Blood pressure response to acupuncture in a population at risk for autonomic dysreflexia

Averill A, Cotter AC, Nayak S, Matheis RJ, Shiflett SC. Blood pressure response to acupuncture in a population at risk for autonomic dysreflexia. Arch Phys Med Rehabil 2000;81:1494-7. Objective: To determine whether acupuncture can lead to autonomic dysreflexia (AD) when used to treat chronic pain in individuals with spinal cord injury (SCI). Design: Acupuncture analgesia study. Setting: Medical rehabilitation research center. Participants: Fifteen participants with post-SCI chronic pain who were at risk for AD (ie, SCI at or above T8). Interventions: Half-hour acupuncture treatment sessions twice a week for 7.5 weeks, for a total of 15 treatments. Acupuncture needles were inserted both above and below the patient's spinal lesion level. Blood pressure (BP) was measured before and after acupuncture treatments. Main Outcome Measures: Systolic BP (SBP) and diastolic BP (DBP). Participants monitored for signs and symptoms of AD. Results: On average, SBP and DBP remained stable across all 15 treatment sessions. None of the participants experienced any symptoms of AD. However, examination of individuals' BP readings indicated acute elevations (20mmHg or higher) in SBP for 3 of the 15 participants. Conclusions: Although none of the 15 participants who were at risk for developing AD developed symptoms consistent with this diagnosis, 3 displayed an acute elevation in SBP, suggesting a pattern of imminent AD. Comorbid hypertension appeared to contribute to the elevation in 1 patient. Therefore, careful monitoring of patients with SCI or hypertension during acupuncture treatments is advisable. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation