The use of electrophoresis. Therapeutic effects of drug electrophoresis

Electrophoresis is a physiotherapeutic procedure based on the simultaneous effect of electricity and a drug on the tissues of the body. Electric current has an irritating effect on peripheral nerve fibers, along which impulses propagate to the autonomic nervous system. Injected through intact skin, the drug interacts with the cells of the body. This option of physiotherapy provides the effect of a pharmacological agent on the entire body due to the uniform flow of active substances into the blood and lymph.

The principle of electrophoresis is based on the polarity of the particles. Under the influence of a direct electric current, the molecules of the active substance move along the trajectory of the propagation of electricity from one electrode to another. Some drugs are administered from only one pole, others can be administered from both. In order to properly perform electrophoresis, strict adherence to the algorithm for performing physiotherapy is necessary. Otherwise, the therapeutic effect will not be achieved.

General principles

Electrophoresis through intact skin is carried out in two versions. In the first variant, a pad is wetted with the drug, which is placed on the skin at the site of the electrode. There are pads that initially contain a medicinal substance. This greatly facilitates the procedure and is convenient for those who conduct electrophoresis at home. The second embodiment is distinguished by the fact that the active substance is in solution, which is filled in a special container, the patient's hands or feet are placed in it. This method allows you to enter a larger amount of the drug, since the solution comes into contact with a large area of the skin.

In medical institutions, electrophoresis is performed through the mucous membranes. The cavity organs (stomach, bladder, rectum, vagina) are filled with a solution of the drug. This method allows you to influence the entire mass of the target organ.

Electrophoresis is the same method of administering medications as intramuscular, intravenous injections.

A complex of substances penetrates into the body, which have an impact on metabolic processes in tissues. In the presence of hypersensitivity or an allergic reaction in the past to the components of the drug, their administration by electrophoresis is contraindicated.

Methodology

The standard electrode for electrophoresis is represented by a metal or fabric plate. For the procedure in the neck area, electrodes in the form of a collar are used. If it is necessary to influence small areas of the body (for example, the nose), then smaller electrodes are used.

Before starting the procedure, the nurse must warn the patient about the sensations that arise during its implementation. A burning or tingling sensation may occur. If the sensations become acute, intense pain appears, then a change in the therapy regimen or its termination may be necessary. Properly done procedure is accompanied by pleasant sensations.

There is an important rule. Electrophoresis is not performed on areas with damaged skin. Also, it cannot be performed in the presence of birthmarks or pigmented nevi in the target area.

The technique of applying electrodes depends on the location and size of the affected area, the nature of the disease. If a transverse arrangement is provided, then the electrodes are applied on opposite surfaces of the body (for example, the abdomen and back). In the longitudinal position, the electrodes are located on the same surface, but one is somewhat closer to the pathological focus, the other further. This method is suitable for affecting the limbs, the spine. The duration of the procedure is 15-30 minutes.

Physiotherapy using electrophoresis is carried out mainly by the following devices: Potok-1, GR-2, GK-2, Elfor, Elfor-Prof. These devices are small, so it is possible to perform procedures at home. Self-administration of procedures is not recommended, as supervision by specially trained nursing staff is necessary for the correct implementation.

Examples of drug electrophoresis

In pulmonology, surgery and orthopedics, the practice of electrophoresis with enzyme preparations and hormones is common. One of the most commonly used enzymes is hyaluronidase, which is marketed under the trade name "Lidase". In addition, there is hyaluronidase with the addition of specific components that provide a longer effect - the drug "Longidase".

In order to allow penetration of large molecules such as enzymes through the skin, the use of buffer solutions is necessary. Usually, solutions of acids (for lidase) or alkalis (for enzymes such as trypsin, chymotrypsin) are used for this purpose. Also, an alkaline buffer is necessary to ensure effective electrophoresis of hormones (for example, hydrocortisone).

To achieve a greater effect, combined agents are used. For example, the drug "Karipain" is a complex of papain, chymopapain, collagenase, lysozyme, proteinase and bromelain. It is used for diseases of the joints (arthritis, arthrosis, contractures), spine (hernia, osteochondrosis in the lumbar region and neck).

For pain in the spine in neurological practice, electrophoresis with novocaine is used. Buffer solutions are not required for this procedure. It is possible to administer a pure preparation. Usually a 0.25-5% solution is used.

In pulmonology, physiotherapeutic treatment is practiced for acute and chronic pathologies during the period of convalescence.

Important! The use of any methods of physiotherapy, including electrophoresis, in the acute phase of the disease is strictly prohibited.

During recovery from pneumonia, exacerbations of chronic obstructive pulmonary diseases, bronchitis, electrophoresis with aminofillin, novocaine, lidase is used.

Electrophoresis Options

Medicinal electrophoresis according to the method of Vermel. The patient is in the supine position. One large electrode is placed on the back between the shoulder blades. Electrodes with opposite poles are fixed in the region of the calf muscles.

The Shcherbak technique is usually used for pathology of the cervical or lumbar spine. A conventional rectangular electrode is applied to the lumbar region. The second in the form of a collar wraps around the neck and descends to the chest.

In the complex pathology of the hip joints, electrophoresis of the panty zone according to Shcherbak is used. One of the electrodes, as in the previous version, is on the lower back. The other two are in the projection of the hip joints on the anterior surface of the thigh.

Special options include electrophoresis of the face, eyes, wound areas, nose, and sympathetic ganglion areas. In gynecological practice, cavity electrophoresis is used, in which one of the electrodes is located on the lumbar region, and the other in the vaginal cavity. In proctology and urology, it is possible to use a rectal electrode for the treatment of chronic inflammatory diseases of the perirectal tissue, bladder, and prostate.

Features in children

In pediatrics, electrophoresis is used for the same indications as for adult patients. However, the child's body, to a greater extent than an adult, consists of water, and, consequently, of electrolyte solutions. In addition, in a child, the skin has little resistance. The galvanic current used for electrophoresis has a faster and more pronounced effect. Therefore, a separate calculation method is used in dosing procedures.

Before the procedure, it is necessary to carefully examine the child. The presence of diathesis, pustular diseases, skin lesions is a contraindication for electrophoresis. After the procedure, it is necessary to treat the place of application with petroleum jelly or baby cream. Parents should monitor the condition and behavior of their child both in a medical institution and at home. Disturbance of appetite, sleep, restlessness or lethargy indicate possible side effects of electrophoresis itself or drugs that are administered with it.

Safety

Electrophoresis is a procedure using electric current. Despite the fact that direct current is supplied to the electrodes, in most cases the device is connected to an alternating current network. Any malfunction in the device can cause electrical injury. Therefore, conducting electrophoresis on your own at home is not recommended. If it is impossible to visit medical institutions, it is preferable to contact centers that provide home visit services.

An incorrectly selected dose of current can cause skin burns. If a burning sensation or intense pain occurs, the procedure is stopped. The device turns off. The burn site is treated with a solution of potassium permanganate or an alcohol solution of tannin.

In the office where electrophoresis is performed, there must be a first aid kit in case of anaphylactic shock.

It contains: a solution of adrenaline 0.1%, prednisolone or dexamethasone in ampoules, ampophylline, antiallergic drugs (diazolin, loratadine), a bottle with a 0.9% sodium chloride solution, syringes, systems, tourniquet. The staff of the physiotherapy room must be able to provide assistance with complications of an allergic nature.

Conventional galvanization is now gradually giving way to the method of drug electrophoresis - the introduction of medicinal substances into the body using direct current. In this case, two factors act on the body - the drug and the galvanic current.

In solution, as well as in tissue fluid, many medicinal substances decompose into ions and, depending on their charge, are introduced during electrophoresis from one or another electrode. Penetrating during the passage of current into the thickness of the skin under the electrodes, medicinal substances form the so-called skin depots, from which they slowly enter the body. Medicinal substances can be in the skin from 1-2 to 15-20 days. The duration of deposition is largely determined by the physicochemical properties of substances and their interaction with skin proteins. The medicinal ions in the skin are a source of long-term nerve impulses, which also contributes to a longer action of medicinal substances.

However, not all medicinal substances can be used for electrophoresis. Some drugs under the influence of current change their pharmacological properties, may decompose or form compounds that have a harmful effect. Therefore, if it is necessary to use any substance for drug electrophoresis, one should study its ability to penetrate the skin under the action of galvanic current, determine the optimal concentration of the drug solution for electrophoresis, and the characteristics of the solvent. The concentration of most medicinal solutions used for electrophoresis is 1-5%.

Metal ions, as well as positively charged particles of more complex substances, such as calcium, magnesium, sodium, novocaine, quinine, vitamin Biz, are introduced into the tissues of the body from the gasket of the positive electrode (anode). lidase, dikain, diphenhydramine, etc. acid radicals and negatively charged particles of complex compounds, such as chlorine, bromine, iodine, penicillin, salicylate, eufillin, hydrocortisone, nicotinic acid, are introduced into the electrode (cathode) (Table 1).

Table 1 - List of medicinal substances recommended for electrophoresis

Medicine	Input ion (substance)	Solution concentration	Polarity
Adrenaline hydrochloride	Adrenalin	0.1% (0.5-1 ml per gasket)
Analgin	Analgin
Vitamin B 12	cyanocobalamin
Gangleron Heparin sodium salt	Gangleron	5000-10000 units per procedure
Hyaluronidase	Hyaluronidase	0.1-0.2 g per 30 ml acidified (up to pH 5.0- 5,2) distilled water or acetate buffer
hydrocortisone succinate (water soluble)	Hydrocortisone	The contents of the ampoule are dissolved in a 0.2% soda solution or alkalized (up to pH 8.5-9.0) water
Therapeutic mud	Dirt Components	Native or mud solution


Diphenhydramine	Diphenhydramine
	organic sulfur
Potassium (sodium) iodide	Potassium (sodium) iodine
Potassium (sodium) chloride	Potassium (sodium) chloride
calcium chloride	Calcium chlorine
Ascorbic acid	Ascorbic acid
Aminocaproic acid	Aminocaproic acid
Aspartic acid	Aspartic acid	1-2%, prepared with alkalized (pH 8.9) distilled water
Nicotinic acid	Nicotinic acid
Xicaine (lidocaine)
		0.1 g per 30 ml of acetate buffer or acidified (pH 5-5.2) distilled water 1-5%
Lithium (carbonate, benzoate)
Magnesium sulfate
copper sulfate

Methionine	Methionine	0.5-2% a) on acidified (up to pH 3.5-3.6) water; b) on alkalized (up to pH 8.0-8.2 water)
Sodium paraaminosalicylate	Sodium para-aminosalicylic acid
Sodium salicylate	Salicylic acid
Neomycin sulfate	Neomycin	5000-10000 U/ml
Novocaine hydrochloride	Novocaine

Norsulfazol-sodium	norsulfazol

Oxytetracycline Dehydrate (Terramycin)	Oxytetracycline	0.25-0.5 g per procedure
Oxytetracycline hydrochloride	Oxytetracycline	0.5-1.0 per procedure
Panangin	Aspartic acid radical
papaverine hydrochloride	Papaverine
Penicillin sodium salt	Penicillin	5000-10000 U/ml

Sulfadimezin	Sulfadimezin	1-2%, prepared with dilute hydrochloric acid 2-5%, prepared with alkalized distilled water (pH 8.5-8.7)

Tetracycline hydrochloride	Tetracycline	5000-10000 U/ml
Thiamine bromide	Thiamine (vitamin B,)
Trimecain	Trimecain
		5-10 per procedure prepared with acidified distilled water
zinc sulfate
Aloe extract liquid	Biologically active substances and inorganic ions
Erythromycin	Erythromycin	0.1-0.25 g per procedure: prepared with 70% alcohol
Eufillin	Theophylline
Ephedrine hydrochloride

When using complex chemical compounds containing several ions of opposite charge (mineral water, therapeutic mud and mud solution), both electrodes are active, i.e. ions of these compounds are introduced simultaneously from two poles.

The introduction of medicinal substances by electrophoresis has a number of advantages over conventional methods of their use:

1) the medicinal substance acts against the background of the electrochemical regime of cells and tissues changed under the influence of galvanic current;

2) the medicinal substance comes in the form of ions, which increases its pharmacological activity;

3) the formation of a "skin depot" increases the duration of the drug;

4) a high concentration of the medicinal substance is created directly in the pathological focus;

5) the mucous membrane of the gastrointestinal tract is not irritated;

6) the possibility of simultaneous administration of several (from different poles) medicinal substances is provided.

Due to these advantages, drug electrophoresis is increasingly used, including in the treatment of diseases of the cardiovascular system, in oncological practice, and in the treatment of tuberculosis. New promising developments of this therapeutic method are emerging, for example, electrophoresis of medicinal substances from solutions previously introduced into the abdominal organs.

However, there are also limitations for the use of electrophoresis, primarily due to the characteristics of the medicinal substances themselves. Many of them are electrically neutral, have low electrophoretic mobility or lose their activity under the influence of an electric current.

Indications for the use of drug electrophoresis consist of indications for galvanization and tolerability of prescribed drugs. Contraindications are similar to those: for galvanization, taking into account the individual tolerance of the medicinal substance.

Dosage

The intensity of exposure during galvanization and drug electrophoresis is determined by the current strength used, expressed in milliamps (mA). The calculation of the maximum allowable current strength is carried out in terms of current density, i.e., the current strength per 1 cm2 of the active electrode area<мА/см2). Чтобы рассчитать максимальную силу тока, следует значение его плотности умножить на площадь электрода, т. е. величину поверхности прокладки. Выбор значения плотности тока зависит от площади активного электрода, места воздействия, индивидуальной чувствительности к току, возраста и пола больного. Чем больше площадь электрода, тем меньше должна быть плотность тока. Если используются электроды разной площади, то для расчета силы тока учитывают площадь меньшего электрода. В случаях, когда катод или анод представлены сдвоенным электродом, для расчета берут сумму площадей этих электродов. Плотность тока при общих и сегментарных воздействиях не должна превышать 0,01-0,05 мА/см2, а при местных процедурах - 0,05-0,1 мА/см2, для детей дошкольного возраста - 0,03 мА/см2, школьного - 0,05 мА/см2.

When dosing direct current, it is necessary to take into account the sensations of the patient. During the procedure, the patient should experience a slight tingling sensation in the area where the electrodes are applied.

The duration of the procedure may vary:

10-15 minutes with general and reflex-segmental methods of exposure and 30-40 minutes with local ones. The course of treatment is 10-20 procedures, daily or every other day.

Equipment

The source of direct current during galvanization are devices in which the alternating current of the industrial lighting network is rectified and smoothed, then it is supplied to the patient through flexible insulated wires, at the ends of which clamps are fixed, connected to electrodes. The current strength is controlled by a milliammeter, which provides for switching the used current strength to 5 or 50 mA.

Rules for the operation of galvanizing devices are the same. As an example, we give a description of one of the Potok-1 devices.

The Potok-1 portable device operates on AC mains with a frequency of 50 Hz at a voltage of 127 or 220 V. The device is manufactured according to protection class II and does not require grounding.

An attachment can be attached to the device, which allows it to be used for galvanization of limbs using chamber baths. When a doctor prescribes a galvanization or drug electrophoresis procedure, the name of the method, the name of the drug, the concentration of the solution, the pole of administration, the site of exposure, the technique, the current strength (mA), the duration (min), intervals (daily or every other day), the number of procedures per a course of treatment.

Methodology

After reviewing the appointment of a physiotherapist, the nurse must prepare the patient for the procedure.

Galvanization and drug electrophoresis is carried out with the patient lying down or sitting, depending on the purpose. The nurse needs to examine the surface of the skin at the site of the electrodes. The skin should not have abrasions, scratches or other damage. Contaminated greasy skin before the procedure must be washed with warm water and soap or cleaned and degreased with cotton wool soaked in alcohol. On the corresponding part of the patient's body, electrodes are placed, consisting of a metal plate, usually lead, and a wet, hydrophilic cloth pad.

Lead plates should be even and smooth (for this they are smoothed with a metal roller), the edges should be rounded, the thickness of the plates should be 0.3-1 mm. Over time, the plates become coated with lead oxide, which impairs electrical conductivity, and therefore they should be periodically cleaned with sandpaper. Currently, electrodes made of conductive (graphitized) fabric of various shapes and sizes are becoming more common. Most often, rectangular electrodes are used, as well as electrodes in the form of a half mask, collar, or special electrodes for abdominal procedures (vaginal, rectal, etc.).

Hydrophilic pads should correspond to the shape of the plates and protrude beyond their edges by 1-2 cm from all sides. They protect the skin from the damaging effects of electrolysis products, increase its electrical conductivity, and ensure good contact of the electrodes with the patient's body. Gaskets are made from white flannel, baize, calico and other hydrophilic fabrics. They look like a notebook made up of 8-16 layers of fabric.

To carry out the procedure, the pads are moistened with warm water, squeezed out, electrodes are inserted into them, placed on the corresponding areas of the skin and fixed with rubber bandages, sandbags or the weight of the patient's body. After applying the electrodes, the patient lying on the couch is covered with a sheet or a light blanket. At the same time, the electric wires going from the patient to the device should not sag and stretch.

The electrical wires connected to the electrodes are connected to the device according to the polarity indicated in the doctor's prescription.

Before turning on the device, the voltage switch should be set to the position corresponding to the mains voltage (127 or 220 V), the current intensity regulator knob to the “O” position, the milliammeter shunt switch to the “5” or “50” position, respectively, the current strength indicated at the doctor's prescription. To turn on the device, insert the plug into the mains socket, turn the switch to the “On” position, after which the signal light on the device panel lights up. Then, slowly and smoothly turning the handle of the current strength regulator, observing the readings of the milliammeter and focusing on the patient's sensations, set the current strength necessary for the procedure. During the procedure, the patient should feel a slight burning sensation, tingling in the area where the electrodes are applied, about which he should be warned. If there is a strong burning sensation, a painful sensation under the electrodes, the current strength should be reduced, and if these phenomena do not disappear, then the procedure should be interrupted and a doctor should be called or the patient should be referred to him.

Depending on the place of application of the electrodes, transverse and longitudinal methods are distinguished. With the transverse method, the electrodes are located opposite each other on opposite parts of the body, while the current acts on deep-lying tissues, with the longitudinal method, the electrodes are located on one side of the body, superficially located tissues are affected.

A special technique is the impact of galvanic current in chamber baths. In this case, the patient places the limbs in earthenware baths, which are filled with water. In ophthalmic practice, eye baths are used for galvanization and electrophoresis.

After the end of the procedure, the handle of the current strength regulator is slowly and smoothly turned counterclockwise to the zero position of the potentiometer arrow, the switch is turned to the “Off” position, and the electrodes are removed from the patient. In children, under the influence of galvanic current at the location of the electrodes, the skin coarsens and becomes dry, cracks may form, therefore, after each procedure, it should be lubricated with a nourishing cream or glycerin, diluted by half with water. After each procedure, the hydrophilic pads must be washed under running water and sterilized by boiling at the end of the day. Moreover, gaskets for galvanization and drug electrophoresis, depending on the charge of the ion, are sterilized separately.

electrophoresis- This is a physiotherapeutic procedure in which the human body is exposed to constant electrical impulses in order to provide a general and local therapeutic effect. Also, with the help of electrophoresis, drugs are administered through the skin and mucous membranes. This route of drug administration has a number of advantages over other methods of administration.

There are the following main routes of administration of drugs:

using electrophoresis;
injection route ( intramuscularly, intravenously, intradermally, subcutaneously);
oral route ( through the mouth).

Each of the above methods has both advantages and disadvantages.

Administration method	Advantages	Flaws
*With the help of electrophoresis*	painlessness of the procedure; there are practically no side effects and allergic reactions; the therapeutic effect of the administered drug can last from one to twenty days; the possibility of administering the drug directly to the focus of inflammation; when administered, the drug does not pass through the gastrointestinal tract and is not destroyed in it.	not all drugs can be administered by this method; There are a number of contraindications to this procedure.
*Injection route*	the administered drug does not irritate the gastrointestinal tract; the drug enters immediately into the general circulation, due to which the therapeutic effect of the drug occurs quite quickly ( within 10 - 15 minutes); the ability to administer the exact dose of the drug.	soreness of the procedure; risk of developing complications such as thromboembolism ( due to the introduction of air into the bloodstream), phlebitis ( inflammation of the vein wall).
*oral route*	assistance is not required to administer the drug; convenient and painless method of administration.	has a slow therapeutic effect, since before entering the general circulation, the drug must pass through the intestines and liver; hydrochloric acid in the gastrointestinal tract, as well as liver enzymes, partially destroy the drug, thereby weakening its therapeutic effect.

History of electrophoresis

In 1809, the German scientist Ferdinand Reiss, who was invited to Moscow University to head the Department of Chemistry, first mentioned such concepts as electrophoresis and electroosmosis ( movement of solutions through capillaries when setting an external electric field). However, the phenomena studied by the scientist were not widespread, as is believed due to the fire that occurred in 1812, in which most of the works were destroyed.

Subsequently, the Swedish biochemist Arne Tiselius published a work in 1926 in which he described a U-shaped quartz tube designed for electrophoresis, then in 1930 the tube material was replaced with silver chloride.

In 1936, thanks to the availability of a good base of research and experimental work, the first apparatus for electrophoresis was developed. The shape of the previously proposed tubes was changed to narrow cells and then to glass sections. These changes made it possible to increase the optical susceptibility and more effectively eliminate the heat produced by the passage of an electric current.

In practice, A. Tiselius tested the device for the first time, thanks to the study of horse serum. After exposure to electrophoresis after a while, the scientist noticed four bands separated from each other. It was the migration of blood proteins, three globulins ( alpha, beta and gamma) and albumin ( globulin and albumin are plasma proteins). Subsequently, similar tests were carried out on human and rabbit sera, in which similar results were also observed.

This made it possible to establish that in a liquid medium, molecules with an electric charge, under the influence of an electromagnetic field, move to the region opposite to the charged electrode.

After some time, A. Tiselius, in addition to the electrophoresis apparatus, began to use an ultracentrifuge, which made it possible to more accurately differentiate the migration of proteins and calculate the conditional amount of proteins in the composition.

In 1950, a more modern method was described, which consisted in dividing proteins on filter paper, which was subsequently cut into strips, where dyes were added, and the content of proteins in these solutions was examined. It should also be noted that this method made it possible to record the migration of proteins, which was previously impossible, since after turning off electrophoresis, they merged again.

The presented experimental works of A. Tiselius were subsequently widely used in medicine.

For example, this research method allows to identify protein abnormalities and is currently widely used by many countries for diagnosis:

infectious and inflammatory diseases;
genetic and immune disorders;
malignant tumors.

Also today, electrophoresis, in which protein solutions and sols are used ( colloidal solutions), is a physiotherapeutic method of treatment and prevention of many diseases.

The mechanism of the therapeutic action of electrophoresis

Electrophoresis is carried out using various devices, one of which is the "Flow". This device has been used in modern physiotherapy for more than fifty years. The Potok electrophoresis apparatus has two holes for electrodes ( with plus and minus signs), buttons for setting the required time, as well as a current regulator. Its modern analogue is equipped with digital indicators that display a certain procedure time, as well as a given current strength.

Note: The purpose of the method of this treatment is carried out only after consulting a doctor.

During the consultation, the doctor collects an anamnesis ( medical history) of the patient and prescribes certain examinations to exclude the presence of contraindications for electrophoresis. After confirming the possibility of electrophoresis, the patient is allowed directly to the procedure itself.

Before the procedure, the medical worker examines those parts of the patient's body, on which pads with electrodes will subsequently be applied. In places where pads are applied, the patient's skin should be clean, without any neoplasms or damage ( e.g. pustular lesions, moles). Gaskets, in turn, are soaked in a solvent; it is usually saline or water. Then the drug is prepared and applied to the pad.

Note: As a gasket, a hydrophilic material or gauze folded in several layers wrapped in filtered paper is used.

For the upcoming procedure, it is necessary to dissolve the medicinal substance in saline ( aqueous solution of sodium chloride 0.9%). To do this, it is necessary to warm the prepared solution to body temperature and, by drawing ten milliliters into the syringe, inject it into the vial with the necessary drug. Then you should shake the bottle slightly and add an anesthetic and anti-inflammatory agent to it, for example, 0.5 ml of Dimexide. The finished medicine is drawn into a syringe and distributed on a pre-prepared gasket.

Note: This gasket will be connected to the plus.

On the second pad ( which will be connected to negative) another medicinal substance is poured, as a rule, Eufillin 2% is used. Eufillin improves blood circulation, which leads to saturation of organs and tissues. Moreover, this drug relaxes smooth muscles and combines analgesic properties, due to which it is especially effective for muscle pain.

Then the pads are applied to the affected parts of the patient's body and electrodes are attached to them. In case of diseases of the cervical or thoracic spine, a gasket with a positive electrode is applied directly to the affected area of the body, and a gasket with a negative electrode is placed on the lumbar region. If electrophoresis is to be carried out in the lumbar region, then a pad with a positive electrode is placed on the lumbar region, and a pad that is connected to the minus is placed on the thighs of the legs. After applying, the gaskets are fixed with a load ( usually use special sandbags) and the patient is covered with a sheet.

There are also other methods of electrophoresis, in which the method of applying a medicinal substance, the procedure for applying electrodes and the type of electrical effect differ.

There are the following ways of using electrophoresis:

bath;
interstitial;
cavity.

Tray method
into container ( bath) with built-in electrodes, a solution and the necessary medicinal substance are poured, after which the patient immerses the affected part of the body there.

Interstitial method
Via other routes of administration for example, orally or intravenously) a drug is administered to the patient and electrodes are applied to the diseased area of \u200b\u200bthe body. The method is especially effective in diseases of the respiratory system ( e.g. laryngitis, bronchitis).

cavity method
A solution with a medicinal substance is introduced into the vagina or rectum of the patient, and an electrode is also brought inside. An electrode of a different polarity is attached to the outer surface of the body. This method is used for diseases of the pelvic organs and the large intestine.

During the procedure, the medical worker gradually adds current, while being interested in the patient's well-being. The current regulator is fixed when the patient feels a slight tingling sensation. If the patient feels burning or itching during electrophoresis, the procedure should be stopped immediately.

The procedure usually takes ten to fifteen minutes. The duration of the course, as a rule, includes ten to twenty procedures daily or every other day.

For electrophoresis, there are also the following devices:

"Elfor";
"Elfor Prof";
Potok-1 and others.

Under the action of electrophoresis, the drug substance is converted into electrically charged particles ( ions), which move through the skin. The main part of the drug lingers here, providing a local therapeutic effect to a greater extent. Another part of the drug enters the tissues of the body through certain areas of the skin and spreads throughout the body with the flow of blood and lymph.

The penetration of drugs into the body is carried out through the following components of the skin:

excretory ducts of sweat glands;
excretory ducts of the sebaceous glands;
hair follicles;
intercellular spaces.

A good therapeutic effect of any drug administered by electrophoresis depends on the degree of absorption of the drug.

The quality of absorption of the drug can be affected by the following factors:

patient's age;
place of impact;
the duration of the procedure;
solvent properties;
dose and concentration of the administered drug ( as a rule, the concentration of the solutions used for the procedure is from one to five percent);
strength of electric current;
the charge and size of the ion;
individual tolerance.

It should be noted that positively and negatively charged particles of the administered drug have different therapeutic effects on the body.

Therapeutic effect of positively charged particles	Therapeutic effect of negatively charged particles
anti-inflammatory	secretory ( biologically active substances are produced and released into the general circulation)
anesthetic	relaxing ( usually for muscles)
dehydrating ( effective for edema)	vasodilating
calming	normalization of metabolism

What drugs can be used for electrophoresis?

In electrophoresis, the drug, depending on the charge present, is injected through the positive ( anode) or negative ( cathode) poles.

In electrophoresis, only those drugs are used that, under the influence of current, are able to penetrate the skin. The drugs can be administered either alone or in combination with other agents to enhance the therapeutic effect.

The main medicinal substances that are administered through the positive pole ( anode)

Name of the drug	Indications	Expected effect
*Aloe*	It is used for ophthalmic diseases, for example, uveitis, conjunctivitis and keratitis, as well as for diseases such as bronchial asthma, gastric and duodenal ulcers. For skin lesions ( e.g. trophic ulcers, burns)	Improves metabolism and cell nutrition, which helps to accelerate the regeneration process ( recovery) tissues. Also, this drug stimulates local immunity and has an anti-inflammatory effect.
*Adrenaline hydrochloride*	It is used in ophthalmology for increased intraocular pressure, as well as for open-angle glaucoma. Epinephrine during electrophoresis is added to solutions of local anesthetics ( e.g. novocaine).	With increased intraocular pressure, the use of adrenaline helps to reduce it. In bronchial asthma, it contributes to the expansion of the bronchi. It also has a vasoconstrictive effect, provokes vasoconstriction of the abdominal organs, skin and mucous membranes.
*Atropine*	It is indicated for pain, peptic ulcer of the stomach and duodenum, bronchial asthma, as well as for inflammatory diseases of the eyes ( e.g. iridocyclitis, keratitis).	Decreases secretion of glands ( e.g. sweat, gastric, bronchial), and also reduces the tone of smooth muscles. The drug is added to solutions of painkillers to eliminate pain.
*Vitamin B1*	It is used for various diseases of the nervous ( e.g. neuritis, sciatica, paresis, paralysis) and digestive system ( e.g. hepatitis, gastric and duodenal ulcers). Also, this drug is used for skin diseases ( e.g. dermatitis, psoriasis, acne) and diseases accompanied by vitamin B1 deficiency.	It has anti-inflammatory, anti-allergic and analgesic effects. Normalizes metabolism, as well as the work of the cardiovascular, digestive and nervous systems.
*Decain*	It is used in diseases accompanied by severe pain syndrome.	It has an anesthetic effect with the elimination of painful sensations. As a rule, it is used in conjunction with other drugs to enhance the medicinal effect ( e.g. adrenaline).
*Diphenhydramine*	Indicated in allergic diseases ( e.g. allergic conjunctivitis, urticaria), sleep disturbance and pain syndrome. It is also used as an addition to the main treatment for bronchial asthma, gastritis and stomach ulcers.	Produces a calming, hypnotic and anti-allergic effect. This drug is used to eliminate pain, in addition, for example, with novocaine. Helps to relax the smooth muscles of the internal organs.
*Calcium*	It is used for diseases in which calcium deficiency is observed. It is used for bone fractures, inflammatory diseases of the oral cavity, allergic diseases, as well as for violations of blood clotting ( with bleeding).	It has a hemostatic, anti-allergic, and anti-inflammatory effect. It also helps to replenish the lack of calcium in the body, which, for example, in case of fractures, accelerates the process of bone regeneration.
*Potassium*	Used for potassium deficiency in the body and for heart disease ( e.g. atrial fibrillation, tachycardia).	It normalizes the water-electrolyte balance, osmotic pressure, and also compensates for the lack of potassium in the body.
*Karipain*	Indicated in diseases of the musculoskeletal system ( e.g. osteochondrosis, joint contracture, sciatica), as well as for burns, postoperative wounds and the presence of keloid scars.	Eliminates pain, has an anti-inflammatory effect. It improves blood circulation at the site of exposure, which accelerates the process of tissue regeneration.
*Codeine*	It is used for pain syndrome, as well as for unproductive cough.	It has analgesic and antitussive effects.
*Lidaza*	The drug is indicated for keloid scars, wounds and ulcers. Used for musculoskeletal e.g. osteoarthritis, osteochondrosis, joint contracture) and eye ( e.g. keratitis, retinopathy) diseases.	The injected drug breaks down hyaluronic acid ( connective tissue thickener), which contributes to the softening of scar tissue. It also reduces tissue swelling and inhibits the development of contractures.
*Lidocaine*	It is used for diseases accompanied by pain syndrome ( for example, with osteochondrosis, neuralgia).	Eliminates pain.
*Lysoamidase*	It is used for infectious and inflammatory diseases such as mastitis, osteomyelitis, stomatitis, endometritis, tonsillitis and others. It is also used for burns and purulent-necrotic skin lesions ( e.g. furuncle, carbuncle, folliculitis).	Inhibiting the vital activity of gram-positive bacteria ( e.g. streptococci, staphylococci, gonococci) accelerates the healing process in infectious diseases. With local exposure, it helps to cleanse the wound from purulent contents and necrotic ( dead) tissues, which will lead to rapid regeneration ( restoration) of affected tissues.
*Magnesium*	It is used with a lack of magnesium in the body, with heart diseases ( e.g. hypertension, arrhythmia, ventricular tachycardia), depression and irritability.	The intake of magnesium in the body has a beneficial effect on the nervous, bone ( strengthens bones, teeth) and muscle ( reduces muscle spasm) systems. Magnesium also normalizes the heart rhythm during arrhythmias.
*copper sulfate*	It is used for anemia, for diseases of the cardiovascular, digestive and musculoskeletal systems. It is also used in such infectious and inflammatory diseases ( e.g. conjunctivitis, urethritis, vaginitis), as it has an anti-inflammatory and disinfecting effect.	Since copper is involved in the biosynthesis of hemoglobin, its use effectively fights anemia. It also participates in the formation of the protein structure of connective bone and cartilage tissue, therefore the use of copper is indicated for osteochondrosis, osteoarthritis and other diseases of the musculoskeletal system.
*Mummy*	Indicated in diseases of the musculoskeletal ( e.g. fractures, dislocations, sciatica) and the respiratory system ( e.g. asthma, bronchitis). It is also effective in skin diseases ( e.g. ulcers, burns) and diseases of the gastrointestinal tract ( e.g. gastric and duodenal ulcers, colitis).	The composition of this drug includes eighty active biological substances ( vitamins, essential oils, amino acids and others), which have anti-inflammatory, analgesic, immunostimulating, and regenerating effects.
*Novocaine*	It is used for diseases accompanied by pain.	It has a local anesthetic effect.
*Papain*	It is used for osteochondrosis, intervertebral hernia, neuritis, as well as for thermal or chemical burns.	It rejects necrotic tissues and cleanses the wound from purulent contents. It produces an anti-inflammatory effect, also accelerates the healing process of tissues.
*Papaverine*	It is used for diseases accompanied by spasmodic conditions ( for example, spasm of the pyloric sphincter of the stomach, urinary tract, bronchospasm).	Eliminates muscle spasm, and also reduces the tone of the smooth muscles of the internal organs. It has a vasodilating effect, which leads to a decrease in blood pressure in hypertension ( e.g. angina pectoris).
*Pachycarpine*	It is indicated for such diseases as endarteritis, ganglioneuritis, and also myopathy.	Helps lower blood pressure by expanding the lumen of arterioles. Causes contractility of the uterine muscles.
*Platifillin*	It is used for hypertension and angina pectoris. It is also used for diseases accompanied by muscle spasms, for example, with stomach and duodenal ulcers, cerebral vasospasm, cholecystitis and bronchial asthma.	It promotes relaxation of smooth muscles, as a result of which it affects the expansion of blood vessels, thereby improving blood circulation and lowering blood pressure.
*Ribonuclease*	Indicated in diseases of the respiratory system ( e.g. exudative pleurisy, bronchitis, bronchiectasis, pneumonia), as well as an anti-inflammatory drug for otitis, sinusitis, osteomyelitis, thrombophlebitis and other diseases.	It produces an anti-inflammatory effect, and also has a thinning effect on sputum, mucus and pus.
*Salicylic acid*	seborrhea, psoriasis, pityriasis versicolor, burn, eczema and others.	It produces an antiseptic, anti-inflammatory and exfoliating effect, which contributes to the rapid healing of affected tissues. Also, this drug inhibits the work of the sebaceous and sweat glands.
*Streptomycin*	It is indicated for infectious and inflammatory diseases, for example, for pneumonia, endocarditis, bacterial diarrhea, urinary tract infections and other diseases.	A broad-spectrum antibacterial drug that has an inhibitory effect on gram-negative ( e.g. Escherichia coli, gonococcus, pneumococcus) and Gram-positive ( e.g. staphylococcus) bacteria.
*trypsin*	Used for diseases of the respiratory system e.g. pneumonia, bronchitis, pleurisy) and ENT organs ( e.g. sinusitis, otitis media). Also indicated for ocular e.g. iridocyclitis, iritis) and skin ( e.g. burns, bedsores, trophic ulcers) diseases.	It has an anti-inflammatory and anti-burn effect, and also rejects necrotic tissues and produces a thinning effect on purulent contents and blood clots. Accelerates the healing process of affected tissues.
*Eufillin*	It is used for hypertension, impaired cerebral and renal circulation, bronchial asthma, as well as for osteochondrosis, osteoarthritis and intervertebral hernia.	Reduces spasm of smooth muscles of internal organs and blood vessels, which helps to lower blood pressure, improves blood circulation and eliminates bronchospasm. It also has an analgesic effect.

The main medicinal substances that are administered through the negative pole ( cathode)

Name of the drug	Indications	Expected effect
*Ampicillin*	Indicated in infectious and inflammatory diseases of the respiratory system ( e.g. pneumonia, bronchitis) and ENT organs ( e.g. otitis media, tonsillitis, sinusitis). It is also used for infectious diseases of the skin, gastrointestinal tract ( e.g. cholecystitis, salmonellosis) and the genitourinary system ( e.g. cystitis, cervicitis, gonorrhea).	Broad-spectrum antibacterial drug. Depresses life ( produces a bactericidal effect) Gram-positive and Gram-negative bacteria.
*Ascorbic acid*	It is used in diseases accompanied by blood loss ( for example, with poorly healing wounds, burns, gastric and duodenal ulcers, colitis), as well as with a lack of ascorbic acid, during the recovery period to strengthen immunity.	Stimulates the body's defenses, accelerates the process of tissue regeneration, normalizes the process of blood clotting. Reduces allergic and inflammatory reactions, and also compensates for the lack of ascorbic acid in the body.
Acetylsalicylic acid(aspirin)	It is used in febrile conditions and in diseases accompanied by pain ( e.g. migraine, neuralgia, osteochondrosis). It is also used to reduce the risk of thrombosis.	It has analgesic, anti-inflammatory and antipyretic effects. It also thins the blood, which reduces the risk of thrombosis.
*Baralgin*	It is indicated for diseases accompanied by painful sensations and spasm of smooth muscles ( e.g. in renal colic, intestinal colic and biliary colic).	A drug that has analgesic and antipyretic effects. It also reduces spasm of smooth muscles.
*Bromine*	It is used for insomnia, irritability, the initial stages of hypertension, as well as for stomach and duodenal ulcers.	Produces a calming effect. Also, in inflammatory diseases accompanied by pain, it has an analgesic effect ( for example, with herpes zoster).
*Heparin*	It is used for varicose veins, as a prophylaxis, if there is a risk of thrombosis. It is also used for injuries, bruises and tissue swelling.	Anticoagulant, the main action of which is aimed at thinning the blood, which reduces the risk of thrombosis. When applied locally, it has an anti-inflammatory and anti-edematous effect. It also improves microcirculation.
*Humisol*	Used in diseases of the musculoskeletal ( e.g. rheumatism, arthritis, arthrosis) and the nervous system ( e.g. plexitis, neuralgia). Also used for eye diseases e.g. blepharitis, keratitis, iritis) and ENT organs ( e.g. otitis media, pharyngitis, rhinitis).	The drug is a biogenic stimulant ( substances of plant and animal origin). It has anti-inflammatory and analgesic effect. It also improves metabolism and accelerates the healing process of tissues.
*Iodine*	It is indicated for skin diseases of an inflammatory nature, as well as for open wounds and abrasions. Also used for atherosclerosis, neuralgia, neuritis, thyroid diseases ( such as hyperthyroidism).	An antiseptic that inhibits the vital activity of bacteria, and also has an anti-inflammatory effect. Affects the metabolism, accelerating the process of their decay. Affects the level of cholesterol, reducing it.
*A nicotinic acid*	Used in diseases of the gastrointestinal tract ( e.g. gastric and duodenal ulcer, gastritis, colitis), as well as in atherosclerosis, angina pectoris, poorly healing wounds, trophic ulcers and diseases accompanied by vasospasm ( for example, with spasm of the vessels of the extremities, brain).	It produces a vasodilating effect, improves blood circulation and reduces the risk of blood clots. It also reduces the level of cholesterol in the blood, which prevents the development of atherosclerosis.
*Panangin*	It is used in diseases of the cardiovascular system ( e.g. arrhythmia, heart failure), as well as with a deficiency of potassium and magnesium in the blood.	Compensates for the lack of magnesium and potassium in the body ( deficiency of these micronutrients increases the risk of developing heart disease). It also normalizes the heart rate.
*Penicillin*	It is used in diseases accompanied by an infectious process ( e.g. gonorrhea, pneumonia, furunculosis). With inflammatory diseases of the ear or eyes, as well as as a preventive measure for the development of an infectious process in case of burns, wounds, as well as in the postoperative period.	A broad-spectrum antibiotic inhibits the activity of gram-positive ( e.g. staphylococcus, streptococcus) and Gram-negative ( e.g. meningococcus, gonococcus) bacteria.
*Sulfur*	Used for skin conditions such as acne, scabies, seborrhea, and psoriasis.	Has an antiseptic is detrimental to fungi and bacteria) and exfoliating effect ( softens rough skin layers). Promotes rapid healing of affected tissues.
*streptocide*	Indicated in infectious and inflammatory diseases of the skin ( e.g. erysipelas, acne, boils), as well as burns and wounds. Used in diseases of the ENT organs ( e.g. angina) and the genitourinary system ( e.g. cystitis).	Broad spectrum antibiotic. Stops growth and development of gram-positive and gram-negative bacteria.
*Tannin*	Used for diseases of the oral cavity ( e.g. stomatitis, gingivitis) and ENT organs ( e.g. pharyngitis). Also indicated for skin diseases ( e.g. trophic ulcers, bedsores) and burns.	An alcohol-containing solution that has an antiseptic and anti-inflammatory effect. It also produces a vasoconstrictor effect, which leads to a decrease in pain.

It should also be noted that there are drugs that can be administered both from the negative and from the positive pole (anode or cathode):

eufillin;
gumizol;
histidine;
lidase;
trypsin and others.

Indications for electrophoresis

Indications for electrophoresis depend on the following factors:

the patient's diagnosis;
the mechanism of action of the drug used;
presence of contraindications.

Electrophoresis is widely used to treat:

diseases of the respiratory system;
ENT diseases ( ear, throat, nose);
diseases of the gastrointestinal tract;
diseases of the cardiovascular system;
diseases of the genitourinary system;
diseases of the nervous system;
diseases of the musculoskeletal system;
skin diseases;
eye diseases;
dental diseases.

Diseases of the musculoskeletal system

osteochondrosis; osteoarthritis; arthritis; spondylosis dislocation; fracture; joint contracture.
*Diseases of the endocrine system*
*Skin diseases*	burn; acne seborrhea; scarring; psoriasis; trophic ulcers; bedsores; dermatitis; folliculitis; furuncle; carbuncle; scabies.
*eye diseases*	iridocyclitis; uveitis; iritis; conjunctivitis; blepharitis; keratitis; optic atrophy.
Dental diseases trace elements, hormones); stimulates the body's defenses; It should also be noted that electrophoresis has adequately proven itself when used in infants. *Electrophoresis in infants can be used in the following cases:* increased or decreased muscle tone; minor neurological disorders; diseases of the musculoskeletal system; diseases accompanied by painful sensations; diathesis; diseases of ENT organs; burns. Contraindications for electrophoresis Like any other physiotherapeutic method, the procedure using electrophoresis has its contraindications. *Contraindications to electrophoresis are:* absolute; in the acute stage (for example, Side effects of electrophoresis To date, the occurrence of serious side effects during electrophoresis has not been identified. However, there is a possibility of allergic reactions to the medicinal substances used during the procedure. Also, excessive or prolonged exposure to electric current on the patient's body can cause redness and irritation of the skin at the site of the pad.

METHODS OF GALVANIZATION AND DRUG ELECTROPHORESIS

1. OSTEOCHONDROSIS OF THE SPINE

Osteochondrosis of the spine is one of the most common diseases of the musculoskeletal system. The reason for its development is malnutrition and the gradual degeneration of the intervertebral discs, which are an elastic and elastic gelatinous “pad” between the vertebral bodies. The intervertebral joints are semi-joints, and their damage caused by osteochondrosis is considered identical to what occurs with deforming osteoarthritis.

With the development of osteochondrosis, the discs become dehydrated, lose their normal structure, and are destroyed. Bone outgrowths - osteophytes - appear along the edges of the vertebrae. As a result, there is a decrease in the height of the vertebrae, infringement of the nerve roots in the intervertebral foramina. This leads to the development of pain in the spine and in the zone of innervation of the strangulated roots on the body and limbs.

The disease often affects the lumbar spine, less often - the cervical and thoracic regions. It develops in middle-aged and elderly people. Its frequency is, according to various estimates, 30-55% among people over the age of 45 years. Contributes to the development of osteochondrosis of the spine, excess nutrition, metabolic disorders, obesity, past spinal injuries.

In the phase of exacerbation of the disease, pain in the spine region increases sharply, radiating along the intervertebral roots, a clinical picture of radiculitis of the lumbar, thoracic or cervical spine occurs. During this period, LE of local anesthetics, analgesics and anti-inflammatory drugs, ganglionic blockers (novocaine, analgin, baralgin, sodium salicylate, benzohexonium, pentamine) is used. Outside the period of exacerbation, patients are shown LE drugs that improve the condition and nutrition of the intervertebral discs and nerve roots, local blood circulation, relieve spasms of muscles and blood vessels (sulfur, zinc, lithium, teonikol, nicotinic acid, aminofillin, bischofite, therapeutic mud or mud wringers) .

1.1. Novocaine electrophoresis

Indications: osteochondrosis of the spine (lumbar, thoracic, cervical) in the acute phase if the patient has radicular pain, sensitivity disorders and blood circulation in the corresponding area.

The technique of carrying out the procedures is the same as with drug electrophoresis of novocaine on the joints, however, the positive electrode (anode) is placed near the spine in the area of maximum pain, and the negative electrode (cathode) is placed in the symmetrically located paravertebral region.

The area of each of the electrodes is 40–60 cm2. A medicinal pad of 3–4 layers of gauze or filter paper moistened with 0.5% ampoule solution of novocaine hydrochloride in an amount of 6–10 ml is placed between the anode and the body. The duration of the procedure is 15–30 minutes. Procedures are carried out daily, with persistent pain 2 times a day. The course is 10-20 procedures, depending on the dynamics of the pain syndrome.

1.2. Electrophoresis of analgin, baralgin or sodium salicylate

Indications: osteochondrosis of the spine (lumbar, thoracic, cervical) in the acute phase with severe radicular pain and inflammatory manifestations.

The procedure is carried out according to the method described in paragraph 2.1., however, an electrode-cathode (-) with a medicinal pad moistened with a 10-fold diluted 50% ampoule solution of analgin, 5% sodium salicylate solution or 2% baralgin in the amount of 6–10 ml. The duration of the procedure is 15–30 minutes. Course - 10-20 daily procedures.

1.3. Electrophoresis of ganglioblockers (benzohexonium or pentamine)

Indications: osteochondrosis of the spine (lumbar, thoracic, cervical) in the acute phase with severe radicular pain, sensitivity disorders, numbness, vascular disorders in the affected area. It is most indicated for lesions of the cervical spine, in which circulatory disorders of the brain are often observed due to compression of the vertebrobasilar artery by the transverse processes of the vertebrae.

The procedure is carried out according to the method described in p. The duration of the procedure is 15–30 minutes. Course - 10-20 daily procedures.

1.4. Sulfur, zinc or lithium electrophoresis

Indications: chronic progressive course of osteochondrosis of the spine outside the period of exacerbation.

Sulfur is part of the complex organic substances that form the basis of the intervertebral discs. The purpose of using LE sulfur is to preserve their integrity and structure. Trace elements zinc and lithium improve the trophism of the intervertebral discs, are necessary for the connective tissue, ligaments, tendons of the paravertebral joints, their articular capsules and joint bags.

The method is performed according to clause 2.1., however, during sulfur electrophoresis, a cathode electrode (-) is installed in the affected area, under which (to the body) a medicinal pad moistened with a 10–30% aqueous solution of ichthyol in an amount of 6–10 ml is placed. During electrophoresis of zinc and lithium, an anode electrode (+) is placed in the affected area, under which there is a medicinal pad moistened, respectively, with a 2% solution of zinc sulfate or a 3–5% solution of lithium chloride in an amount of 4–5 ml. The duration of the procedure is 15–30 minutes. Course - 10-20 daily procedures.

1.5. Bischofite electrophoresis

Indications: see section 2.4. and p. 1.11 (Polyclinic magazine No. 1, p. 56) The rich inorganic (salt) composition of bischofite determines its indication for restoring the properties of intervertebral discs, bone tissue of the vertebrae. Bischofite has a trophic and resolving effect, improves nutrition and blood circulation of tissues, and reduces the severity of pain.

The technique is carried out according to clause 2.1., however, under both electrodes - the anode and the cathode (between them and the body), medicinal pads moistened with a 10% aqueous solution of bischofite are placed. After the electrophoresis procedure, the skin in the affected area is not cleaned and washed from the salt “mantle”, but on the contrary, it is covered with clean gauze napkins and wrapped for 2–8 hours. The duration of the procedure is 15-30 minutes. Course - 10-20 daily procedures.

1.6. Electrophoresis of therapeutic mud (electromud treatment)

Indications: see p. 2.4 and p. 1.10 (magazine "Polyclinic" No. 1, p. 56). Therapeutic mud has a trophic and resolving effect, improves nutrition and blood circulation of tissues, and relieves pain. The packaged gythium mud from the Sestroretsky Kurort deposit is used. Various therapeutic components of the mud have bipolar mobility in an electric field, so mud electrophoresis is carried out from both electrodes - the cathode (-) and the anode (+).

The technique is carried out according to paragraph 2.1., however, under both electrodes - the anode and the cathode, mud cakes are placed, wrapped in 3-4 layers of gauze. The thickness of the mud cake is 2–3 cm, the temperature of the mud is 40°C. The duration of the procedure is 15-30 minutes. Course - 10-20 daily procedures.

1.7. Electrophoresis of vasodilating drugs (teonicol, nicotinic acid, aminophylline)

Indications: osteochondrosis of the spine during a period of moderate exacerbation and without exacerbations, in the presence of circulatory disorders in the area of the corresponding spinal roots, coldness of the legs and feet, the occurrence of numbness and other disorders of skin sensitivity.

The procedure is carried out according to the method described in paragraph 2.1., however, during teonicol electrophoresis, an anode electrode (+) with a medicinal pad moistened with a 5 ml solution of the drug diluted in a 5% solution of the drug is placed on the area of \u200b\u200bmaximum pain.

During electrophoresis of nicotinic acid, an electrode-cathode (-) with a medicinal pad moistened with 2–4 ml of a 1% solution of nicotinic acid is placed on the area of maximum pain. During electrophoresis of eufillin, medicinal pads moistened with 3–5 ml of a 2.4% ampoule solution of eufillin are placed under both electrodes, but an electrode-cathode (-) is placed in the zone of maximum pain. The duration of the procedure is 15–30 minutes. Course - 10-20 daily procedures.

1.8. Bipolar electrophoresis of novocaine and nicotinic acid

Indications: osteochondrosis of the spine during the period of exacerbation and without exacerbations, in the presence of severe pain and circulatory disorders in the area of the corresponding spinal roots, coldness of the legs and feet, the occurrence of numbness and other disorders of skin sensitivity.

The procedure is carried out according to the method described in paragraph 2.1., however, an electrode-anode (+) with a medicinal pad moistened with 4–6 ml of a 0.5% solution of novocaine is placed on the area of maximum pain, and an electrode cathode (-) with a medicinal pad moistened with 2-4 ml of 1% nicotinic acid solution. The duration of the procedure is 15–30 minutes. Course - 10-20 daily procedures.

2. INFLAMMATORY DISEASES OF THE JOINTS: ARTHRITIS, POLYARTHRITIS, RHEUMATOID ARTHRITIS, BECHTEREV'S DISEASE (ANKYLOSING SPONDYLOARTHRITIS)

Inflammatory diseases of the joints (arthritis and polyarthritis) develop as a result of the penetration of microorganisms or their toxins into the joint cavity, as well as the result of various disorders of the body's immunity (autoimmune reactions, allergies). The reasons for the development of inflammation of the joints in some diseases are not fully understood. Inflammation affects the inner (synovial) membrane of the joints. Chronic long-term course of articular inflammation in rheumatoid arthritis, Bechterew's disease leads to the destruction of articular cartilage, the development of coarse connective tissue in the joint. The joints lose their mobility, grow together, the so-called bone ankylosis develops.

Some of the inflammatory diseases of the joints are acute and can be completely cured (gonorrhea, brucellosis, salmonella arthritis). Others are chronic with alternating exacerbations and remissions. During the period of bright exacerbations of inflammatory diseases of the joints, LE is not indicated.

When the exacerbation and moderate severity of arthritis subside, galvanization or LE of novocaine (for pain relief), analgin and sodium salicylate, aminocaproic acid, heparin (to eliminate inflammation), nicotinic acid, aminophylline and theonicol (to improve blood circulation in the joints and provide a resolving effect) are used, lithium (to improve the condition of ligaments, joint bags, tendons), bischofite and therapeutic mud (to improve trophism).

Most of the treatments are described in section 1 of this brochure, with the exception of aminocaproic acid LE and heparin.

2.1. Aminocaproic acid electrophoresis

Indications: arthritis, polyarthritis, rheumatoid arthritis, ankylosing spondylitis during a period of moderate exacerbation of diseases. Aminocaproic acid has an anti-inflammatory effect, normalizes impaired immune function, and helps to eliminate allergies.

Treatment is carried out according to the method described in paragraph 1.1. (Polyclinic magazine No. 1, p. 55), however, under the electrode-anode (+), installed in the area of \u200b\u200bmaximum pain, a medicinal pad is placed from 3-4 layers of gauze or filter paper moistened with 2-8 ml of a 5% solution of aminocaproic acids. The amount of drug, as well as the area of the electrodes, depends on the caliber of the affected joint. The duration of the procedure is 15–30 minutes. Procedures are carried out daily. Course - 8-12 procedures, depending on the reverse dynamics of joint inflammation.

2.2. Heparin electrophoresis

Indications: see section 3.1. Heparin is a natural substance produced in the body of humans and animals, has anti-coagulant and anti-inflammatory effects, normalizes impaired immune function.

Treatment is carried out according to the method described in paragraph 1.1. (Polyclinic magazine No. 1, p. 55), however, between the electrode-cathode (-), installed in the area of \u200b\u200bmaximum pain, and the body, a medicinal pad is placed from 3-4 layers of gauze or filter paper, on which 5000-10000 units are applied (1-2 ml) heparin sodium salt. The amount of drug, as well as the area of the electrodes, depends on the caliber of the affected joint. The duration of the procedure is 15–30 minutes. Procedures are carried out daily. Course - 8-12 procedures, depending on the reverse dynamics of joint inflammation.

3. DISEASES OF PERIARTICULAR TISSUES (BURSITIS, MYOSITIS, TENDOVAGINITIS, EPICONDYLITIS, CANEAL SPUR)

Diseases of the periarticular tissues develop independently, and also as a complication of degenerative-dystrophic and inflammatory diseases of the joints, the consequences of injuries of the musculoskeletal system.

Bursitis(inflammation of the periarticular mucous bags) often accompanies arthrosis, arthritis, polyarthritis of various origins. Symptoms of bursitis are pronounced, but limited in area, swelling near the joint (usually the knee or elbow), swelling, moderate pain, and with purulent bursitis, sharp pain, redness, and a local increase in skin temperature.

Myositis- inflammation of the muscle (group of muscles). It is manifested by swelling and swelling of the muscle, sharp pain when pressing on it, pain during movement. tendovaginitis- inflammation of the sheath of the muscle tendons. Often associated with myositis.

Epicondylitis- inflammation of the periosteum of large protrusions of the long tubular bones of the limbs (ulna, radius, shoulder, femur, lower leg), which are called epicondyles and are located near the joints, at the points of attachment of muscle tendons. Accompanied by local swelling, redness, pain on movement, severe pain on movement.

Heel spurs- bone growths that develop in the region of the posterior and lateral surfaces of the calcaneus in the area of attachment of the Achilles tendon and in the area where its mucous tendon bags are located. It develops as a reactive formation of the periosteum due to chronic mechanical trauma. Manifested by local pain and discomfort at rest and especially during movement. Periodically, an inflammatory reaction occurs in the heel spur area. At the same time, local edema, swelling, redness, and a sharp increase in pain develop.

In case of exacerbation of all diseases of the periarticular tissues, LE painkillers (0.5% novocaine solution) and anti-inflammatory (5% analgin solution or 5% sodium salicylate solution) are used, and when the exacerbation subsides, absorbable (2% potassium iodide solution, 10% bischofite solution, therapeutic mud deposit "Sestroretsky resort") vasodilating (5% solution of theonicol, 1% nicotinic acid).

Update: October 2018

Electrophoresis - refers to physiotherapeutic procedures and more than other methods are practiced for various diseases in adults and children. During the procedure, the human body is affected by electrical impulses (direct current), which are generated by a special device and have a therapeutic effect at the general and local levels. At the same time, drugs are administered through the skin or mucous membranes.

An excursion into the history of electrophoresis

The leading method of physiotherapy would not have been possible without a continuous current generator, which was created by the Italian physicist A. Volta in the 19th century.

The first talk about electroomos, which is the movement of solutions through capillaries when exposed to an electric field, took place as early as 1809. It was then that the scientist from Germany, Ferdinand Reis, first mentioned electrophoresis. However, his research was not widely disseminated.

In 1926, Arne Tiselius, a Swedish biochemist, described the first tube needed for the procedure. The first device for electroprocedures was invented in 1936 - the previously proposed tubes were transformed into more efficient narrow cells, and a little later they were replaced by glass sections. Long-term studies conducted on horse serum made it possible to reveal the mechanism of action of electrophoresis: molecules with an electric charge, under the influence of an electric current in a liquid medium, move to the zone opposite to the charged electrode.

Apparatus for the procedure

Electrophoresis is performed using different devices, but the most famous is Potok, which has been used in physiotherapy for more than 50 years. The structure of the device is simple: holes for electrodes marked + and -, buttons for determining the procedure time and a current regulator.

The devices of the new model are equipped with digital indicators and a display (Elfor, Elfor Prof, etc.)

The general positive effect of the procedure on the body

Reducing the severity of the inflammatory process;
Elimination of edema;
Reduction of pain syndrome;
Stimulation of the production of substances with biological activity;
Relaxation of muscles with the elimination of increased tone;
Calming effect on the central nervous system;
Improvement of blood microcirculation;
Acceleration of tissue regeneration;
Defense activation.

Mechanism of therapeutic action

The action of an electric current leads to the fact that the drug is converted into ions with an electric charge, which penetrate the skin. It is in the skin that the main part of the drug remains, a slightly smaller part is transported through the lymph and blood throughout the body.

Ions with different charges have different effects on the body. So, negatively charged ions have:

secretory effect, i.e. affect the production of substances with biological activity and their entry into the bloodstream;
relaxing effect on smooth muscle tissue;
vasodilating effect;
normalizing effect on metabolism.

Ions with a positive charge have anti-edematous, anti-inflammatory, soothing and analgesic effects.

Areas of the skin involved in drug transport:

excretory ducts of sweat and sebaceous glands;
intercellular areas;
hair follicles.

The efficiency of electrophoresis directly depends on the completeness of drug absorption, which is influenced by the following factors:

the person's age;
the strength of the supplied current;
properties of the solvent in which the drug is dissolved;
concentration and dose of the drug;
ion size and charge;
location of the electrodes;
the duration of the procedure;
individual characteristics of the organism, such as tolerance and susceptibility of the procedure.

How is the procedure carried out

Electrophoresis is carried out in a physiotherapy room by a medical worker. There are devices for home use, for each of which an instruction is developed, which should be strictly observed.

Classical percutaneous method. The nurse examines the parts of the body on which the electrodes will be placed - the skin must be healthy, without moles, damage and inflammatory elements. On one pad, which is a sterile gauze, a pre-prepared main drug is applied, on the second, similar, another drug is applied, most often 2% aminophylline, which improves blood circulation, relaxes smooth muscles and has a slight analgesic effect. The first gasket is connected to the plus, and the second to the minus.

After preparation, the pads are applied to the skin, electrodes are attached to them and fixed with a load or elastic bandages, after which the device is turned on.

The strength of the current and the time of the procedure are selected individually. The nurse gradually increases the current during the procedure and asks how the patient feels. Normal sensations are a slight tingling in the place where the electrodes are attached. But burning, itching and pain are a signal to immediately stop the procedure.

The average procedure time is 10-15 minutes. Procedures for small children differ in shorter duration. The duration of the course is 10-20 procedures, which are carried out daily or every other day.

Other methods of electrophoresis

Bath. The drug and solution are poured into a bath with built-in electrodes. After preparation, the patient immerses the affected part of the body in the bath.
cavity. The solution with the preparation is introduced into the cavity (vagina, rectum) and one of the electrodes is brought into the same cavity. The second electrode is attached to the skin. Used for diseases of the large intestine and pelvic organs.
Interstitial. The drug is administered in the traditional way, for example, intravenously or orally, and the electrodes are applied to the projection of the affected organ. Such an introduction is especially effective in pathologies of the respiratory organs (,).

Advantages and disadvantages of drug administration by electrophoresis

Advantages:

The introduction is not accompanied by pain;
A low concentration of a medicinal substance in solution (up to 10%), which is sufficient to provide a high therapeutic effect;
The introduction of the drug directly into the focus of inflammation;
Minimum adverse and allergic reactions;
Long-term therapeutic effect of the administered drug (up to 20 days);
The classical route of passage of drugs through the gastrointestinal tract when taken orally is bypassed, which means that the bioavailability of drugs increases.

Flaws:

Not all drugs can be introduced into the body using electrophoresis;
The procedure itself has a number of strict contraindications.

Drugs that are used in electrophoresis

Depending on the charge, the drug is injected through the positive or negative pole. During the procedure, it is permissible to use only those drugs that penetrate the skin. Each medicine has its own indications and has a certain therapeutic effect. Consider the main drugs used in electrophoresis:

Name of the drug	Indications	Therapeutic effect
Drugs administered through the positive pole
Atropine	and 12 duodenal ulcer; inflammatory diseases of the organs of vision; bronchial asthma.	The secretion of glands decreases and the tone of smooth muscle tissue decreases. Eliminates pain.
Calcium	diseases associated with calcium deficiency (bone fractures, hip dysplasia); inflammatory processes in the oral cavity; allergic diseases; Electrophoresis with calcium chloride is prescribed for violations of blood clotting.	Anti-allergic, hemostatic and anti-inflammatory action. Replenishment of calcium deficiency.
Eufillin	Electrophoresis with eufillin is indicated for: bronchial asthma; violation of renal and cerebral circulation; osteoarthritis, and intervertebral hernia.	Reducing spasm of smooth muscles, lowering blood pressure, improving blood circulation and eliminating bronchospasm. Elimination of pain syndrome.
Vitamin B1	pathologies of the nervous system (sciatica, neuritis, paresis and paralysis); diseases of the digestive system (PUD and 12 duodenal ulcer,); skin diseases (, dermatitis); conditions associated with vitamin B1 deficiency.	Anti-inflammatory, analgesic and anti-allergic effect. Normalization of metabolism and the work of these organs and systems.
Karipazim	osteochondrosis; intervertebral hernia; arthrosis, arthritis. Electrophoresis with caripazim for hernia in complex treatment in the early stages of the disease helps to avoid surgery.	Softening of the cartilaginous tissue of the intervertebral discs. Scarring of damaged collagen fibers and restoration of their elasticity. Anti-inflammatory action.
Diphenhydramine	allergic diseases (, dermatitis); insomnia; pain syndrome; bronchial asthma, and GU (as an additional treatment).	Soothing, hypnotic, analgesic and anti-allergic effect. Relaxation of smooth muscles.
Lidaza	Electrophoresis with lidase is performed when: skin lesions (wounds, ulcers and keloid scars); diseases of the musculoskeletal system (osteochondrosis, contractures); eye diseases (retinopathy, keratitis).	Breakdown of hyaluronic acid, which is involved in the formation of scars. Reduction of tissue swelling and slowing down the mechanism of contracture formation.
Magnesium	conditions associated with magnesium deficiency; heart disease (hypertensive b-n,); irritability, depression.	Normalization of the heart rate, the functioning of the nervous system and the musculoskeletal system.
Mummy	diseases of the musculoskeletal system (fractures, sciatica); respiratory diseases (bronchitis, bronchial asthma); diseases of the digestive system (PUD, colitis); skin diseases (burns, ulcers).	More than 80 biologically active substances have a complex effect on the body, including regenerating, anti-inflammatory, etc.
	Conditions that are accompanied by spasms (spasm of the urinary tract, bronchospasm, etc.).	Elimination of muscle spasm, tone of smooth muscle tissue of internal organs. vasodilating effect. Decreased blood pressure.
	eye diseases (keratitis, conjunctivitis); bronchial asthma; YABZH and 12 duodenal ulcer; skin lesions (burns, trophic ulcers).	Acceleration of tissue regeneration processes. Stimulation of immunity at the local level. Pronounced anti-inflammatory effect.
Novocaine	Pain syndrome accompanying the disease.	Local analgesic effect.
Drugs administered through the negative pole
Iodine	skin diseases of an inflammatory nature, open wounds; hyperthyroidism; neuralgia, neuritis,.	Anti-inflammatory effect. Inhibition of the growth of pathogenic bacteria. Reducing cholesterol levels.
Ampicillin	infectious and inflammatory processes of the respiratory system (bronchitis, tonsillitis); , sinusitis; skin infections; infections of the gastrointestinal tract and genitourinary system (,).	Bactericidal effect on a wide range of infectious agents.
A nicotinic acid	diseases of the gastrointestinal tract (GU and 12 duodenal ulcer); atherosclerosis,; long-term non-healing wounds, trophic ulcers; diseases that occur with spasms of blood vessels.	vasodilating effect. Improvement of blood circulation. Reducing blood cholesterol levels.
streptocide	skin infections (erysipelas, acne); burns, wounds; infectious diseases of ENT organs (tonsillitis, tonsillitis); urinary tract infections.	Inhibition of the growth of pathogenic flora.
Heparin	varicose disease; injuries, swelling of tissues, bruises; prevention of thrombosis.	Blood thinning. Anti-inflammatory and anti-edematous action. Improvement of microcirculation.
Humisol	joint diseases (arthritis, polyarthritis, arthrosis); diseases of ENT organs (sinusitis, rhinitis, otitis media, pharyngitis); sciatica, myalgia.	Pronounced adaptogenic action. Anti-inflammatory and analgesic effects. Increasing the nonspecific resistance of the organism.

The following drugs can be administered both from the anode and from the cathode):

lidase
eufillin;
gumizol;
histidine;
trypsin and others.

Indications for electrophoresis

It is easier to list contraindications for treatment, since the procedure is indicated for most common diseases of almost all organs and systems. However, the lack of mass use of the available procedure and the interest of patients is explained by several factors:

doctors do not always offer patients this method of auxiliary treatment;
since the procedures are carried out in a physiotherapy room, the course of treatment is burdensome for some patients;
not all people trust such procedures and treat them with caution.

Indications for the procedure in young children under 1 year old:

hyper- or hypotonicity of muscles;
neurological disorders of a slight degree of severity;
diseases of the musculoskeletal system (including dysplasia and immaturity of the hip joints);
diathesis;
burns;
diseases of the ENT organs.

Contraindications to electrophoresis - absolute and relative

As with any other physiotherapy, electrophoresis is characterized by indications and contraindications. Contraindications are divided into absolute, in which the procedure is prohibited, and relative, in which the decision on the possibility of physiotherapy is made by the doctor.

Electrophoresis is not performed in the acute stage of the disease or during exacerbation of chronic pathologies - this is an absolute contraindication for all patients.

Contraindications
Absolute	relative
The general serious condition of the patient T 38 and more Poor blood clotting Intolerance to electric current or drug used to treat Tuberculosis in active form severe mental illness Malignant tumors Renal and in the acute stage menstruation in women Presence of a pacemaker Severe cardiovascular insufficiency Violation of the integrity of the skin in the places where the electrodes are placed	Pregnancy Hypertension in the acute stage Children's age up to 2 years

Even in the absence of direct contraindications to the procedure, the doctor always weighs all the pros and cons, assesses the general state of physical and mental health before prescribing physiotherapy.

Side effects of electrophoresis

If the technique of the procedure is fully observed, no side effects occur. Perhaps the development of allergic reactions to the drug used for treatment. Often, hyperemia remains at the site of application of the pad, which quickly disappears after the removal of the electrodes.