Medicinal electrophoresis: indications and contraindications, methods, algorithm, mechanism of action, advantages. Electrophoresis - types, effective treatment, contraindications (electrophoresis for children, at home, with aminophylline, with lidase, caripazim) De

On most sites it is written about electrophoresis, that this is a method of administration medicines in the tissue of the body with the help of a direct electric current of low voltage and low power, which it combines medicinal properties electric current and the positive effects of the administered medicinal substance. But not all features are disclosed, which will be discussed below.

The method is based on three phenomena:

Conductivity of body structures.
The ability of the current to directly influence the processes in the field of application (galvanization).
The ability of drugs to decompose into ions under the influence of electricity (electrolytic dissociation).

The effect of galvanization implies the dissociation of inorganic salts of the body into positive and negative ions, moving in accordance with their own charge towards a positively or negatively charged electrode. Water moves with the ions. As a result, edema with loosening occurs under the cathode, while under the anode, the tissues are compacted and wrinkled.

In the zone of current influence, the movement of lymph and blood increases, metabolic and trophic processes and regeneration of bone, nervous, connective tissue are accelerated, and active substances are formed. These areas of increased intensity metabolic processes become especially susceptible to administered drugs, which gives electrophoresis a number of advantages over other methods of administering drugs with a relatively small number of disadvantages:

Advantages	Flaws
Painless procedure	This method can administer a limited number of drugs.
In comparison with taking drugs orally and by injection, electrophoresis is much less likely to cause negative reactions to the drug, and side effects are much less pronounced.	There are fairly wide contraindications to the use of electrophoresis
The medicinal substance is injected directly into the pathological focus with the formation of high concentrations there, but without saturating the body
A significant amount of the substance is injected into the superficial layers of the skin and is fixed there for a long time in the form of a “depot”, ensuring the duration of the action of the medicinal substance.
The therapeutic effect of the administered drug lasts 1-20 days
The medicinal substance is not degradable in the gastrointestinal tract
The substance is administered as a combination of individual ingredients, and not in a molecular form, which increases its pharmacological activity in the absence of ballast substances

Side effects of the procedure

Along with such a wide range of advantages, the procedure also has a number of side effects in children and adults:

The electric current has a pronounced effect on the growing areas of the bone and can slow down the processes in them or accelerate them unevenly and lead to the formation of small exostoses - outgrowths.
Due to the increased sensitivity of children's skin, electrophoresis can cause irritation, dryness, so electrophoresis for children has limited indications.
The increased permeability of the skin makes the baby's tissues particularly susceptible to medications. And even seemingly adjusted dosages can cause allergic phenomena. Read more about the types of rash in children and their cause.
Electric current actively affects the nervous system. In addition to a calming, positive effect, it can cause the opposite effect - increased excitability of the brain, drowsiness without falling asleep, irritability, photosensitivity.

Cathode and anode - the key of electrophoresis

Positively charged particles soothe, anesthetize, relieve swelling, negative - relax, dilate blood vessels, improve metabolism

When choosing an electrophoresis technique, it must be remembered that opposite reactions develop in the tissues under the cathode and anode.

Under the cathode, there is a noticeable increase in the permeability of cell membranes, tissues swell, metabolic processes are activated, cells become more excitable.

Under the anode, cell permeability decreases, their excitability weakens, and metabolic processes are inhibited.

It is also of great importance to take into account the direction of current flow.. For example, when applying the cathode to the forehead or eyes, and the anode to the back of the head, a decrease in the excitability of the brain is noted. With the opposite arrangement, the excitability of the brain decreases. The medicinal substance must be administered from the pole, according to the polarity corresponding to the charge of the substance. As a rule, one drug is injected from one pole.

Physiotherapist Irina Pashkovskaya talks about the electrophoresis procedure on video:

7 ways to carry out the procedure for various pathologies

Examples of how electrophoresis is done with various diseases:
1
Maxillary sinus electrophoresis. After washing the sinus with a puncture needle, the patient is laid on his side. An electrode 4 × 4 cm is placed on the skin above the sinus, and 10 × 10 cm on the back of the head. An antibiotic, antiseptic or anti-inflammatory is mainly used as a medicinal substance. Indicated for inflammation of the maxillary sinus various genesis.
2
Electrophoresis of the mucous membranes of the oral cavity and teeth. The prepared solution is taken into the patient's mouth and held until the end of the procedure. 2 electrodes are placed on the top and lower jaw on one side (of the same polarity), and 1 on the back of the head (opposite polarity). This procedure is used for gum diseases of inflammatory origin (gingivitis, periodontitis), to improve healing after surgical interventions (for example, traumatic removal, alveolitis), for remineralizing therapy.
3
Electrophoresis according to Shcherbakov. A special cuff/pad around the neck, shoulders and part of the back is placed on the corresponding zone, and the second pad is fixed on the lumbar region. Electrophoresis of the collar zone is shown for hypertension, sleep pathologies, and the consequences of craniocerebral injuries.
4
Electrophoresis of the stomach. A solution of a medicinal substance diluted in the required concentrations is taken by the patient inside. One electrode is fixed on the epigastric region or under the right ribs, the second - on the back. The patient is located on the back, abdomen or side, depending on which part of the stomach is expected to be affected.
5
Pulmonary electrophoresis apply when bronchial asthma, atelectasis, chronic pneumonia and bronchitis. Pre-irrigate the bronchus during bronchoscopy or using ultrasonic inhalation. Electrodes are placed on the skin of the chest and back.
6
Electrophoresis of caripazim in osteochondrosis, it is carried out in order to lyse fragments of the intervertebral disc that have fallen into the intervertebral space. It is required to conduct at least 3 courses of caripazim per year for 3-4 years. The procedure involves the transverse location of the electrode from the back and front surface of the body.
7
Electrophoresis of the pelvic organs. It is carried out by the classical method with the placement of electrodes on the skin of the pubic symphysis and sacrum, or in the form of a cavity procedure with the introduction of one of the electrodes into the rectum, vagina. The cavity method is more effective in the treatment Bladder, prostate. The medicinal substance in both methods can be administered percutaneously or be previously introduced into the rectum or vagina.

All indications and contraindications for the procedure

Indications for electrophoresis are:

diseases of the peripheral nervous system- plexitis, neuritis, radiculitis;
CNS diseases - neurosis, arachnoiditis, consequences ischemic strokes;
hypertension of the 1st-2nd degree, atherosclerosis of large and medium arteries;
pathology of the respiratory system - pleurisy, bronchitis, tracheitis;
diseases of the digestive system - chronic gastritis, ulcer duodenum, biliary dyskinesia, intestines. If - this may be a symptom of dangerous diseases, urgently conduct an examination;
diseases of bones and joints - arthritis, deforming osteoarthritis and osteochondrosis, recovery period after fractures and injuries;
diseases of the genitourinary organs - urethritis, cystitis, chronic pyelonephritis, prostatitis, ovarian dysfunction;
correction functional disorders nervous tissue in children (electrophoresis with aminophylline for infants who have undergone);
pathology of ENT organs - sinusitis, otitis media, tubotitis, neuritis;
eye diseases - retinal dystrophy, clouding of the corneas, the consequences of injuries, atrophy of the optic nerve;
normalization of maturation of bone and cartilage tissue, especially in children (electrophoresis is used for infants with dysplasia).

We often use electrophoresis at the department for remineralizing therapy, for periodontitis. Get amazing effects. In particular, after a 2-week course of fluorine and calcium preparations, the increased sensitivity of the teeth completely disappears.

With periodontitis, the gums are strengthened quickly and for a long time. Electrophoresis, of course, is not enough for the complete disappearance of symptoms, but without it, the duration of treatment is much longer.

The procedure relieves inflammation, pain, has a resolving and regenerating effect.

Electrophoresis is contraindicated in:

malignant neoplasms;
tendency to bleeding, including hemophilia;
systemic blood diseases;
eczema and various etiologies of itchy dermatosis;
increased sensitivity to current;
the presence of metal implants;
on the heart area (current affects sinus node and breaks the rhythm
hemorrhagic strokes;
after suffering abdominal bleeding;
pustular skin diseases.

Contraindications for electrophoresis in children are the same as those for adults, but additionally include increased attention to dosages.

Separately, is it possible to do electrophoresis at a temperature . It is possible if the temperature is caused by the disease that is to be treated with electrophoresis. For example, temperature during exacerbations of systemic diseases of the joints. If it is SARS or more severe causes, it is advisable to postpone electrophoresis.

If prescribed during pregnancy

During pregnancy, endonasal electrophoresis is successfully used during toxicosis.

Pregnancy is not a contraindication for electrophoresis, and in some cases it is considered the most desirable way to administer medications.

In particular, the treatment regimen for uterine fibroids suggests electrophoresis as one of the safest methods of therapy.

It is undesirable to use electrophoresis in the first and third trimester of pregnancy. due to the high reflex activity of the uterus during this period, but depending on what the electrophoresis of the pregnant woman is for, the indications can be revised.

Otherwise, contraindications during pregnancy correspond to general contraindications. If there are contraindications to electrophoresis, phonophoresis is used - the introduction of drugs using ultrasound. Limitation - the destructibility of certain substances under the influence of sound waves.

Electrophoresis for children: pros and cons

In pediatric practice, electrophoresis is rarely used. First of all, this applies to children aged from infants to primary school. Reason - more frequent side effects. At the same time, it was noted that electrophoresis for infants and young children is highly effective in hypo- and hypertonicity of muscles, hip dysplasia, and neurological pathologies, although the degree of this effectiveness varies for each child.

Often, electrophoresis is combined with baby massage, which is carried out after the administration of medications and contributes to a better distribution of the medication in the body.

If a doctor has prescribed a course of electrophysiotherapy, they should not be neglected.

To begin with, it is enough to apply the minimum effective concentrations of drugs and current values, and after making sure of safety, switch to the indicated therapeutic values.

In medical practice, electrophoresis for newborns and infants is carried out in order to:

Activation of cardiovascular and respiratory functions.
Correction of the development of tissues of the hip joints. The procedure normalizes metabolic processes in the joints, helps to strengthen them. But. Electrophoresis with calcium chloride always acts only as an additional measure in complex treatment hip dysplasia. It is impossible to cure a baby exclusively with such a physiotherapy. This pathology implies not only the underdevelopment of the joint, but also the displacement of its components, which electrophoresis with calcium cannot affect.
Stimulation of maturation of nervous tissues.
Normalization of muscle tone. Why a child can throw his head back, we tell in this. And about the causes of chin trembling in infants.

Separately about the use in ICP

For newborns and infants, electrophoresis is sometimes performed to correct intracranial pressure (especially electrophoresis on the cervical region). This procedure is of controversial use for the correction of intracranial pressure.. The treatment of such a serious condition is also required serious. Quite often, the diagnosis of increased ICP is made unreasonably and electrophoresis of the cervical spine is not necessary for the baby. But it has an effect on tissues and it is harmful to carry out such a procedure for no reason.

Electrophoresis is used to improve brain nutrition and relieve intracranial pressure in infants.

None of the diagnostic methods today makes it possible to measure ICP objectively. The doctor can always draw a conclusion based on the totality of data.

If you have been prescribed Ratner electrophoresis with aminofillin for the treatment of increased ICP without a serious examination, this is a reason to think. Such a procedure can only help with muscle hypertonicity, congestion in the cervical region.

Electrophoresis according to Ratner is a procedure in which one electrode is placed on the cervical vertebrae, and the second on the ribs, on the right side of the sternum. Medicinal substance - Euffilin and Papaverine. It is indicated for circulatory disorders in the cervical region, to correct the functional consequences of postpartum injuries, to improve metabolic processes in tissues.

Also, in order to reduce ICP, electrophoresis with magnesia is prescribed. The need for the procedure is also controversial and requires consultation with several pediatric specialists to make an informed decision. The mother of the child should understand, having received a referral for electrophoresis, that this cannot be the main and only method of treatment for suspected increased intracranial pressure.

Use at home

It is possible to use electrophoresis at home, but this will require certain knowledge. First of all, knowledge of the pathology in which the use of electrophoresis is supposed to be used, knowledge of how to prepare a solution for electrophoresis (the principles of mixing and selecting the dosage of drugs), the ability to use the apparatus itself for physiotherapy. For a person without a medical education, a specialist must show the technique of manipulation and for the first time control its implementation.

If it is really difficult for you to visit a physiotherapy room, try to find a way how to do it. Or call a doctor at home if you want to do electrophoresis at home. Still, this is an intervention in the body, albeit a gentle one. It must be supervised by a specialist.

The use of drugs and their effect

Among the most commonly used drugs in electrophoresis are the following:

A drug	Dosage for electrophoresis	Pathology/Effect
ADRENALIN	1 ml 0.1% solution in isotonic solution 30 ml	As an addition to an anesthetic for pathologies of the musculoskeletal system - injuries, radiculitis
ANALGIN	5% solution	The period of exacerbation and acute arthritis, osteochondrosis, arthrosis
AMINOCAPRONIC ACID	0.5 ml 5% solution in isotonic solution 20 ml	Inflammatory foci of various origins to reduce the permeability of vascular walls, arthritis, ankylosing spondylitis
HEPARIN	5000-10000 IU per 30 ml isotonic solution	Arthritis, polyarthritis, Bechterew's disease
HYDROCORTISONE		Similar to corticosteroids. Stops foci of inflammation in the joints, inflammation of the upper respiratory tract, spine
IODINE	2-5% potassium iodide solution	Arthrosis, exacerbations of osteochondrosis
POTASSIUM	2-5% potassium chloride solution	With inflammation of the periarticular tissues, bursitis, myositis, tendovaginitis, epicondylitis
CALCIUM	2-5% calcium chloride solution	It is indicated for the consequences of injuries associated with bone damage, allergies, blood clotting disorders, in a child it is also useful for gingivitis and other diseases of the mucous membranes.
LIDOCAINE	0.5% lidocaine solution
NOVOCAINE	0.5-2% novocaine solution	Chronic arthritis, arthrosis, spondylosis
NO-SHPA	4 ml of 1-2% solution per pad	Antispasmodic. It is used for spasms of various localization, mainly smooth muscle muscles of the gastrointestinal tract
PAPAVERINE	0.5% solution of papaverine hydrochloride	Muscular antispasmodic. Used to restore neuromuscular conduction in injuries
PLATIFFILIN	1 mg 0.2% per 20 ml sodium chloride	Applicable for hypertension and a tendency to hypertension to reduce pressure, with cerebrosclerosis, reduces the frequency of angina attacks, improves myocardial nutrition
PREDNISOLONE	25 mg per 30 ml of 1% sodium bicarbonate solution	Anti-inflammatory. analogue of corticosteroids. Reduces inflammation of the joints, ENT organs, spine
PENICILLIN	100000-200000 units per 20 ml of sodium chloride	Antibiotic. Applicable for bacterial infections different localization
THIAMIN	2-5% thiamine solution	Loss of sensation in the extremities, paresthesia, numbness, weakness contractile function muscles
TRIPSIN	10 mg per 20 ml acetate buffer solution	Dissolves dead tissues, thins viscous secretions, exudates, blood clots. For crush injuries during the recovery period
UNITOL	3-5% solution	To restore nerve conduction in polyneuropathies in patients diabetes, treatment of post-traumatic cuts (disturbance of sensitivity)
FLUORINE	2% fluorine solution	Reduces resorption bone tissue, stimulates osteoblasts to form new bone structures, in dentistry increases the mineralization of teeth, destroys bacteria that provoke caries
CHymotrypsin	5 mg per 20 ml acetate buffer solution	Dissolves necrotic tissues, thins exudates, viscous secretions, blood clots. With spasms, crush injuries during the recovery period
EUFILLIN	0.5-1% solution	On the region of the spine in violation of skin sensitivity, respectively, spinal roots, with osteochondrosis in subacute and chronic course with moderate pain.
EPHEDRINE	0.1-0.5% solution	With asthma, hypotension, otosclerosis, it constricts blood vessels, increases blood pressure, and expands the bronchi
fibrinolysin	20,000 units per 20 ml acetate buffer solution	With subacute and aggravated thrombophlebitis, with fresh hematomas. Dissolves blood clots, fresh blood clots

I personally use electrophoresis quite widely. First of all, with paresis, sensitivity disorders of the segmental type, with traumatic neuropathies. With diabetic polyneuropathy they tried, but the effect was achieved only at its initial stages.

The use of anticholinesterase drugs - Neuromidin, Mediatorn - shows itself especially well.

Often I also use vitamins of group B. The effect, of course, depends on the pathology and susceptibility of the patient, but it comes quite quickly - on the 4-7th day.

Conclusion

Summing up the information about what electrophoresis is, we can say that this is one of the most effective and safe ways to administer drugs for a wide range of diseases, as well as during pregnancy. Simple, but requiring an understanding of a number of physical laws and the pharmacology of the substances used, it is not in vain that it is carried out by specially trained personnel. This is a medical manipulation, and the doctor decides on its necessity.

Galvanization is a physiotherapeutic method in which the patient's body is exposed to a continuous electric current of low strength and voltage.

Galvanic current penetrates the organs and tissues of the human body, stimulating the occurrence of complex physical and chemical processes.

Therapeutic effect

The mechanism of action of galvanization is the continuous action of an electric current of small strength and tension on certain parts of the body and skin of the patient. When a current is applied to the human body, the balance of ions in the cells changes, and physical and chemical transformations occur.

The use of galvanization leads to the following effects:

Main parameters of the procedure

The galvanization procedure in physiotherapy can be carried out with different dosage density, current strength and duration of exposure. For this physiotherapeutic method, a low voltage current (up to 80 V) and low power (up to 50 mA) is used. The current density varies from 0.01 mA/cm2 to 0.08 mA/cm2.

The strongest current is used for therapeutic effects on the trunk and limbs (from 15 mA to 30 mA). When applying electrodes to the area of the head, face, mucous membranes, the current strength does not exceed 5 mA.

The current is supplied to the patient's body using electrodes (lead plates up to 1 mm thick, with a wet gasket, and a cord connected to the plate). Also, the electrodes can be built into a reservoir (“bath”) used to immerse a part of the body requiring therapy into it. A hydrophilic pad and water in the tank are necessary to prevent burns of the patient's skin by electrolysis products.

The electrodes can have a rectangular shape, be in the form of a half mask (application on the face), in the form of a "collar" (for influencing the upper back and shoulder girdle), in the form of a funnel (for use in the ear area), "bath". There are also cavity electrodes for intravaginal and rectal use.

After fixing the electrodes on the patient's body, or placing a part of the body in the "bath", the current starts and gradually increases until the required parameters are reached. The procedure ends with a gradual decrease in current until it is turned off.

The electrodes can be applied transversely or longitudinally. Transverse imposition contributes to a more effective effect on deep tissues. The electrodes are located on opposite parts of the body, opposite each other. The longitudinal arrangement provides an impact on the surface areas of the tissues. The electrodes are placed on one side of the body.

During the procedure, it is necessary to take into account the patient's feelings. A normal reaction to the current is manifested in the form of a sensation of "creeping goosebumps", a slight tingling. The current density must be reduced if a burning sensation occurs.

After 5-7 sessions of galvanization, the patient's condition may worsen. This effect indicates the positive effect of the procedures performed.

The duration of the procedure ranges from 15 minutes (with general exposure) to 40 minutes (with local exposure). The therapeutic course consists of 10-20 galvanization sessions. It is recommended to carry out the procedure daily or every other day. Passage of a repeated course is possible in a month.

Place in neurological and general medical practice

Galvanization is effective method therapy of such neurological diseases:

Also, galvanization is widely used in the following areas of medicine:

cardiology;
gastroenterology;
urology;
pulmonology;
dentistry;
surgery;
endocrinology;
orthopedics;
gynecology;
cosmetology;
dermatology;
ophthalmology.

Technique and methods of the procedure

Before starting the procedure, the patient's skin must be cleansed. In the presence of damage to the skin, these areas must be treated with petroleum jelly, and covered with cotton wool, rubber or oilcloth.

The electrodes are applied longitudinally (impact on superficial tissues) and transversely (impact on deep tissues and organs). Perhaps the arrangement is transverse-diagonal.

During the procedure, the patient takes a sitting or lying position. The electrodes are attached with adhesive plaster, bandage, or small containers of sand.

There are various methods of applying galvanization:

Electrophoresis as an improved method of galvanization

The combination of galvanization with drugs is called electrophoresis. Galvanic current is used for more effective assimilation of drugs by the body, and makes their effect effective and soft.

Medicinal solutions are introduced into the body through the mucous membranes and skin under the influence of an electric field. The most effective effect is hair follicles, ducts sebaceous glands, intercellular spaces and sweat glands.

The drugs used in electrophoresis contain ions (charged particles) that are introduced into the body by various electrodes. The choice of electrode depends on the charge of the ions. During one procedure, different substances can be injected from different points of influence.

The electrophoresis procedure is painless, however, discomfort is possible in the form of a slight tingling in the area of electrode application.

inflammatory processes;

Electrophoresis can be carried out in various ways:

Through the skin– electrodes are placed on the patient's skin.
With the help of baths- a solution of a medicinal substance is placed in a tank with built-in electrodes, and a part of the body that requires exposure is placed in this “bath”.
cavity method- a solution of the drug is administered rectally or into the vagina. The electrode is also inserted inside. An electrode with a different polarity is attached to the outside of the body (used for the treatment of diseases of the large intestine and pelvic organs).
Interstitial method- the drug is administered orally, inhalation, intravenously, electrodes are applied to the affected organ or area (most effective for respiratory diseases).

As a result of the procedure, medicinal substances accumulate in the skin, and can remain there from 12 hours to 20 days. Due to this, a longer effect of drugs is provided, and their slow removal from the body.

The advantage of the method is that the accumulation of the drug occurs locally, without spreading it to the entire body.

The concentration of the drug in the area of application is several times higher than the concentration with conventional methods of administration. Electrophoresis allows you to introduce drugs into areas with impaired microcirculation and blood circulation, where the penetration of medications is usually difficult. A positive feature of the method is also a low level of allergic and adverse reactions.

Applied devices

Apparatus for galvanization and electrophoresis are electronic AC rectifiers of the lighting network. The following devices are used for the galvanization procedure:

Potok-1, Potok-01M, Potok-Br;
"GR";
"AGN-1", "AGN-2";
"Radius";
"NET";
"ETHER";
"ELFOR", "ELFOR-Prof";
"ESMA".

Apparatus for galvanization and electrophoresis ELFOR

Contraindications to the use of physiotherapy

individual intolerance to galvanic current;
the presence of neoplasms or suspicions of them;
acute inflammatory diseases;
severe cardiovascular disease;
acute purulent diseases;
systemic blood diseases;
severe atherosclerosis;
eczema, dermatitis;
feverish conditions;
diseases of the skin;
skin damage;
impaired skin sensitivity;
during pregnancy;
with cachexia.

Electrophoresis treatment is a physiotherapeutic ultrasonic procedure that takes place under sinusoidally modulated currents (smt) of external influence of an electric field. Medical procedure(electrophoresis) is done in order to provide an additional local therapeutic effect in the area of damage to the joints of the spine, with various diseases of the musculoskeletal system of a neurological or post-traumatic orientation, for example, with intercostal neuralgia, with osteochondrosis, arthritis, after a joint injury, dislocation or after a bone fracture articular segments. Consider what it is - electrophoresis, what is an apparatus for electrophoresis, what is the technique for conducting electrophoresis in a hospital, and also determine how electrophoresis can be done at home for an adult and a child.

The basis of the therapeutic physiotherapy technique is the process of electrolytic dissociation, when medicinal substances enter the human body through the sweat and sebaceous glands in the form of positive and negative ions, which are evenly distributed in the cells of the body. The use of drugs for electrophoresis, coupled with sinusoidally modulated currents (smt), has many positive effects:

decrease in the intensity of the inflammatory response of the body;
reduction of swelling in the area of pain localization;
acceleration of regenerative processes in the tissue structure;
improvement of blood microcirculation in the vessels;
stabilization of muscle tone;
normalization of metabolic functions of the body;
stimulation of the release of biologically active trace elements;
activation of the immune-stimulating functions of the body.

The technique of conducting physiotherapy by electrophoresis (iontophoresis) with the active introduction of medicinal components allows the accumulation of valuable therapeutic substances in the pain zone of the inflammation focus, which is sometimes unattainable with oral and / or injection therapy. The pharmacological solution has practically no side effects on the body, as it bypasses the gastrointestinal organs of vital activity.

Medicines for electrophoresis

Home electrophoresis or electrophoresis treatment in a hospital setting involves the use of those pharmacological groups that actively penetrate the skin and give the maximum therapeutic effect. The table of the main drugs used in electrophoresis is as follows.

Dosage forms administered through positive electrical ions:

Name of the drug	Indications for electrophoresis	Therapeutic effect
Vitamin B1	Radiculitis, rehabilitation after a fracture, osteochondrosis of the spine, intercostal neuralgia, arthritis, arthrosis of the joints, other neuralgic pathologies	Normalization of metabolic functions, anti-inflammatory, anti-allergic and analgesic effect
Pentoxifylline	Occlusive lesions of peripheral arteries, pain in the calf muscles, joints of the spine, with convulsions	Improvement of blood microcirculation and rheological properties of blood, reduction of peripheral vascular resistance.
Atropine	All types of pathologies of the gastrointestinal tract, respiratory organs, muscle spasms of the intervertebral zone	Decreased smooth muscle tone, elimination of pain symptoms
Calcium	Fracture recovery, hip dysplasia, spinal neuralgia	Replenishment of calcium deficiency in the articular cartilage of the spine, anti-inflammatory, hemostatic and anti-allergic effect
Lidaza	Electrophoresis of the collar zone, diseases of the supporting osteoarticular system	Reduced tissue swelling, slowing down contracture formations
Novocaine	Concomitant pain symptoms of neurological pathologies	Indication of electrophoresis with novocaine - local anesthesia
Dexamethasone	Rheumatoid arthritis in the acute phase	Immunosuppressive, antishock, desensitizing and antitoxic action
Magnesia (sodium sulfate)	Stretching of the knee or elbow joints, convulsions with preeclampsia, tachycardia, arterial hypertension	Sedative, diuretic, anticonvulsant action
Karipazim	Intervertebral hernia, osteochondrosis, arthritis and / or arthrosis of the joints	Softening of cartilage tissue, scarring of fibers after fracture, anti-inflammatory activity
Mummy	All types of neurological pathologies of the musculoskeletal system, diseases of the respiratory system, skin and genitourinary system	The drug has many biologically active components, providing a complex therapeutic effect on the body.
Papaverine	Muscle spasms	Vasodilating effect, elimination of muscle spasms
Eufillin	Intervertebral hernia, osteochondrosis, osteoarthritis and other neurological conditions of the supporting system of the spinal column	Improving blood circulation, eliminating pain symptoms, reducing antispasmodics

Dosage forms administered through negative electrical ions:

Name of the drug	Application of electrophoresis	The therapeutic effect of the drug
A nicotinic acid	Spasmolytics of blood vessels, trophic ulcers and / or non-healing wounds after a fracture of the joints	Vasodilating effect, improvement of main blood flow, removal of spasmolytic tension from the affected joints
Iodine	Skin inflammatory processes of infectious formation, restoration of damaged joints	Growth elimination pathogenic bacteria, anti-inflammatory and antiseptic action
Heparin	Post-traumatic conditions of the musculoskeletal system, prevention of thrombosis, tissue recovery after injuries and bruises	Anti-inflammatory and anti-edematous action, blood thinning, improvement of the main blood supply to blood vessels
Humisol	Arthritis, arthrosis and other joint diseases	Adaptogenic effect, analgesic and anti-inflammatory effect, increase in the overall resistance of systemic organs
Ampicillin	Infectious lesions of the osteoarticular segments	Bactericidal elimination of infectious pathogens

Indications and contraindications

Electrophoresis at home, or in a stationary medical physiotherapy room, can replace almost any type of physiotherapy treatment, so it is prescribed, recommended and done not only for adults, but also for children. However, devices for electrophoresis are not currently widely used, and the reasons for the lack of interest in them are explained by several factors:

the immunity of the attending physician to this type alternative treatment neurological pathologies;
unwillingness of patients to burden themselves with frequent visits to the physiotherapy rooms of their polyclinics at the place of residence;
distrust of such procedures.

However, electrophoresis treats many diseases, for example:

diathesis in young children, except for newborns and babies under 1 year old;
helps with neurological disorders with a slight degree of severity;
removes age spots skin for various dermatological conditions;
restores muscle hyper- and hypotonus;
best promotes the healing of burns;
massage and electrophoresis are often recommended for women to restore hormonal balance;
electrophoresis for children is very effective in the treatment of ENT diseases.

However, electrophoresis has an undeniable advantage over other types of physiotherapy in the treatment of diseases of the musculoskeletal system, hernia of the vertebral sections, articular dysplasia, and so on.

Attention! Before doing electrophoresis, you need to get the advice of a specialist who will indicate with what better medicine you can do electrophoresis, and how to do physiotherapy at home.

When using electrophoresis at home, it must be remembered that there are absolute and relative contraindications for electrophoresis treatment. This is especially important to consider when using portable devices for home treatment.

An absolute contraindication for electrophoresis, for all patients without exception, is an exacerbation of chronic conditions of the vital organs.

Other absolute conditions include:

hemophilia (poor blood clotting);
it is not recommended to do electrophoresis at a temperature of 38º C and above;
oncological diseases or the presence in the body of various tumor-like neoplasms of an unexplained nature;
the presence in the body of pacemakers and other foreign bodies life support;
violation of the integrity of the skin;
clinical conditions of the cardiovascular, dermatological, genitourinary and endocrine systems;
open form of tuberculosis.

To the question of whether it is possible to do electrophoresis during menstruation, there is no definite answer, however, most experts say no.

Relative contraindications include:

children under 2 years of age;
pregnant women;
patients with arterial hypertension.

Types and methods of home physiotherapy

The most popular portable devices for electrophoresis at home are:

apparatus "Elfor";
portable electrophoresis "Elfor Prof";
medical device "Potok-1".

Thanks to the Elfor device, physiotherapeutic procedures can be carried out without leaving home. The operation of the Elfor medical device is based on the use of galvanic current, which concentrates drugs in a certain localizing zone. The device "Elfor" is completely safe and does not cause side effects. The device is recommended for the treatment of the elderly, middle-aged patients and children. Indications for use:

vegetative-vascular dystonia;
osteochondrosis and its complications;
diseases of the pelvic organs in women;
arthrosis, arthritis of the joints;
asthma pathologies, bronchopulmonary diseases etc.

Hardware kit "Elfor" can be purchased at any pharmacy chain Russian Federation and CIS countries.

Other portable treatments have similar treatment characteristics, differing only in pricing.

There are various ways to introduce medicines into the human body with a sinusoidally modulated current (smt):

Electrophoresis with bischofite is the introduction into the body of the biochemical components of a natural mineral containing a large number of natural components: salt, bromine, calcium, copper, iodine, iron and other components. Having a trophic and resolving effect on the body, bischofite improves blood circulation and nutrition in the tissue fibers of the joints, making pain symptoms more moderate.
Electrophoresis with hydrocortisone is a physiotherapeutic procedure that allows you to slow down the autoimmune and allergic reactions in the body. Hydrocortisone provides a reduction in intense pain in the joints, relieves inflammation and swelling in the affected areas. The most effective use of physiotherapy for articular diseases of the knees, intercostal neuralgia, carpal tunnel syndrome, neuritis of the facial nerve.
Electrophoresis with Neuromidin contributes to impulse stimulation along the nerve fibers of the articular elements, has a beneficial effect on the neuromuscular and interneuronal synapses of the central nervous system and its peripheral areas.

The duration of a one-time session of physiotherapy is selected individually, depending on clinical symptoms, severity and severity of neurological or other pathology. On average, the duration of treatment with household electrophoresis is 15-20 minutes, and the general course of physiotherapy is no more than 10-15 procedures. After a 60-day break, and an examination of the patient's condition by a consulting physician, the physiotherapy course of home treatment can be continued.

Physiotherapy technique

Electrophoresis, or iontophoresis does not provide for a treatment session different kind gels, ointments and other lubricants. All that needs to be done is to prepare saline, medicine and a device for treatment.

The algorithm for performing the home procedure is as follows:

Prepare a saline solution to soak two pads. Liquid temperature - 37-39º C.
Before starting the procedure, it is necessary to assemble the electrical circuit of the device, as indicated in the instructions for use.
Pharmacological drugs are poured through a disposable syringe onto one of the pads, which acts as a positive ion.
A similar procedure is performed with another gasket, in this case, already a negative ion.
Red or black electrodes are inserted into the pads. Polarity is obligatory.
By applying gaskets to the affected areas, the power supply of the electrical appliance is turned on.
The level of current strength is determined by the sensitivity of the patient.
During the procedure, the current is gradually increased so that the patient feels a slight tingling in the treatment area.

Depending on the area to be treated, wetting pads may look different, for example, in the form of an ionic collar for the treatment of the cervical spine and / or knee joints, in the form of an ionic belt for the treatment of the lumbosacral and lower back, in the form of rectangular or square pads for the treatment of the back and area chest. Also, for the treatment of feet and / or hands, special reservoirs for saline are used, with the help of which galvanic electrophoresis, or galvanization, is carried out.

If you carry out electrophoresis at home, following a certain sequence of actions specified in the instructions for the device, this will not cause side effects.

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To supply direct current to the patient, electrodes made of metal plates (lead, steel) or conductive graphitized fabric and hydrophilic cloth pads are used.

The latter have a thickness of 1-1.5 cm and protrude beyond the edges of the metal plate or conductive fabric by 1.5-2 cm.

There are other types of electrodes: glass baths for the eyes, cavity electrodes - in gynecology, urology. Hydrophilic pads are designed to exclude the possibility of contact of electrolysis products (acids, alkalis) with the skin and are made of white fabric (flannels, flannels, fumes).

Do not use pads made of woolen or dyed fabric. Hydrophilic pads are sewn from 5-6 layers of fabric (for ease of rinsing in water, boiling and drying), a pocket is sewn from one layer of flannel, into which a lead plate is inserted connected to a current-carrying wire, a metal clip or soldered directly to the wire.

In the office, it is advisable to have a set of lead plates of various sizes from 4 to 800-1200 cm2 or carbon-graphite plates of the same area. In recent years, disposable electrodes have been produced. Electrodes of a special shape are used (in the form of a half mask for the face, a “collar” for the upper back and shoulder girdle, two-bladed, round for the eye area, etc.).

You should be aware that lead ions have a harmful effect on the body, so nurses who constantly work in this office should receive pectin or marmalade. Lead plates must be periodically cleaned with sandpaper and wiped with alcohol to remove lead oxide plaque, and also carefully smoothed with a metal roller before the procedure. The electrodes are fixed with elastic bandages, sandbags or the weight of the patient's body.

Before the procedure nurse should acquaint the patient with the nature of sensations under the electrodes: uniform tingling and slight burning. If unpleasant painful sensations or an uneven burning sensation appear on a certain area of the skin of the patient, without moving or changing position, he should call the sister. It is not recommended to read, talk, sleep during the procedure. After the procedure, you need to rest for 20-30 minutes.

Before the procedure, you should make sure that there are no scratches, abrasions, maceration, rashes on the skin. Hydrophilic fabric pads wet well with warm tap water and placed on the patient's skin, while the lead plate with a current-carrying wire is in the pocket. It is advisable to put filter paper on the skin under the cloth electrode to protect the pad from contamination.

The location of the electrodes on the patient's body is determined by the localization, severity and nature of the pathological process. There are transverse, longitudinal and transverse-diagonal methods. With a transverse arrangement, the electrodes are placed on opposite surfaces of the body - one against the other (stomach and back, outer and inner surfaces knee joint etc.), which provides a deeper impact. With the longitudinal technique, the electrodes lie on one surface of the body: one is more proximal, the other is distal (longitudinally along the spine, along the nerve, muscle).

In this case, more superficial tissues are affected. The transverse-diagonal technique is characterized by the location of electrodes on different surfaces of the body, but one is in its proximal parts, the other is in the distal. With close proximity, the distance between the electrodes should be at least half of their diameter.

By the method of electrophoresis, drugs-electrolytes are most often introduced into the body, dissociating in solutions into ions. Positively charged ions (+) enter from the positive pole (anode), negatively charged (-) - from the negative pole (cathode). With drug electrophoresis, various solvents can be used, the universal and best of them is distilled water. With poor solubility of the drug in water, dimexide is used as a solvent, which also has an anti-inflammatory effect.

For electrophoresis of complex organic compounds (proteins, amino acids, sulfonamides), buffer solutions are used. Medicinal substances, for example, lidase or ronidase, dissolved in an acidic (acetate) buffer solution with pH = 5.2, are injected from the positive pole. Prescribe it: sodium acetate (or citrate) I.4 g, glacial acetic acid 0.91 ml, distilled water 1000 ml, 64 units of lidase (0.1 g of dry matter). 0.5-1 g of Ronidase is dissolved in 15 or 30 ml of acetate buffer.

For electrophoresis of trypsin and chymotrypsin, a borate buffer with pH = 8.0-9.0 (alkaline medium) is used, which is injected from the negative pole. Its composition: boric acid 6.2 g, potassium chloride 7.4 g, sodium (or potassium) hydroxide 3 g, distilled water 500 ml. 10 mg of trypsin or chymotrypsin are dissolved in 15-20 ml of borate buffer. Given the complexity of preparing these buffers, B.C. Ulaschik and D.K. Danusevich (1975) suggested using distilled water, acidified with a 5-10% hydrochloric acid solution to pH = 5.2 (for injection from the anode) or alkalized with a 5-10% caustic alkali solution to pH = 8.0 (for injection from the cathode) .

We give table. 1, which indicates the required amount of caustic alkali or hydrochloric acid in various dilutions for alkalization and acidification. For example: we take 10 ml of a 0.5 solution of glutamic acid and add 0.16 ml of caustic alkali, we get a solution with a pH of 8.0 and enter from the negative pole. When hydrochloric acid is added, pH = 5.0 is created.

Table 1. The required amount of caustic alkali or hydrochloric acid in various dilutions for alkalization and acidification

Solution concentration medicinal substances used for electrophoresis, most often ranges from 0.5 to 5.0%, since it has been proven that large amounts should not be administered. The drug consumption for every 100 cm2 of the pad area is approximately from 10-15 to 30 ml of the solution. Potent agents (adrenaline, atropine, platifillin, etc.) are administered from solutions at a concentration of 1:1000 or applied to the pad in an amount equal to the highest single dose.

Medicinal substances are prepared for no more than a week, potent - immediately before administration. In order to save money, drugs are applied to filter paper, which is placed on the patient's skin, and a cloth pad moistened with warm water is placed on top. Medicinal substances used for electrophoresis are given in table. 2.

Table 2. Medicinal substances used in electrophoresis with direct electric current

During electrophoresis of one drug, one hydrophilic pad of the corresponding polarity is moistened with its solution. With the simultaneous introduction of two substances of different polarity ("bipolar" electrophoresis), both gaskets (anode and cathode) are moistened with them. If it is necessary to introduce two drugs of the same polarity, two gaskets are used, connected by a double wire to one current pole. In this case, one pad is moistened with one, the second - with another medicine.

For electrophoresis of antibiotics and enzymes, in order to avoid their inactivation by electrolysis products, special multilayer pads are used, in the middle of which 3-4 layers of filter paper are placed moistened with a “safety” solution of glucose (5%) or glycocol (1%). You can also use ordinary hydrophilic pads, but their thickness should be at least 3 cm.

After each procedure, it is necessary to thoroughly rinse the pads with running water at the rate of 8-10 liters per one, to remove medicinal substances from them. In the "kitchen" there should be 2 sinks: one for indifferent pads, the other for active ones, that is, moistened with a medicinal substance. For potent drugs, it is more advisable to have separate pads on which you can embroider the name of the drug.

Rinse and boil pads moistened with various medicinal substances should be separately to avoid contamination of them with ions harmful to the body. At the end of the working day, hydrophilic pads are boiled, squeezed and left in a drying cabinet.

The introduction of medicinal substances into dimexides using current is called superelectrophoresis. Dimethyl sulfoxide (DMSO) has the ability to enhance the effect of many drugs and increase the body's resistance to the damaging effects of low temperatures and radiation. DMSO has a pronounced transporting property. DMSO is considered bipolar, but the transfer towards the cathode is more pronounced.

It is possible to use dimxide in the form of applications on the skin, since in this case it is found in the blood after 5 minutes. The maximum concentration is observed after 4-6 hours, the drug is retained in the body for no more than 36-72 hours. 70-90% solutions have a pronounced effect, but they are rarely used due to a severe allergic reaction. Pure dimxide is best used in the form of compresses, and in electrophoresis it is used as a solvent.

Sparingly soluble medicinal substances prepared on DMSO penetrate in larger quantities and to greater depths (dermis and subcutaneous fat). At the same time, they enter the blood faster, and their pharmacological effect increases significantly.

For electrophoresis of water-soluble drugs, it is recommended to use 20-25% aqueous solutions of dimexide, and for difficult and water-insoluble drugs - 30-50% aqueous solutions. To prepare the latter, the drug is first dissolved in a concentrated DMSO solution, and then, with constant shaking, distilled water is added to the desired concentration.

For electrophoresis from a DMSO medium, a 5-10% solution of aspirin in 50% DMSO, a 5-10% solution of analgin in 25% DMSO, a 1-2% solution of trypsin in 25% DMSO, 32-64 IU of lidase in a 25% DMSO solution, 2-5% solution of adebite in 25% DMSO. All of these drugs are administered bipolar. Dimxide causes an allergic reaction in some patients, therefore, before the first procedure, a 25% solution of the drug should be applied to a small area of the skin and the reaction should be observed after 30-40 minutes. If swelling, redness, itching appear on the skin, then DMSO should not be used.

Appointment order. In the appointment, indicate the name of the method (galvanization or electrophoresis with the designation of the concentration of the solution and the polarity of the ion), the place of exposure, the method used (longitudinal, transverse, etc.), current strength in milliamperes, duration in minutes, sequence (daily or every other day), number procedures for a course of treatment.

Bogolyubov V.M., Vasilyeva M.F., Vorobyov M.G.

Medicinal electrophoresis (synonym: iontophoresis, iontophoresis, ionogalvanization, galvanoionotherapy, electroionotherapy) is a combined effect on the body of galvanic current and drugs introduced with it through the skin or mucous membranes. Since 1953, it has been customary in the USSR to use only the term "medicinal electrophoresis" to refer to the method of introducing into the body using a galvanic current not only ions of electrolyte solutions, but also larger particles associated with ions and complex molecules of organic compounds.

Ions of medicinal substances during drug electrophoresis, penetrating mainly through the excretory openings of the sweat and sebaceous glands, are retained in the thickness of the skin under the electrode. From such a skin depot, ions enter the lymph and blood stream gradually. This creates conditions for a longer exposure of the drug to the body - one of the important advantages of electrophoresis compared to other methods of administering drugs. With medicinal electrophoresis, not only stimulation of various protective physiological reactions by galvanic current is observed (see Galvanization), but also the specific effect of the medicinal substance, due to its pharmacological characteristics.

The complex mechanism of the physiological and therapeutic action of drug electrophoresis is based on the complex irritation of the receptor apparatus of the skin by galvanic current and the ions of the drug introduced through it, transmitted through neural pathways higher vegetative centers of the brain, as well as the pharmacological action of a medicinal substance in an electrically active state. Thus, during electrophoresis, along with local changes in tissues, generalized vegetative reflexes arise (according to A.E. Shcherbak, general ionic reflexes). Ionic reflexes are universal: they can be called from any, even a small, area of the skin with normal sensitivity. To obtain a therapeutic effect, it is not necessary to place electrodes in the area of the affected organ or strive in all cases to create a high concentration of medicinal substances in the blood. In physiotherapy practice, extrafocal methods of electrophoresis of medicinal substances in the form of general calcium-, iodine-, zinc-, magnesium-, salicyl- and other ionic reflexes are widely used. Therapeutic value is also focal effects, realized through the reflex mechanism of action of the galvanic current and the introduced substance, and changes in the electroionic state of tissues under the influence of the lines of force of the direct current electric field in the interpolar space. In this case, there is a local increase in blood and lymph circulation, an increase in local metabolism, a change in the permeability of histohematic barriers, which determines the preferential resorption of the medicinal substance flowing through this area by the tissues after it has penetrated from the skin depot into the general bloodstream.

Indications. Electrophoresis is prescribed for many diseases, including severe and long-term current, to be treated with galvanization (see) and various medicinal substances. When prescribing drug electrophoresis of certain drugs, it is necessary to take into account both the features of their pharmacological action and indications for the use of these drugs in other ways of their administration. Medicinal electrophoresis should not be contrasted with other treatments; it should be considered as a way to expand the possibilities of using many drugs with therapeutic and preventive purpose with nervous, surgical, internal, gynecological diseases, diseases of the eyes, ear, etc. By electrophoresis, a wide variety of medicinal substances can be administered, if only the possibility of moving them under the influence of direct current has been established (table).

Medicinal substances most commonly used for electrophoresis

Injected ion or particle (substance used)	Solution Concentration (%)	current pole
Adrenaline (hydrochloric)	0,1	+
Aconitine (nitrate)	0,001-0,002	+
Akrikhin	1	+
Aloe (extract)	*	-
Antipyrine (salicylate)	1-10	+
Vitamin C	5-10	-
Atropine (sulphate)	0,1	+
Acetylcholine (chloride)	0,1	+
Biomycin (hydrochloric acid)	0,5	+
Bromine (sodium or potassium)	1-10	-
Vitamin B1 (thiamine)	2-5	+
Hyaluronidase	0.5-1 g (in 1% novocaine solution)	+
Histamine	0,01	+
Decain	2-4	+
Diphenhydramine	0,25-0,5	+
Dionin	0,1	+
Iodine (potassium or sodium)	1-10	-
Calcium (chloride)	1-10	+
Potassium (chloride)	1-10	+
Sulfothiophene (acid residue; ichthyol)	1-10	-
Codeine (phosphate)	0,1-0,5	+
Cocaine (hydrochloric)	0,1	+
Caffeine (sodium benzoate)	1 (in 5% soda solution)	-
Lithium (salicylate, etc., except carbonate)	1-10	+
Magnesium (magnesium sulphate)	1-10	+
Copper (sulfate)	1-2	+
Morphine (hydrochloric acid)	0,1	+
A nicotinic acid	1	-
Novocain (hydrochloric acid)	1-10	+
Osarsol	1 (in 0.5% soda solution)	+
Papaverine (hydrochloric)	0,1	+
PABA (novocaine)	1-10	+
PASK	1-5	-
Penicillin (sodium salt)	**	-
Pilocarpine (hydrochloric acid)	0,1-1	+
Platifillin (sour tartrate)	0,03	+
Prozerin	0,1	+
Salicylic acid (acid residue; sodium)	1-10	-
Salsolin (hydrochloric)	0,1	+
Sulfur (hyposulfite)	2-5	-
Silver (nitrate)	1-2	+
Synthomycin	0,3	+
Streptomycin (calcium chloride)	***	+
Streptocid (white)	0.8 (in 1% soda solution)	-
Strychnine (nitrate)	0,1	+
Sulfazol	0.8 (in 1% soda solution)	-
Sulfate (magnesium sulphate)	2-10	-
Sulfite (sodium hyposulfite)	2-2,5	-
Terramycin (oxytetracycline, powder)	***	+
Tuberculin	10-25	+
Urotropin	2-10	+
Phosphoric acid (radical, sodium)	2-5	-
Ftalazol	0,8	-
Quinine (dihydrochloride)	1	+
Chlorine (sodium)	3-10	-
Zinc (chloride)	0,1-2	+
Ezerin (salicylate)	0,1	+
Eufillin	2	-
Ephedrine	0,1	+

* Aloe extract is prepared from leaves aged for 15 days in the dark at t° 4-8°. A slurry is prepared and poured with distilled water (100 g of mass per 300 ml of water), infused for an hour at room temperature, boiled for 2 minutes, filtered and poured into a bowl of 50-200 ml. The bottles are boiled in a water bath for 15 minutes. The extract is stored in a dark place.
** 600-1000 IU per 1 cm 2 pads (5000-10,000 IU in 1 ml of solution).
*** Like penicillin.
**** 100,000-1,000,000 IU (in 0.1-1 g of powder) per pad (solvent - saline, 10-30 ml).

Depending on the features clinical picture, the course of the process and the state of the body, reflex-segmental (see Segmental-reflex therapy), general or local electrophoresis procedures are prescribed.

Contraindications: neoplasms, decompensation of cardiac activity, acute inflammatory processes, a tendency to bleeding, some forms of eczema and dermatitis, individual intolerance to the prescribed medicinal substance or galvanic current.

Electrophoresis technique. For medicinal electrophoresis, galvanic current sources are used. Apply metal electrodes, thick cloth pads, observing all the rules for the procedures and location of the electrodes, as in galvanization. In contrast to galvanization, a piece of filter paper moistened with a solution of a medicinal substance prepared in distilled water is applied to a wet pad under the active electrode, or a piece of gauze folded in half - according to the size of the pad, and the pad under the indifferent electrode is moistened with warm water.

The procedures are carried out at a current density ranging from 0.01 to 0.1 mA/cm 2 depending on the technique (the larger the pad area, the lower the current density should be used to avoid over-irritation and adverse reactions). The duration of the procedure is 10-20 minutes, less often 30 minutes, if necessary, it is increased to 40-60 minutes. During the course of treatment, an average of 15-20 procedures should be carried out, prescribed daily, every other day or at other intervals with special techniques. With long-term or recurrent diseases, after a one-two-month break, you can repeat the courses of treatment.

In practice, in addition to local application, the following methods of electrophoresis of medicinal substances are most common.

General ionic reflections according to Shcherbak. Two electrodes with pads with an area of 120-140 cm 2 each are placed transversely or diagonally, more often on the shoulder (Fig. 3) or on the thigh. The electrodes are connected by means of flexible insulated wires to sources of galvanic current in accordance with the polarity of the introduced ions. Usually, solutions of calcium chloride, potassium iodide, zinc sulfate, sodium bromide, magnesium sulfate, sodium salicylate are used. A rubber bandage is applied above the electrodes to induce a mild degree of congestive hyperemia. The current density is gradually increased from 0.05 mA/cm 2 to 0.15-0.2 mA/cm 2 . The duration of the procedure is 20 minutes. After the 10th and 17th minutes, a one-minute break is made to reduce the polarization resistance.

Rice. 3. The location of the electrodes when causing a common ionic reflex:
1 and 2 - lead plates with cloth pads;
3 - insulated wire;
4 - rubber bandage.

Rice. 4. Location of the electrodes at the ion collar.

Ionic collars(calcium, iodide, bromide, salicylic, magnesium, novocaine, aminophylline, etc.). Three layers of filter paper or gauze with an area of 1000 cm 2 dipped in 50 ml of a solution of a medicinal substance prepared in distilled water (t ° 38-39 °) are applied to the collar zone (cervical and two upper thoracic skin segments). A gasket of the same area of flannel or calico 1 cm thick is placed on top of the metal electrode. Another electrode with a pad of 400 cm2 is placed in the lumbosacral region (Fig. 4). Cloth pads are moistened with warm water (t ° 38-39 °). With the help of an ionic collar, calcium from the anode and bromine from the cathode (calcium bromide collar), novocaine from the anode and iodine from the cathode (novocaine-iodine collar) and some other combinations can be simultaneously injected. During the first procedures, the current is gradually increased from 4-6 to 10 mA, and the duration of the session is from 6 to 10 minutes. If necessary, the current can be increased to 16 mA, and the duration of the procedure - up to 20 minutes.

Rice. 5. Arrangement of electrodes at the upper and lower ionic belts.

Ionic belts(calcium, bromide, iodide, magnesium, etc.). At the level of the lower thoracic and upper lumbar vertebrae (with the upper belt) or at the level of the lower lumbar and sacral vertebrae (with the lower belt), three layers of filter paper or gauze with an area of 1125 cm 2 (15X75 cm) moistened with 50 ml of a medicinal substance solution are applied, prepared with distilled water (t° 38-39°). A cloth pad of the same area 1 m thick and a metal electrode are placed on top. Two indifferent electrodes with pads with an area of 320 cm 2 each are placed on the front surface of the upper third of the thighs with the upper belt or on the back of the thighs with the lower belt (Fig. 5). The current is from 8 to 15 mA, the duration of the procedure is 8-10 minutes, if necessary, it is increased to 15-20 minutes.

Rice. 6. Location of electrodes in general electrophoresis.

General electrophoresis according to Vermel. An active electrode with filter paper on a 300 cm2 pad moistened with a drug solution is placed in the interscapular region, and two indifferent electrodes with 150 cm2 pads are placed on the back surface of the legs (Fig. 6). Current 10-30 mA, procedure duration 20-30 minutes.

Orbital-occipital electrophoresis according to Bourguignon. Two active round-shaped electrodes with a diameter of 5 cm with pads moistened with a solution of a medicinal substance are applied in the orbital area over closed eyes; an indifferent electrode with a gasket with an area of 40-60 cm 2 is placed on the back of the neck. Current up to 4 mA, procedure duration up to 30 minutes.

Nasal electrophoresis, proposed by N. I. Grashchenkov and G. N. Kassil, consists in the introduction into both nostrils of cotton swabs moistened with a medicinal substance at the tinned ends of the wires or gauze turundas, the ends of which are laid over a strip of oilcloth over upper lip, covering with an active electrode measuring 2x3 cm. An indifferent electrode with a gasket with an area of 80 cm 2 is placed on the back of the neck.

Sometimes electrophoresis of medicinal substances is used using four- or two-chamber baths. A number of special electrophoresis techniques are used in otiatry, ophthalmology, gynecology, and dermatology. Electrophoresis of medicinal substances can be combined with inductothermy (see) and mud applications (see. Mud therapy).