Intra-Individual Comparison of 3 Various Pre-Treatments for Reducing the Retching Irritation (Gag-Reflex) During Laryngoscopy

H. P. Ogal 1, H. Hammermann 2, C. Schellenberg 1, J. Henning 3, R. Luedke 4, S. Duennes 1, W. Krumholz , 3, H. Glanz 2, G. Hemelmann 1
Department of Anaesthesiology and Intensive Care Medicine, Justus-Liebig-University, Giessen, Germany

Department of ENT, Justus-Liebig-University ,Giessen, Gerrnany 2
Department of Psychology, Justus-Liebig-University,Giessen ,Germany 3
Institute of Medical Information Processing, University of Tuebingen, Germany 4
Department of Anaesthesiology, Bethlehem Hospital, Stolberg, Gerrnany 5


In this case, acupuncture at Ren Mai 24 was compared to the usual procedure (Lidocain spray). 36 patients with increased retching reflex (gag-reflex) were chosen and each pa-tient in the experimental randomized 3×3 cross-over design was laryngoscopied three times.

The investigational process was standardized. Objective and subjective stress indicators (heart rate, salivary cortisol, visual analog scale) were compiled and intra-individually evaluated. The following pre-treatments were randomized and blind studied:

– Acupuncture at Ren Mai 24
– Topical anaesthesia with lidocain spray
– Control group without pre-treatment Results:
– The group with acupuncture at Ren Mai 24 (p<0.005) as well as the group with topical anaesthesia with lidocain spray (p<0.01) differed significantly from the control group.


In the present investigation of patients with a pathological increased retching reflex (gag-reflex), there was a significant reduction of the retching reflex, which was obtained by applying the acupuncture of the Ren Mai 24 (p<0.005) spot as well as the usual method (topical anaesthesia with lidocain spray) (p<0.01). The advantages of acupuncture treatment are the maintained aspiration protection, the time-restrictable effect, non-occurrence of dysaesthesia (burning, choking) and the possible application of an additional topical anaesthesia in cases of insufficient effect.


Chen Y. , Deng L. ( 1989) Essentials of Contemporary Chinese Acupuncturist’s clinical experiences. Foreign Languages Press; Beijing
Gleditsch J. ( 1997) Akupunktur in der HNO-Heilkunde, Hippokrates, Stuttgart
Kirschbaum C., Strasberger C., Jammers W., Hellhammer D. (1989) Cortisol and Behavior; Adaptation of a radioimmunoassay kit for reliable and inexpensive salivary cortisol determination. Pharmacology Biochemistry & Behavior. 34: 747-751
Ren X. ( 1997) Making an impression of a maxillary edentulous patient with gag reflex by pressing caves. J-Prosthet-Dent. 78(5): 533
Rose R., Hurst M. (1975) Plasma cortisol and growth hormone responses to intravenous catheterization. J-Human Stress 1 : 22-36