• Klinger de Souza Amorim
  • Fernanda Gama Venceslau
  • Anne Caroline Gercina Carvalho Dantas
  • Francisco Carlos Groppo
  • Rodrigo Pimentel da Silveira
  • Liane Maciel de Almeida Souza



Hypertension, Acupuncture, Auriculotherapy



Objective: Evaluate the effectiveness of blood pressure control in hypertensive patients using bloodletting on ear apex technique before tooth extraction. Methods: This observational prospective case series carried out on 65 volunteers who needed simple tooth extraction and had blood pressure above 140 / 90mmHg. The blood pressure measurement occurred 5 minutes after the baseline and after bleeding. Subsequently, the blood pressure measurement occurred in three moments: 15 minutes after bleeding, after anesthesia, and at the end of the procedure.  Results: There were significantly more successes than failures. Every patient who presented successful results had the pressure remained at the recommended levels after anesthesia and at the end of the procedure.  Also, there was sex influence with higher failure rates in men. Conclusion: The bloodletting on ear apex technique reduced the blood pressure satisfactorily in most cases, remaining at the recommended mean levels even when verified after anesthesia and at the end of the procedure.


World health Organization. Health topics/Hypertension. Available at Accessed August 15, 2020.

Whelton PK., Carey RM., Aronow WS., Casey DE., Collins KJ., Himmelfarb CD., et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults a report of the American College of Cardiology/American Heart Association Task Force on Clinical pr. Hypertension 2018:E13–115. Doi: 10.1161/HYP.0000000000000065. DOI:

MacDougall JD., Tuxen D., Sale DG., Moroz JR., Sutton JR. Arterial blood pressure response to heavy resistance exercise. J Appl Physiol 1985;58(3):785–90. Doi: 10.1152/jappl.1985.58.3.785. DOI:

Pioli MR., Ritter AMV., de Faria AP., Modolo R. White coat syndrome and its variations: Differences and clinical impact. Integr Blood Press Control 2018:73–9. Doi: 10.2147/IBPC.S152761. DOI:

Oparil S., Acelajado MC., Bakris GL., Berlowitz DR., Cífková R., Dominiczak AF., et al. Hypertension. Nat Rev Dis Prim 2018:18014. Doi: 10.1038/nrdp.2018.14. DOI:

Maciocia G. The Foundations of Chinese Medicine: A Comprehensive text. 3o. Elsevier Health Sciences; 2015.

Kwon CY., Lee B., Lee JA. Efficacy and safety of bloodletting on ear apex for primary hypertension: A systematic review and meta-analysis. Eur J Integr Med 2018:90–100. Doi: 10.1016/j.eujim.2018.09.011. DOI:

Auteroche B., Navailh P. Diagnosis in Chinese Medicine (in Portuguese). 1a. São Paulo: ANDREI; 1992.

Lee EW. Auriculo acupuntura. 6th ed. São Paulo: ICONE; 2007.

Ernesto González García. Auriculotherapy - Huang Li Chun School (in portuguese). 1a. São Paulo: Roca; 2006.

Marcos Lisboa Neves. Practical Manual of Auriculotherapy (in portuguese). 6a. Florianópolis, Santa Catarina, Brazil: Merithus; 2018.

Doyle DJ., Garmon EH. American Society of Anesthesiologists Classification (ASA Class). StatPearls Publishing; 2018.

Yang J., Chen J., Yang M., Yu S., Ying L., Liu GJ., et al. Acupuncture for hypertension. Cochrane Database Syst Rev 2018. Doi: 10.1002/14651858.CD008821.pub2. DOI:

Chen H., Shen FE., Tan XD., Jiang WB., Gu YH. Efficacy and safety of acupuncture for essential hypertension: A meta-analysis. Med Sci Monit 2018;24:2946–69. Doi: 10.12659/MSM.909995. DOI:

Zhao H., Li D., Li Y., Yang Y., Liu Y., Li J., et al. Efficacy and safety of acupuncture for hypertension: An overview of systematic reviews. Complement Ther Clin Pract 2019:185–94. Doi: 10.1016/j.ctcp.2018.12.003. DOI:

The Japanese Society of Hypertension. Chapter 12. Hypertension under special conditions. Hypertens Res 2014;37(4):343–8. Doi: 10.1038/hr.2014.15. DOI:

Grossman E., Nadler M., Sharabi Y., Thaler M., Shachar A., Shamiss A. Antianxiety treatment in patients with excessive hypertension. Am J Hypertens 2005;18(9):1174–7. Doi: 10.1016/j.amjhyper.2005.03.728. DOI:

Watanabe Y., Higuchi H., Ishii-Maruhama M., Honda Y., Yabuki-Kawase A., Yamane-Hirano A., et al. Effect of a low dose of midazolam on high blood pressure in dental patients: A randomised, double-blind, placebo-controlled, two-centre study. British Journal of Oral and Maxillofacial Surgery, vol. 54. Churchill Livingstone; 2016. p. 443–8. DOI:

Conway A., Rolley J., Sutherland JR. Midazolam for sedation before procedures. Cochrane Database Syst Rev 2016. Doi: 10.1002/14651858.CD009491.pub2. DOI:

Mancuso CE., Tanzi MG., Gabay M. Paradoxical reactions to benzodiazepines: Literature review and treatment options. Pharmacotherapy 2004:1177–85. Doi: 10.1592/phco.24.13.1177.38089. DOI:

Oliveira RR., Silvério-Lopes S. Systemic arterial hypertension: hypotensive effect of bloodletting in the cerebral reflex point of auriculotherapy. Rev Bras Ter e Saúde 2013;4(1):1–5. Doi: 10.7436/rbts-2013.04.01.01. DOI:

Gori L., Firenzuoli F. Ear acupuncture in European traditional medicine. Evidence-based Complementary and Alternative Medicine, vol. 4. Hindawi Limited; 2007. p. 13–6. DOI:

He W., Wang X., Shi H., Shang H., Li L., Jing X., et al. Auricular acupuncture and vagal regulation. Evidence-Based Complement Altern Med 2012. Doi: 10.1155/2012/786839. DOI:

Joyner MJ., Wallin BG., Charkoudian N. Sex differences and blood pressure regulation in humans. Exp Physiol 2016;101(3):349–55. Doi: 10.1113/EP085146. DOI:

Júnior GPA., Rodrigues ADM. Federal Council of Dentistry Resolution -161/2015. Brazil: Federal Council of Dentistry; 2015.




How to Cite

Amorim, K. de S., Venceslau, F. G., Dantas, A. C. G. C., Groppo, F. C., da Silveira, R. P., & Souza, L. M. de A. (2023). BLOODLETING ON EAR APEX FOR ARTERIAL BLOOD PRESSURE CONTROL IN DENTAL PATIENTS. A CASE SERIES. Revista Contemporânea, 3(07), 7412–7426.