Use of lidocaine for super sensitive patients?

[Guest guest]

A patient of mine suggested using lidocaine on the skin prior to

inserting the needles to reduce discomfort. I had to admit that I have

never considered that before. First of all I don't know if it is

considered sterile, second I don't know if it would be contraindicated

for any reason and lastly I don't know if such a practice would even be

legal.

 

Dentist numb the gum before putting the needle of Novocain into the

month, I wonder if it would be OK for acupuncturists to use a topical

anesthetic for our super sensitive patients?

 

Any thoughts?

 

Christopher Vedeler L.Ac., C.Ht.

Oasis Acupuncture

<http://www.oasisacupuncture.com/> http://www.oasisacupuncture.com

9832 N. Hayden Rd.

Suite 215

Scottsdale, AZ 85258

Phone: (480) 991-3650

 

 

 

 

 

 

[Guest guest]

Hi Christopher & All,

 

> Dentist numb the gum before putting the needle of Novocain into the

> month, I wonder if it would be OK for acupuncturists to use a topical

> anesthetic for our super sensitive patients? Any thoughts? Christopher

> Vedeler L.Ac., C.Ht.

 

 

Neural Therapy practitioners and Trigger point therapists often inject the

sensitive points with various solutions containing 0.25-0.50% local

anaesthetic (originally Impletol, but any registered local anaesthetic is

OK), which dose not inhibit the clinical effect. Such concentrations are

far below those normally used to induce local anaesthesia

(concentrations of usually are 2-3%).

 

Activation of the peripheral sensory nerves, and transmission of the

stimuli to the neuroendocrine centres in the thalamus, hypothalamus &

periaqueductal neurons around the 3rd ventricle are key mechanisms in

the AP effect.

 

Therefore, IMO, one should NOT use local anaesthetic on a point at

concentrations that will numb the skin. In animal experiments, numbing

the acupoint before AP stimulation abolishes the AP effect.

 

If guide-tules are used with heavy pressure on the acupoints, im my

experience it is very rare to meet patients twho cannot tolerate insertion

of 30-gauge needles.

 

For supersensitive patients, or those with a prior history of needle-

shock, one can use strong acupressure, guasha, TENS, or laser.

Alternatively, one might try finer needles, such as 34-38-guage.

 

Best regards,

 

[Guest guest]

I always use a 38 gauge needle, only using the larger gauges when I'm doing

electroacupuncture. With the 38 gauge, I almost never ever have patients

complaining that the sensation is too much too bear.

 

I also find that being very hands-on with patients helps a lot. When they first

lie on the table, I'll place my hand on their belly and encourage them to begin

focusing on their breath. With a patient who seems nervous, I'll delay

inserting the first needle till I see that their breath is becoming deeper and

more relaxed. And I always make sure that the hand not holding the needle is on

the patient, fairly close to where the needle will be inserted. That second

hand is comforting to them and also helps distract their attention from the

needle insertion. Someone once described the two hands to me as mother and son.

The son inserts the needle, but the mother soothes and makes it possible for

that to happen in the first place.

 

If I'm treating someone who has never had acupuncture before, I avoid points

like LI 4, P6, facial, hand, ear or foot points, etc. for the first insertion.

Fearful people also seem worried about abdominal points. So, I'll usually start

with a very gentle, shallow insertion of ST 36 and let them see that it's an

essentially painless procedure. Building their confidence often nips potential

problems in the bud. Then, I can go on to points to which they may be more

sensitive.

 

Because I use such thin needles, and because I have such a gentle touch, when I

do rarely meet a patient who is hypersensitive, I consider that information in

the development of their diagnosis. I explain to them that their

hypersensitivity is an indication of an imbalance, much as ticklishness is, and

I work with them to develop lifestyle changes that will calm their

hypersensitivity or fear.

 

Hope this helps. I'm really enjoying reading all the posts since I've joined

this list.

Thank you all for sharing your wisdom.

- Elizabeth Casey, L.Ac.

 

-

Chinese Medicine

Monday, August 28, 2006 6:12 PM

Re: Use of lidocaine for super sensitive patients?

 

 

Hi Christopher & All,

 

> Dentist numb the gum before putting the needle of Novocain into the

> month, I wonder if it would be OK for acupuncturists to use a topical

> anesthetic for our super sensitive patients? Any thoughts? Christopher

> Vedeler L.Ac., C.Ht.

 

Neural Therapy practitioners and Trigger point therapists often inject the

sensitive points with various solutions containing 0.25-0.50% local

anaesthetic (originally Impletol, but any registered local anaesthetic is

OK), which dose not inhibit the clinical effect. Such concentrations are

far below those normally used to induce local anaesthesia

(concentrations of usually are 2-3%).

 

Activation of the peripheral sensory nerves, and transmission of the

stimuli to the neuroendocrine centres in the thalamus, hypothalamus &

periaqueductal neurons around the 3rd ventricle are key mechanisms in

the AP effect.

 

Therefore, IMO, one should NOT use local anaesthetic on a point at

concentrations that will numb the skin. In animal experiments, numbing

the acupoint before AP stimulation abolishes the AP effect.

 

If guide-tules are used with heavy pressure on the acupoints, im my

experience it is very rare to meet patients twho cannot tolerate insertion

of 30-gauge needles.

 

For supersensitive patients, or those with a prior history of needle-

shock, one can use strong acupressure, guasha, TENS, or laser.

Alternatively, one might try finer needles, such as 34-38-guage.

 

Best regards,

 

 

 

 

 

 

 

[Guest guest]

Elizabeth, you spoke of lifestyle changes to deal with the sensitivity and

ticklishness, would you mind sharing what you do? I have a patient who is very

sensitive and very ticklish on her back. Its almost ridiculous trying to get a

needle into her back!

Julie

 

-

Liz

Chinese Medicine

Monday, August 28, 2006 4:34 PM

Re: Re: Use of lidocaine for super sensitive patients?

 

 

I always use a 38 gauge needle, only using the larger gauges when I'm doing

electroacupuncture. With the 38 gauge, I almost never ever have patients

complaining that the sensation is too much too bear.

 

I also find that being very hands-on with patients helps a lot. When they

first lie on the table, I'll place my hand on their belly and encourage them to

begin focusing on their breath. With a patient who seems nervous, I'll delay

inserting the first needle till I see that their breath is becoming deeper and

more relaxed. And I always make sure that the hand not holding the needle is on

the patient, fairly close to where the needle will be inserted. That second hand

is comforting to them and also helps distract their attention from the needle

insertion. Someone once described the two hands to me as mother and son. The son

inserts the needle, but the mother soothes and makes it possible for that to

happen in the first place.

 

If I'm treating someone who has never had acupuncture before, I avoid points

like LI 4, P6, facial, hand, ear or foot points, etc. for the first insertion.

Fearful people also seem worried about abdominal points. So, I'll usually start

with a very gentle, shallow insertion of ST 36 and let them see that it's an

essentially painless procedure. Building their confidence often nips potential

problems in the bud. Then, I can go on to points to which they may be more

sensitive.

 

Because I use such thin needles, and because I have such a gentle touch, when

I do rarely meet a patient who is hypersensitive, I consider that information in

the development of their diagnosis. I explain to them that their

hypersensitivity is an indication of an imbalance, much as ticklishness is, and

I work with them to develop lifestyle changes that will calm their

hypersensitivity or fear.

 

Hope this helps. I'm really enjoying reading all the posts since I've joined

this list.

Thank you all for sharing your wisdom.

- Elizabeth Casey, L.Ac.

 

-

Chinese Medicine

Monday, August 28, 2006 6:12 PM

Re: Use of lidocaine for super sensitive patients?

 

Hi Christopher & All,

 

> Dentist numb the gum before putting the needle of Novocain into the

> month, I wonder if it would be OK for acupuncturists to use a topical

> anesthetic for our super sensitive patients? Any thoughts? Christopher

> Vedeler L.Ac., C.Ht.

 

Neural Therapy practitioners and Trigger point therapists often inject the

sensitive points with various solutions containing 0.25-0.50% local

anaesthetic (originally Impletol, but any registered local anaesthetic is

OK), which dose not inhibit the clinical effect. Such concentrations are

far below those normally used to induce local anaesthesia

(concentrations of usually are 2-3%).

 

Activation of the peripheral sensory nerves, and transmission of the

stimuli to the neuroendocrine centres in the thalamus, hypothalamus &

periaqueductal neurons around the 3rd ventricle are key mechanisms in

the AP effect.

 

Therefore, IMO, one should NOT use local anaesthetic on a point at

concentrations that will numb the skin. In animal experiments, numbing

the acupoint before AP stimulation abolishes the AP effect.

 

If guide-tules are used with heavy pressure on the acupoints, im my

experience it is very rare to meet patients twho cannot tolerate insertion

of 30-gauge needles.

 

For supersensitive patients, or those with a prior history of needle-

shock, one can use strong acupressure, guasha, TENS, or laser.

Alternatively, one might try finer needles, such as 34-38-guage.

 

Best regards,

 

[Guest guest]

I treat overtly sensitive patients quite a bit, and i would say that

the best method i have used is a hypnotherapeutic approach (which,

btw has a long history in china). Patients with CFS or Fibromyalgia

are always hypersensitive and frankly it's much more than just their

periphery that is acute in response to change (ie. any modality that

forces them from their limited construction of reality which usually

involves pain).

I can't really go into all the therapeutics, but the most important

thing i have found is tone of voice, this of course is secondary to

my

personal state of mind. When i am in a sustained light alpha state,

the patient

very often will sync with my field, this alone has healing potential,

but for patients with hypersensitivity, it essentially instructs the

parasympathetic to take over, when this happens the " tickle factor "

is

significantly reduced.

Regards, Tymothy (ps. unless you are in a state that allows for

injection, new mexico and florida i believe, it is not in our scope

to inject anything into our patients)

 

 

>

> Elizabeth, you spoke of lifestyle changes to deal with the

sensitivity and ticklishness, would you mind sharing what you do? I

have a patient who is very sensitive and very ticklish on her back.

Its almost ridiculous trying to get a needle into her back!

> Julie

>