{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T20:28:34Z","timestamp":1793651314036,"version":"4.5.1"},"reference-count":20,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T00:00:00Z","timestamp":1585612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicines"],"abstract":"<jats:p>Background: Gagging during transesophageal echocardiography examination (TEE) can be distressing and even dangerous for patients. The needling of acupuncture point CV24 was described to be effective in reducing the gag reflex during TEE in patients with ischemic stroke or transient ischemic attack. Methods: We describe a proposal for a prospective, randomized, patient, practitioner and assessor-blinded, single-center trial with two arms\/groups; real acupuncture will be compared to placebo acupuncture. A total of 60 (30 per group) patients scheduled for elective TEE in order to exclude a cardiac embolic source, endocarditis or for valve failure evaluation will be recruited according to patients\u2019 selection criteria and receive either indwelling fixed intradermal needles at acupoints CV24 and bilateral PC6 or placebo needles at the same areas. Patients, the practitioners who will perform the TEE procedure, and the assessor of the outcome measures will be unaware of the group\u2019s (real or placebo) allocation. Results: The primary outcome is the intensity of gagging, measured using verbal rating scale (VRS-11) from 0 = no gagging to 10 = intolerable gagging. Secondary outcomes include the incidence of gagging, the use of rescue medication, patients\u2019 satisfaction with relief of unwanted side effects during TEE procedure, success of patients\u2019 blinding (patients\u2019 opinion to group allocation), heart rate and oxygen saturation measured by pulse oxymetry. Conclusions: To study the effects of acupuncture against gagging during TEE, we test the needling of acupoints CV24 and PC6 bilaterally. A placebo acupuncture is used for the control group. Trial registration number: NCT NCT0382142.<\/jats:p>","DOI":"10.3390\/medicines7040017","type":"journal-article","created":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T15:37:21Z","timestamp":1585755441000},"page":"17","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Acupuncture for Relief of Gag Reflex in Patients Undergoing Transoesophageal Echocardiography\u2014A Protocol for a Randomized Placebo-Controlled Trial"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6173-5436","authenticated-orcid":false,"given":"Taras I.","family":"Usichenko","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, University Medicine of Greifswald, 17475 Greifswald, Germany"},{"name":"Department of Anesthesia, McMaster University, Hamilton, ON L8S 4K1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"M\u00fcller-Kozarez","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medicine of Greifswald, 17475 Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Knigge","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University Medicine of Greifswald, 17475 Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raila","family":"Busch","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medicine of Greifswald, 17475 Greifswald, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), 17475 Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Busch","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University Medicine of Greifswald, 17475 Greifswald, Germany"},{"name":"German Center for Cardiovascular Research (DZHK), 17475 Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/S0140-6736(95)90584-7","article-title":"Pharyngeal sensation and gag reflex in healthy subjects","volume":"345","author":"Davies","year":"1995","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1136\/jnnp.61.1.96","article-title":"Palatal and pharyngeal reflexes in health and motor neuron disease","volume":"61","author":"Hughes","year":"1996","journal-title":"J. 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