Safety Aspects of Electroacupuncture

Abstract

This issue of Acupuncture in Medicine includes three papers that describe adverse events related to the use of electroacupuncture (EA) ( see articles on pages 88, 143 and 147 ).1,–,3 There are few reports in the literature of such adverse events, and this is likely to be as a result of relative under-reporting of the minor events. More serious adverse events were summarised in 2004,4 and include cardiac problems (angina, cardiac arrest, interference with a demand pacemaker) and deaths related to needle trauma during EA. It seems timely to review the theoretical and practical risks associated with the application of EA. ### Increased depth and altered angulation Depth and angulation of needles is often modified for the application of EA in order to ensure that the needles can support the weight of the electrical leads and clips for the period of stimulation without falling out. EA is often applied for 20–30 min and may involve strong muscle contraction. Under these circumstances, needles need to be angled so that the weight of the attached leads and clips opposes the tendency of the contracting muscle to push the needle out. The use of increased depth of insertion and the need to alter angulation from the more familiar orientation at certain points require the practitioner to have a greater knowledge of anatomy for safe needling.5,–,7 ### Muscle contraction and needle movement During strong, low-frequency electrical stimulation of needles in muscle, vigorous muscle contraction can occur. Often this movement is entirely safe; however, in some locations it may be wise to take precautions to reduce needle movement, for both the safety and comfort of the patient. If a needle is placed close to a motor nerve unusually strong muscle movement will occur quite abruptly on increasing stimulation between about 0.5 and 0.9 mA. Under these …