human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Fifty-one volunteer patients participated in a study to evaluate the effectiveness of  acupuncture  as an analgesic for operative dentistry . For the twenty-six patients r and omly assigned to an acupuncture group , needles were inserted through specially design ed holders into the Ho-Ku points , located between the first and second metacarpals . An acupuncture pulse generator provided electrical current . For the twenty-five patients in a placebo group , the identical needle and holder arrangement was used . When inserted , however , the needles became embedded in plastic on the undersurface of the holders and did not touch the skin of the patient or receive any electrical stimulation . The patients and dentists were blind to this procedural variation . Analysis of ratings and responses indicated no differences in findings for the acupuncture and placebo procedures , with both having 100 % success and high levels of patient acceptance . Since there was no electric current or penetration of the skin in the placebo group , the findings suggest that the successful use of acupuncture for restorative dentistry may be due to psychological and /or placebo effects in combination with a possible diminished need for analgesia because of the modern use of the high-speed drill BACKGROUND In a previous study on the effect of electro-acupuncture ( EA ) in combination with a paracervical block ( PCB ) as an analgesic method during oocyte aspiration in IVF treatment , EA appeared to increase the pregnancy rate . This study was design ed to test the hypothesis that EA as an analgesic during oocyte aspiration would result in : ( i ) a better IVF pregnancy rate than with alfentanil ; ( ii ) peroperative analgesia that was as good as that produced by alfentanil ; ( iii ) less postoperative abdominal pain , nausea and stress ; and ( iv ) a reduction in the use of additional analgesics . Neuropeptide Y ( NPY ) concentrations in follicular fluid ( FF ) were analysed when possible . METHODS AND RESULTS In this prospect i ve , r and omized , multicentre clinical trial , 286 women undergoing oocyte aspiration were r and omly allocated to the EA group ( EA plus a PCB ) or to the alfentanil group ( alfentanil plus a PCB ) . No significant differences were found between the EA and alfentanil groups in any of the IVF variables . NPY concentrations in FF were significantly higher in the EA group compared with the alfentanil group . No correlation between pregnancy rate and NPY concentrations was found in either analgesic group . Both EA plus a PCB and alfentanil plus a PCB induced adequate peroperative analgesia during oocyte aspiration evaluated using the visual analogue scale . After 2 h , the EA group reported significantly less abdominal pain , other pain , nausea and stress than the alfentanil group . In addition , the EA group received significantly lower amounts of additional alfentanil than the alfentanil group . CONCLUSION EA does not improve pregnancy rate in the present clinical situation . The observation that NPY concentrations in FF were higher in the EA group may be important for human ovarian steroidogenesis . The analgesic effects produced by EA are as good as those produced by conventional analgesics , and the use of opiate analgesics with EA is lower than when conventional analgesics alone are used Background In a controlled and double-blind study , the authors tested the hypothesis that preoperative insertion of intradermal needles at acupoints 2.5 cm from the spinal vertebrae ( bladder meridian ) provide satisfactory postoperative analgesia . Methods The authors enrolled patients scheduled for elective upper and lower abdominal surgery . Before anesthesia , patients undergoing each type of surgery were r and omly assigned to one of two groups : acupuncture ( n = 50 and n = 39 for upper and lower abdominal surgery , respectively ) or control ( n = 48 and n = 38 for upper and lower abdominal surgery , respectively ) . In the acupuncture group , intradermal needles were inserted to the left and right of bladder meridian 18–24 and 20–26 in upper and lower abdominal surgery before induction of anesthesia , respectively . Postoperative analgesia was maintained with epidural morphine and bolus doses of intravenous morphine .  Consumption of intravenous morphine  was recorded . Incisional pain at rest and during coughing and deep visceral pain were recorded during recovery and for 4 days thereafter on a four-point verbal rating scale . We also evaluated time-dependent changes in plasma concentrations of cortisol and catecholamines . Results Starting from the recovery room , intradermal acupuncture increased the fraction of patients with good pain relief as compared with the control ( P < 0.05 ) . Consumption of supplemental intravenous morphine was reduced 50 % , and the incidence of postoperative nausea was reduced 20–30 % in the acupuncture patients who had undergone either upper or lower abdominal surgery ( P < 0.01 ) . Plasma cortisol and epinephrine concentrations were reduced 30–50 % in the acupuncture group during recovery and on the first postoperative day ( P < 0.01 ) . Conclusion Preoperative insertion of intradermal needles reduces postoperative pain , the analgesic requirement , and opioid-related side effects after both upper and lower abdominal surgery . Acupuncture analgesia also reduces the activation of the sympathoadrenal system that normally accompanies surgery Acupuncture has been shown to be effective in experimental and clinical acute pain setting s. This study aims to evaluate the effect of preoperative electroacupuncture ( EA ) on intraoperative and postoperative analgesic ( alfentanil and morphine ) requirement in patients scheduled for gynaecologic lower abdominal surgery . Ninety patients were r and omly assigned to one of three groups : Group I ( control group ) –received placebo EA for 45 minutes before induction of general anaesthesia ( GA ) ; Group II –preoperative EA instituted 45 minutes before induction of GA ; Group III – 45 minutes of postoperative EA . The Bispectral Index monitor was used intraoperatively to monitor the hypnotic effect of anaesthetic drugs , and alfentanil was titrated to maintain the blood pressure and pulse rate within ±15 % of basal values . Postoperative pain was managed by intravenous morphine via a patient-controlled analgesia ( PCA ) device . Patients in Group II ( 0.44 ± 0.15μg/kg/min ) received less alfentanil than those in Group III ( 0.58 ± 0.22μg/kg/min ) ( p=0.024 ) , but not significantly less than those in Group I ( 0.51 ± 0.21μg/kg/min ) ( p=0.472 ) . Postoperative morphine consumption was numerically lower in Group II compared with the other groups ; however , the difference was statistically significant only during the period of 6–12 hours between Group II [ 0.03 ( 0.05 ) mg/kg ] and Group I [ 0.10 ( 0.11 ) mg/kg ] ( p=0.015 ) , and Group II and Group III [ 0.08 ( 0.10 ) mg/kg ] ( p=0.010 ) . The 24-hour cumulative morphine consumption for Group II ( 0.52 ± 0.19mg/kg ) was less than that for either Group I ( 0.68 ± 0.38mg/kg ) or Group III ( 0.58 ± 0.27mg/kg ) , but the difference did not reach significance . In conclusion , preoperative EA leads to a reduced intraoperative alfentanil consumption , though this effect may not be specific , and has a morphine sparing effect during the early postoperative period It was a clinic comparative observation of the effects between acupuncture and epidural anesthesia in appendectomy . Eighty patients with appendicitis were r and omly divided into two groups , each of 40 Patients . The results were no significant difference between two groups in successful rate . It is convinced that acupuncture on Zusanli points ( ST36 ) has analgesia . There were less respiratory depression , hypotension , cardiac arrhythmia and less amount of liquid infusion needed than that of the epidural block during operation . Furthermore , in the group of acupuncture anesthesia , the intestinal gas excreted earlier , the analgetics and antibiotics administered were less and the rate of the wound infection were reduced after operation . These postoperative effects were significantly better than the controls . As it is of clear-cut effects of anesthesia by acupuncture with main points Zusanli and auxiliary points Hegu ( LI4 ) and less interfered life sign in the operation , thus it is desirable to use acupuncture anesthesia in appendectomy In 26 patients , undergoing cholecystectomy under electrostimulation anaesthesia ( ESA ) ( n = 14 ) and neurolept anesthesia ( NLA ) ( n = 12 ) the effects on consumption of anaesthetic agents , mean arterial pressure , heart rate , blood gases , lung function , serum cortisol and awareness are compared . Consumption of anaesthetic agents was 21.6 per cent in ESA compared to 100 per cent in NLA . Mean arterial pressure , heart rate and serum cortisol were elevated in ESA compared to NLA , probably due to elevated stress . Awareness 4 hours after anaesthesia was higher in ESA , probably due to less persistence of anaesthetics . Blood gases 1 hour after operation were slightly better after ESA , as also were forced vital capacity and peak flow one day after operation . The results are discussed In search of an anesthetic technique which would inhibit response to surgery stress , we tried to obtain a new method by a combination of a commonly used neuroleptanalgesia ( NLA ) and a traditional Chinese acupuncture , in which by increasing the level of endogenic opioid peptides we would decrease the need for exogenic opiates and thus influence the body response to surgery . The effect of this combined use of NLA and acupuncture was evaluated on the hyperglykemia , cortisol and aldosterone response during pre , intra and postoperative period , fentanyl and dehydrobenzperidol ( DHBP ) requirements , and its postoperative analgetic and antiemetic efficacy . The patient population comprised 40 metabolically healthy patients r and omly divided into experimental and control group . Using the analysis with t-test we have demonstrated that acupuncture , as and adjuvant to NLA , significantly suppresses the hyperglykemia and cortisol response to surgery stress , while it does not influence the aldosterone mechanism and , it significantly reduces fentanyl and DHBP requirements . With chi 2-test we have shown a significant decrease in postoperative vomiting and pain , and as a result of this , a reduction of analgesic requirements . In summary , a combination of neuroleptanalgesia and acupuncture can be recommended as a technique which significantly supresses the response to surgery stress ( intraoperative hyperglykemia and hypercortisolism ) and can be easily applied in the majority of surgical procedures D-phenylalanine ( DPA ) is known to block the activity of carboxypeptidase , an enzyme which de grade s enkephalins , endogenous morphine-like substances . Therefore , it is considered that DPA administered as an inhibiting drug of this degrading enzyme might prolong analgesia induced by acupuncture . 1 ) Thirty patients suffering from chronic low back pain were treated with acupuncture 30 minutes after the oral administration of 4.0 grams of DPA . The results were : excellent in 7 cases , good in 11 , fair in 6 and poor in 6 . Cases grade d excellent and good were then compared with a placebo group . The effect was increased 26 % in the DPA-acupuncture group , which shows no statistically significant difference ( P less than 0.1 ) . 2 ) In 56 patients , tooth extraction was performed under acupuncture anesthesia :  18 had received 4.0 gram of DPA ( P.O. ) 30 minutes earlier . The results were excellent in 8 , good in 6 , fair in 3 , and poor in 1 . The excellent and good cases were compared with 38 placebo group cases . The effect in the DPA-acupuncture anesthesia group was significantly increased by 35 % ( P less than 0.01 ) . 3 ) In order to determine the optimum time for the administration of DPA , two schedules of administration were compared . [ 1 ] DPA was given on the previous day in three 0.5 gram doses ( 26 cases ) . [ 2 ] A single 4 gram dose was administered 30 minutes before treatment ( 30 cases ) . The results from the " excellent " , " good " and " fair " cases showed a 16 % increase in effectiveness when DPA was administered the day before , not a statistically significant difference ( P less than 0.1 ) , but a clear tendency to increase was observed . The above findings show that DPA has an enhancing effect on acupuncture analgesia and anesthesia in clinical practice The effects of acupuncture and transcutaneous electrical stimulation ( TES ) on plasma adrenaline ( A ) and noradrenaline ( NA ) , adrenocorticotropic hormone ( ACTH ) , beta-endorphin ( beta E ) , anti-diuretic hormone ( ADH ) and hydrocortisone ( cortisol ) were evaluated during and , for four days after surgery in 42 male patients su bmi tted to a st and ardized major abdominal operation in a comparative study of three different anaesthetic techniques . Group 1 received acupuncture and transcutaneous stimulation as the main non-ph 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Fifty-one volunteer patients participated in a study to evaluate the effectiveness of  acupuncture  as an analgesic for operative dentistry . For the twenty-six patients r and omly assigned to an acupuncture group , needles were inserted through specially design ed holders into the Ho-Ku points , located between the first and second metacarpals . An acupuncture pulse generator provided electrical current . For the twenty-five patients in a placebo group , the identical needle and holder arrangement was used . When inserted , however , the needles became embedded in plastic on the undersurface of the holders and did not touch the skin of the patient or receive any electrical stimulation . The patients and dentists were blind to this procedural variation . Analysis of ratings and responses indicated no differences in findings for the acupuncture and placebo procedures , with both having 100 % success and high levels of patient acceptance . Since there was no electric current or penetration of the skin in the placebo group , the findings suggest that the successful use of acupuncture for restorative dentistry may be due to psychological and /or placebo effects in combination with a possible diminished need for analgesia because of the modern use of the high-speed drill BACKGROUND In a previous study on the effect of electro-acupuncture ( EA ) in combination with a paracervical block ( PCB ) as an analgesic method during oocyte aspiration in IVF treatment , EA appeared to increase the pregnancy rate . This study was design ed to test the hypothesis that EA as an analgesic during oocyte aspiration would result in : ( i ) a better IVF pregnancy rate than with alfentanil ; ( ii ) peroperative analgesia that was as good as that produced by alfentanil ; ( iii ) less postoperative abdominal pain , nausea and stress ; and ( iv ) a reduction in the use of additional analgesics . Neuropeptide Y ( NPY ) concentrations in follicular fluid ( FF ) were analysed when possible . METHODS AND RESULTS In this prospect i ve , r and omized , multicentre clinical trial , 286 women undergoing oocyte aspiration were r and omly allocated to the EA group ( EA plus a PCB ) or to the alfentanil group ( alfentanil plus a PCB ) . No significant differences were found between the EA and alfentanil groups in any of the IVF variables . NPY concentrations in FF were significantly higher in the EA group compared with the alfentanil group . No correlation between pregnancy rate and NPY concentrations was found in either analgesic group . Both EA plus a PCB and alfentanil plus a PCB induced adequate peroperative analgesia during oocyte aspiration evaluated using the visual analogue scale . After 2 h , the EA group reported significantly less abdominal pain , other pain , nausea and stress than the alfentanil group . In addition , the EA group received significantly lower amounts of additional alfentanil than the alfentanil group . CONCLUSION EA does not improve pregnancy rate in the present clinical situation . The observation that NPY concentrations in FF were higher in the EA group may be important for human ovarian steroidogenesis . The analgesic effects produced by EA are as good as those produced by conventional analgesics , and the use of opiate analgesics with EA is lower than when conventional analgesics alone are used Background In a controlled and double-blind study , the authors tested the hypothesis that preoperative insertion of intradermal needles at acupoints 2.5 cm from the spinal vertebrae ( bladder meridian ) provide satisfactory postoperative analgesia . Methods The authors enrolled patients scheduled for elective upper and lower abdominal surgery . Before anesthesia , patients undergoing each type of surgery were r and omly assigned to one of two groups : acupuncture ( n = 50 and n = 39 for upper and lower abdominal surgery , respectively ) or control ( n = 48 and n = 38 for upper and lower abdominal surgery , respectively ) . In the acupuncture group , intradermal needles were inserted to the left and right of bladder meridian 18–24 and 20–26 in upper and lower abdominal surgery before induction of anesthesia , respectively . Postoperative analgesia was maintained with epidural morphine and bolus doses of intravenous morphine .  Consumption of intravenous morphine  was recorded . Incisional pain at rest and during coughing and deep visceral pain were recorded during recovery and for 4 days thereafter on a four-point verbal rating scale . We also evaluated time-dependent changes in plasma concentrations of cortisol and catecholamines . Results Starting from the recovery room , intradermal acupuncture increased the fraction of patients with good pain relief as compared with the control ( P < 0.05 ) . Consumption of supplemental intravenous morphine was reduced 50 % , and the incidence of postoperative nausea was reduced 20–30 % in the acupuncture patients who had undergone either upper or lower abdominal surgery ( P < 0.01 ) . Plasma cortisol and epinephrine concentrations were reduced 30–50 % in the acupuncture group during recovery and on the first postoperative day ( P < 0.01 ) . Conclusion Preoperative insertion of intradermal needles reduces postoperative pain , the analgesic requirement , and opioid-related side effects after both upper and lower abdominal surgery . Acupuncture analgesia also reduces the activation of the sympathoadrenal system that normally accompanies surgery Acupuncture has been shown to be effective in experimental and clinical acute pain setting s. This study aims to evaluate the effect of preoperative electroacupuncture ( EA ) on intraoperative and postoperative analgesic ( alfentanil and morphine ) requirement in patients scheduled for gynaecologic lower abdominal surgery . Ninety patients were r and omly assigned to one of three groups : Group I ( control group ) –received placebo EA for 45 minutes before induction of general anaesthesia ( GA ) ; Group II –preoperative EA instituted 45 minutes before induction of GA ; Group III – 45 minutes of postoperative EA . The Bispectral Index monitor was used intraoperatively to monitor the hypnotic effect of anaesthetic drugs , and alfentanil was titrated to maintain the blood pressure and pulse rate within ±15 % of basal values . Postoperative pain was managed by intravenous morphine via a patient-controlled analgesia ( PCA ) device . Patients in Group II ( 0.44 ± 0.15μg/kg/min ) received less alfentanil than those in Group III ( 0.58 ± 0.22μg/kg/min ) ( p=0.024 ) , but not significantly less than those in Group I ( 0.51 ± 0.21μg/kg/min ) ( p=0.472 ) . Postoperative morphine consumption was numerically lower in Group II compared with the other groups ; however , the difference was statistically significant only during the period of 6–12 hours between Group II [ 0.03 ( 0.05 ) mg/kg ] and Group I [ 0.10 ( 0.11 ) mg/kg ] ( p=0.015 ) , and Group II and Group III [ 0.08 ( 0.10 ) mg/kg ] ( p=0.010 ) . The 24-hour cumulative morphine consumption for Group II ( 0.52 ± 0.19mg/kg ) was less than that for either Group I ( 0.68 ± 0.38mg/kg ) or Group III ( 0.58 ± 0.27mg/kg ) , but the difference did not reach significance . In conclusion , preoperative EA leads to a reduced intraoperative alfentanil consumption , though this effect may not be specific , and has a morphine sparing effect during the early postoperative period It was a clinic comparative observation of the effects between acupuncture and epidural anesthesia in appendectomy . Eighty patients with appendicitis were r and omly divided into two groups , each of 40 Patients . The results were no significant difference between two groups in successful rate . It is convinced that acupuncture on Zusanli points ( ST36 ) has analgesia . There were less respiratory depression , hypotension , cardiac arrhythmia and less amount of liquid infusion needed than that of the epidural block during operation . Furthermore , in the group of acupuncture anesthesia , the intestinal gas excreted earlier , the analgetics and antibiotics administered were less and the rate of the wound infection were reduced after operation . These postoperative effects were significantly better than the controls . As it is of clear-cut effects of anesthesia by acupuncture with main points Zusanli and auxiliary points Hegu ( LI4 ) and less interfered life sign in the operation , thus it is desirable to use acupuncture anesthesia in appendectomy In 26 patients , undergoing cholecystectomy under electrostimulation anaesthesia ( ESA ) ( n = 14 ) and neurolept anesthesia ( NLA ) ( n = 12 ) the effects on consumption of anaesthetic agents , mean arterial pressure , heart rate , blood gases , lung function , serum cortisol and awareness are compared . Consumption of anaesthetic agents was 21.6 per cent in ESA compared to 100 per cent in NLA . Mean arterial pressure , heart rate and serum cortisol were elevated in ESA compared to NLA , probably due to elevated stress . Awareness 4 hours after anaesthesia was higher in ESA , probably due to less persistence of anaesthetics . Blood gases 1 hour after operation were slightly better after ESA , as also were forced vital capacity and peak flow one day after operation . The results are discussed In search of an anesthetic technique which would inhibit response to surgery stress , we tried to obtain a new method by a combination of a commonly used neuroleptanalgesia ( NLA ) and a traditional Chinese acupuncture , in which by increasing the level of endogenic opioid peptides we would decrease the need for exogenic opiates and thus influence the body response to surgery . The effect of this combined use of NLA and acupuncture was evaluated on the hyperglykemia , cortisol and aldosterone response during pre , intra and postoperative period , fentanyl and dehydrobenzperidol ( DHBP ) requirements , and its postoperative analgetic and antiemetic efficacy . The patient population comprised 40 metabolically healthy patients r and omly divided into experimental and control group . Using the analysis with t-test we have demonstrated that acupuncture , as and adjuvant to NLA , significantly suppresses the hyperglykemia and cortisol response to surgery stress , while it does not influence the aldosterone mechanism and , it significantly reduces fentanyl and DHBP requirements . With chi 2-test we have shown a significant decrease in postoperative vomiting and pain , and as a result of this , a reduction of analgesic requirements . In summary , a combination of neuroleptanalgesia and acupuncture can be recommended as a technique which significantly supresses the response to surgery stress ( intraoperative hyperglykemia and hypercortisolism ) and can be easily applied in the majority of surgical procedures D-phenylalanine ( DPA ) is known to block the activity of carboxypeptidase , an enzyme which de grade s enkephalins , endogenous morphine-like substances . Therefore , it is considered that DPA administered as an inhibiting drug of this degrading enzyme might prolong analgesia induced by acupuncture . 1 ) Thirty patients suffering from chronic low back pain were treated with acupuncture 30 minutes after the oral administration of 4.0 grams of DPA . The results were : excellent in 7 cases , good in 11 , fair in 6 and poor in 6 . Cases grade d excellent and good were then compared with a placebo group . The effect was increased 26 % in the DPA-acupuncture group , which shows no statistically significant difference ( P less than 0.1 ) . 2 ) In 56 patients , tooth extraction was performed under acupuncture anesthesia :  18 had received 4.0 gram of DPA ( P.O. ) 30 minutes earlier . The results were excellent in 8 , good in 6 , fair in 3 , and poor in 1 . The excellent and good cases were compared with 38 placebo group cases . The effect in the DPA-acupuncture anesthesia group was significantly increased by 35 % ( P less than 0.01 ) . 3 ) In order to determine the optimum time for the administration of DPA , two schedules of administration were compared . [ 1 ] DPA was given on the previous day in three 0.5 gram doses ( 26 cases ) . [ 2 ] A single 4 gram dose was administered 30 minutes before treatment ( 30 cases ) . The results from the " excellent " , " good " and " fair " cases showed a 16 % increase in effectiveness when DPA was administered the day before , not a statistically significant difference ( P less than 0.1 ) , but a clear tendency to increase was observed . The above findings show that DPA has an enhancing effect on acupuncture analgesia and anesthesia in clinical practice The effects of acupuncture and transcutaneous electrical stimulation ( TES ) on plasma adrenaline ( A ) and noradrenaline ( NA ) , adrenocorticotropic hormone ( ACTH ) , beta-endorphin ( beta E ) , anti-diuretic hormone ( ADH ) and hydrocortisone ( cortisol ) were evaluated during and , for four days after surgery in 42 male patients su bmi tted to a st and ardized major abdominal operation in a comparative study of three different anaesthetic techniques . Group 1 received acupuncture and transcutaneous stimulation as the main non-ph 
    Output:
    