F, et al. Acupuncture and regulation of GI function. World J Gastroenterol. 2015;21(27):8304–13.

23. Gilbert RT, Farish N, Bergland E, Conaway M, Hance J, Ketcham S, et al. The use of short-term acupressure to prevent long-term PONV: was this a case of too little, too late? J Perianesth Nurs. 2016;32(5):445–52. doi: 10.1016/j.jopan.2015.08.014 28938980

24. Zhang B, Xu F, Hu P, Zhang M, Tong K, Ma G,, et al. Needleless transcutaneous electrical acustimulation: a pilot study evaluating improvement in post-operative recovery. Am J Gastroenterol. 2018;113(7):1026–35. doi: 10.1038/s41395-018-0156-y 29925916

25. Radkey DI, Writt V, Snyder LBC, Jones BG, Johnson RA. GI effects following acupuncture at Pericardium-6 and Stomach-36 in healthy dogs: a pilot study. J Small Anim Pract. 2019;60(1):38–43. doi: 10.1111/jsap.12935 30281151

26. Scallan EM, Simon BT. The effects of acupuncture point pericardium 6 on hydromorphone-induced nausea and vomiting in healthy dogs. Vet Anaesth Analg. 2016;43(5):495–501. doi: 10.1111/vaa.12347 26890432

27. Robertson ID, Burbidge HM. Pros and cons of barium-impregnated polyethylene spheres in gastrointestinal disease. Vet Clin North Am Small Anim Pract. 2000;30(2):448–65.

28. Nelson OL, Jergens AE, Miles KG, Christensen WF. Gastric emptying as assessed by barium- impregnated polyethylene spheres in healthy dogs consuming a commercial kibble ration. J Am Anim Hosp Assoc. 2001;37(5):444–52. doi: 10.5326/15473317-37-5-444 11563443

29. Xu J, Chen JDZ. Intestinal electrical stimulation improves delayed GI emptying and vomiting induced by duodenal distension in dogs. Neurogastroenterol Motil. 2008;20(3):236–42. doi: 10.1111/j.1365-2982.2007.00995.x 17931341

30. Yu X, Yang J, Hou X, Zhang K, Qian W, Chen JD. Cisplatin-induced gastric dysrhythmia and emesis in dogs and possible role of gastric electrical stimulation. Dig Dis Sci. 2009;54(5):922–7. doi: 10.1007/s10620-008-0470-0 18754094

31. Wagner MC, Hecker KG, Pang DSJ. Sedation levels in dogs: A validation study. BMC Vet Res. 2017;13(1):110. doi: 10.1186/s12917-017-1027-2 28420386

32. Chrisman C, Xie H. Canine transpositional acupoints. In: Xie H, Preast V, editors. Xie’s veterinary acupuncture. Ames: Wiley-Blackwell;2007. p. 134–76.

33. Kraus BLH. Efficacy of orally administered maropitant citrate in preventing vomiting associated with hydromorphone administration in dogs. J Am Vet Med Assoc. 2014;244(10):1164–9. doi: 10.2460/javma.244.10.1164 24786163

34. Matsubara LM, Oliva VN, Gabas DT, Oliveira GC, Cassetari ML. Effect of lidocaine on the minimum alveolar concentration of sevoflurane in dogs. Vet Anaesth Analg. 2009;36(5):407–413 doi: 10.1111/j.1467-2995.2009.00471.x 19558370

35. Lorenzutti AM, Martin-Flores M, Litterio NJ, Himelfarb MA, Invaldi SH, Zarazaga MP. A comparison between maropitant and metoclopramide for the prevention of morphine-induced nausea and vomiting in dogs. Can Vet J. 2017;58(1):35–8. 28042152

36. al-Sadi M, Newman B, Julious SA. Acupuncture in the prevention of postoperative nausea and vomiting. Anaesthesia. 1997;52(7):658–61. doi: 10.1111/j.1365-2044.1997.143-az0147.x 9244025

37. Haker E, Egekvist H, Bjerring P. Effect of sensory stimulation (acupuncture) on sympathetic and parasympathetic activities in healthy subjects. J Auton Nerv Syst. 2000:79(1):52–9. doi: 10.1016/s0165-1838(99)00090-9 10683506

38. Liu J, Huang H, Xu X, Chen JD. Effects and possible mechanisms of acupuncture at ST36 on upper and lower abdominal symptoms induced by rectal distension in healthy volunteers. Am J Physiol Regul Integr Comp Physiol. 2012;303(2):R209–217. doi: 10.1152/ajpregu.00301.2010 22592556

39. Lee A, Chan SKC, Fan LTY. Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2015;11:CD003281.

40. Hofmeister EH, Chandler MJ, Read MR. Effects of acepromazine, hydromorphone, or an acepromazine-hydromorphone combination on the degree of sedation in clinically normal dogs. J Am Vet Med Assoc. 2010;237(10):1155–9. doi: 10.2460/javma.237.10.1155 21073386

41. Lin JG, Chen WL. Acupuncture analgesia: A review of its mechanisms of actions. American J Chin Med. 2008;36(4):635–45.

42. Li QQ, Shi GX, Xu Q, Wang J, Liu C-Z, Wang L-P. Acupuncture effect and central autonomic regulation. Evid Based Complement Alternat Med. 2013;276959.

43. Sikander A, Vati Rana S, Pradsad KK. Role of serotonin in gastrointestinal motility and irritable bowel syndrome. Clin Chim Acta. 2009;403(1–2):47–55. doi: 10.1016/j.cca.2009.01.028 19361459

44. White A, Hayhoe S, Hart A, Ernst E, BMAS and AACP. Survey of adverse events following acupuncture (SAFA): a prospective study of 32,000 consultations. Acupunct Med. 2001;19(2):84–92. doi: 10.1136/aim.19.2.84 11829164

45. Lu Z, Dong H, Wang Q, Xiong L. Perioperative acupuncture modulation: more than anaesthesia. Br J Anaesth. 2015;115(2):183–93. doi: 10.1093/bja/aev227 26170347

46. Hay Krause BL. Spotlight on the perioperative use of maropitant citrate. Vet Med (Auckl). 2017;8:41–51.

Článek vyšel v časopise


2019 Číslo 12
Nejčtenější tento týden