CLINICAL COMBINATION OF ACUPUNCTURE,EYE MOVEMENT DESENSITIZATION AND BDORT WITH PARENTERAL SEDATION FOR PAIN AND ANXIETY CONTROL

Abstract

Since 1997, after the National Institute of Health recognized the therapeutic effects of acupuncture, acupuncture has been widely used for the treatment of various diseases. Although acupuncture has value as a way to control anxiety, this use has not been widely used. The same could be said about Bi-digital O-Ring Test (BDORT). Since it was developed in the 1970s, BDORT has proven to be valuable for the diagnosis and selection of beneficial medications for diseases. Rarely has BDORT been utilized in the field of anxiety control.

Since the mid-1990’s, eye movement desensitization and reprocessing (EMDR) has become reasonably popular in the realm of clinical psychology and psychiatry as a non- pharmatherapeutic modality for the treatment of phobias, post-traumatic symptoms and various psycho-trauma cases. There is another desensitization method involving eye movemem known as eye movemem integration (EMI) or eye movement desensitization integration (EMDI).

There are some other sedation methods in alternative and complimentary medicine which has been proved to be valuable for pain and anxiety control especially when supplementing the traditional pharmacological sedation. Those methods include acupuncture (especially P6, HE5, Extl Yintang),hypnosis, EMDI, and EMDR. Bi-Digital O-Ring Test (BDORT) is very valuable in determining the proper sedation agent and dosage for each patient.

The neurophysiological findings reveal that anxiety was closely associated with a functional imbalance between the right and left hemispheres of the brain. It has been theorized that when the sensory and motor functions of the two hemispheres were uncoordinated, anxiety resulted. When the symmetry of brain operation is restored, many experience a growing sense of peace and calm. Eye movements are not only indicative of mind/brain processings, they are also a means by which these functions are activated. The therapist can guide the pattern’s eye movements with hand gestures. Each point to which the eyes are directed corresponds to a different mode of mind/brain processing. A positive mind set is created as the therapist establishes rapport and explains the procedure and its expected beneficial outcome. Because the patient is instructed to deliberately think about the problem (paradoxical intention) a sense of self-control is being encouraged.

An EMDR protocol was developed to enable a patient to desensitize negative images, feelings, cognitions, and bodily sensations and replace them with positive cognitions. Initially, the therapist instructs the patient to target a visual image, feeling, bodily sensation, or cognition. Then, the patient is instructed to follow the movement of the therapist’s fingers as he moves them back and forth very rapidly causing the patient’s eyes to rapidly move back and forth The purpose of such an experience is to track the external stimulus while attending to inner experience. Awareness, therefore, is focused externally, on the therapist’s fingers (in the visual mode) as well as on what is happening internally.

There are distinct physiologic changes during EMDR: (1) respiration synchronizes with the rhythm of the eye movements in the shallow, regular pattern; (2) heart rate slows significantly overall; (3) systolic blood pressure increases during early sets, invariably declines during abreactions, and decreases overall; (4) fingertip skin temperature consistently increases; and (5) the galvanic skin response consistently decreases in a clear “relaxation response.” This relaxing effect of the eye movements suggests that at least one of the mechanisms operating during EMDR is desensitization by reciprocal inhibition, by pairing emotional distress with an unlearned or “compelled” relaxation response.

We examined clinical applications of the eye movement (EM) component of Eye Movement Desensitization (EMD) on fearful dental patients who have histories of traumatic dental experiences. We also used Bi-Digital O-Ring Test (BDORT) to select the proper dosage of sedative to minimize the adverse side effects. For patients who did not respond well to EM, we used BDORT to select the proper sedative medication and its dosage. In certain difficult cases, we supplemented these techniques with acupuncture to augment the sedative effects. Findings were based on the clinical impressions and assessments of both the patients and the operating team. Results showed that EM, although effective in enabling patients to undergo non- invasive dental procedures such as clinical examination and simple prophylaxis, had only limited beneficial effect with invasive procedures such as extraction, drilling, and injections, etc. We also found that BDORT greatly reduced adverse side effects of sedatives such as hypertension, hypotension, hypoxia, tachycardia, bradycardia, nausea, and vomiting. For most apprehensive patients, we found that EMD and acupuncture combined with BDORT predetermined dosage for the submucosal sedation enabled these patients to undergo the complete dental treatment.