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Emre B, Didem ÖE, Yasemin Ç. Effect of electroacupuncture on pain after periodontal flap surgery: a randomized controlled trial. J TRADIT CHIN MED 2025; 45:184-191. [PMID: 39957173 PMCID: PMC11764923 DOI: 10.19852/j.cnki.jtcm.2025.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 03/20/2024] [Indexed: 02/18/2025]
Abstract
OBJECTIVE To examine the effect of electro-acupuncture (EA) application on postoperative pain levels and the amount of analgesic use in patients who underwent periodontal flap surgery. METHODS In this prospective, randomized and controlled study, patients planned for periodontal surgery were divided into two groups [EA group (n = 22): patients who received electroacupuncture and control group (n = 22): patients who did not receive electroacupuncture]. Electroacupuncture was applied bilaterally to the Hegu (LI4), Daying (ST5), and Jiache (ST5) points of the patients in the EA group immediately before and after the flap surgery for 30 min at a frequency of 50 Hz to each point at a current that the patient could tolerate. The patients in the control group underwent flap surgery without applying electroacupuncture. Patients were asked to record their pain levels on the visual analog scale and the number of analgesic tablets they took during the 7 postoperative days on the given form. RESULTS The total mean score of pain felt in the EA group (16.60 ± 2.78) was found to be significantly lower than that in the control group (31.37 ± 2.78) (P = 0.001). No significant difference was found between the groups regarding the amount of analgesics taken (4.77 ± 4.72, 5.82 ± 3.11) (P = 0.111). CONCLUSIONS Our study shows that electro-acupuncture application is beneficial in reducing pain after periodontal flap surgery. Overall, more research is needed to fully understand the effects of electro-acupuncture on postoperative pain.
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Affiliation(s)
- Bulut Emre
- 1 Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, 25100, Türkiye
| | - Özkal Eminoğlu Didem
- 1 Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, 25100, Türkiye
| | - Çayır Yasemin
- 2 Department of Family Medicine, Faculty of Medicine, Atatürk University, Erzurum 25100, Türkiye
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Makkad B, Heinke TL, Sheriffdeen R, Meng ML, Kachulis B, Grant MC, Popescu WM, Brodt JL, Khatib D, Wu CL, Kertai MD, Bollen BA. Practice Advisory for Postoperative Pain Management of Thoracic Surgical Patients: Executive Summary: A Report by Society of Cardiovascular Anesthesiologists. J Cardiothorac Vasc Anesth 2024:S1053-0770(24)00941-8. [PMID: 39864980 DOI: 10.1053/j.jvca.2024.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Revised: 12/03/2024] [Accepted: 12/04/2024] [Indexed: 01/28/2025]
Abstract
Patients after thoracic surgery experience significant pain that can disrupt normal respiratory mechanics, increase the risk of respiratory complications, and impair recovery. Poorly controlled postoperative pain can develop into persistent postoperative pain. In addition, using opioids for pain control in the thoracic surgical population makes them more susceptible to opioid-related side effects due to their pre-existing comorbidities. The lack of consensus on how to effectively attain pain control in this surgical population has resulted in variability in the analgesic regimens utilized by providers across institutions and practices. The overall goal of this practice advisory is to identify opportunities for improvement in the postoperative pain management of thoracic surgical patients and provide guidance to perioperative providers through the provision of evidence-based recommendations.
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Affiliation(s)
- Benu Makkad
- Department of Anesthesiology, University of Cincinnati College of Medicine, Cincinnati, OH.
| | - Timothy Lee Heinke
- Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC
| | - Raiyah Sheriffdeen
- Department of Anesthesiology, Medstar Washington Hospital Center, Washington, DC
| | - Marie-Louise Meng
- Department of Anesthesiology, Duke University Medical Center, Durham, NC
| | - Bessie Kachulis
- Department of Anesthesiology, Columbia University, New York, NY
| | - Michael Conrad Grant
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Wanda Maria Popescu
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, VA Connecticut Health Care System, West Haven, CT
| | - Jessica Louise Brodt
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA
| | - Diana Khatib
- Department of Anesthesiology, Weil Cornell Medical College, New York, NY
| | - Christopher L Wu
- Department of Anesthesiology, Hospital of Special Surgery, Weill Cornell Medical College, New York, NY
| | - Miklos D Kertai
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN
| | - Bruce Allen Bollen
- Department of Anesthesiology, Missoula Anesthesiology and The International Heart Institute of Montana, Missoula, MT
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Makkad B, Heinke TL, Sheriffdeen R, Meng ML, Kachulis B, Grant MC, Popescu WM, Brodt JL, Khatib D, Wu CL, Kertai MD, Bollen BA. Practice Advisory for Postoperative Pain Management of Thoracic Surgical Patients: A Report from the Society of Cardiovascular Anesthesiologists. J Cardiothorac Vasc Anesth 2024:S1053-0770(24)00942-X. [PMID: 39890582 DOI: 10.1053/j.jvca.2024.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Revised: 12/03/2024] [Accepted: 12/04/2024] [Indexed: 02/03/2025]
Abstract
Pain after thoracic surgery is often significant, which can disrupt normal respiratory mechanics and impair the clearance of secretions, thus increasing the risk of postoperative respiratory complications. Poorly controlled acute pain can lead to persistent post-thoracotomy pain and continued opioid use that can affect quality of life. With the increased awareness of opioid-associated adverse effects and recent emphasis on enhanced recovery, opioid-sparing multimodal analgesia has been used widely for acute pain management after thoracic surgery. This practice advisory reviews, evaluates, and summarizes the recent literature related to pharmacological therapies and non-pharmacological therapies used for postoperative pain management after thoracic surgery and offers guidance to providers in making appropriate pain management decisions for their patients.
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Affiliation(s)
- Benu Makkad
- Department of Anesthesiology, University of Cincinnati College of Medicine, Cincinnati, OH.
| | - Timothy Lee Heinke
- Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC
| | - Raiyah Sheriffdeen
- Department of Anesthesiology, Medstar Washington Hospital Center, Washington, DC
| | - Marie-Louise Meng
- Department of Anesthesiology, Duke University Medical Center, Durham, NC
| | - Bessie Kachulis
- Department of Anesthesiology, Columbia University, New York, NY
| | - Michael Conrad Grant
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Wanda Maria Popescu
- Department of Anesthesiology, Yale School of Medicine, VA Connecticut Health Care System, West Haven, CT
| | - Jessica Louise Brodt
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA
| | - Diana Khatib
- Department of Anesthesiology, Weil Cornell Medical College, New York, NY
| | - Christopher L Wu
- Department of Anesthesiology, Hospital of Special Surgery, Weill Cornell Medical College, New York, NY
| | - Miklos D Kertai
- Department of Anesthesiology, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN
| | - Bruce Allen Bollen
- Department of Anesthesiology, Missoula Anesthesiology and The International Heart Institute of Montana, Missoula, MT
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Lu L, Xie C, Li X, Zhou Y, Yin Z, Wei P, Gao H, Wang J, Yong Y, Song J. Efficacy and safety of electrical acupoint stimulation for postoperative nausea and vomiting: A systematic review and meta-analysis. PLoS One 2023; 18:e0285943. [PMID: 37256901 PMCID: PMC10231798 DOI: 10.1371/journal.pone.0285943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 05/03/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Postoperative nausea and vomiting are typical postsurgical complications. Drug therapy is only partially effective. The goal of our meta-analysis is to systematically evaluate the efficacy and safety of electrical acupoint stimulation for postoperative nausea and vomiting and to score the quality of evidence supporting this concept. METHODS PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov were searched from inception to March 19, 2020. RESULTS Twenty-six studies (2064 patients) were included. Compared with control treatment, electrical acupoint stimulation reduced the incidence of postoperative nausea and vomiting (RR 0.49, 95% CI 0.41 to 0.57, P < 0.001), postoperative nausea (RR 0.55, 95% CI 0.47 to 0.64, P < 0.001) and postoperative vomiting (RR 0.56, 95% CI 0.45 to 0.70, P < 0.001). Electrical acupoint stimulation also reduced the number of patients requiring antiemetic rescue (RR 0.60, 95% CI 0.43 to 0.85, P = 0.004). No differences in adverse events were observed. Subgroup analysis showed that both electroacupuncture (RR 0.58, 95% CI 0.46 to 0.74, P < 0.001) and transcutaneous electrical acupoint stimulation (RR 0.44, 95% CI 0.34 to 0.58, P < 0.001) had significant effects. Electrical acupoint stimulation was effective whether administered preoperatively (RR 0.40, 95% CI 0.27 to 0.60, P < 0.001), postoperatively (RR 0.59, 95% CI 0.46 to 0.76, P < 0.001), or perioperatively (RR 0.50, 95% CI 0.37 to 0.67, P < 0.001). The quality of evidence was moderate to low. CONCLUSIONS Electrical acupoint stimulation probably reduce the incidence of postoperative nausea and vomiting, postoperative nausea, postoperative vomiting, and reduce the number of patients requiring antiemetic rescue, with few adverse events.
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Affiliation(s)
- Liyue Lu
- Department of Anesthesiology & Research Institute of Acupuncture Anesthesia, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chenlong Xie
- Department of Anesthesiology & Research Institute of Acupuncture Anesthesia, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xing Li
- Department of Anesthesiology, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yalan Zhou
- Department of Anesthesiology, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhiyu Yin
- Department of Anesthesiology, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Pan Wei
- Department of Anesthesiology, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Hao Gao
- Department of Anesthesiology, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jian Wang
- Department of Anesthesiology, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yue Yong
- Department of Anesthesiology & Research Institute of Acupuncture Anesthesia, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Anesthesiology, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiangang Song
- Department of Anesthesiology & Research Institute of Acupuncture Anesthesia, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Department of Anesthesiology, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Wu X, Chen T, Wang K, Wei X, Feng J, Zhou J. Efficacy and safety of transcutaneous electrical acupoints stimulation for preoperative anxiety in thoracoscopic surgery: study protocol for a randomised controlled trial. BMJ Open 2023; 13:e067082. [PMID: 36797022 PMCID: PMC9936321 DOI: 10.1136/bmjopen-2022-067082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
INTRODUCTION Preoperative anxiety occurs at a very high rate in patients undergoing video-assisted thoracoscopic surgery (VATS). Moreover, it will result in poor mental state, more analgesic consumptions, rehabilitation delay and extra hospitalisation costs. Transcutaneous electrical acupoints stimulation (TEAS) is a convenient intervention for pain control and anxiety reduction. Nevertheless, TEAS efficacy of preoperative anxiety in VATS is unknown. METHODS AND ANALYSIS This single-centre randomised sham-controlled trial will be conducted in cardiothoracic surgery department of the Yueyang Hospital of Integrated Traditional Chinese and Western Medicine in China. A total of 92 eligible participants with pulmonary nodules (size ≥8 mm) who are arranged for VATS will be randomly assigned to a TEAS group and a sham TEAS (STEAS) group in a 1:1 ratio. Daily TEAS/STEAS intervention will be administered starting on 3 days before the VATS and continued once per day for three consecutive days. The primary outcome will be the generalised anxiety disorder scale score change between the day before surgery with the baseline. The secondary outcomes will include serum concentrations of 5-hydroxytryptamine, norepinephrine and gamma-aminobutyric acid, intraoperative anaesthetic consumption, time to postoperative chest tube removal, postoperative pain, and length of postoperative hospital stay. The adverse events will be recorded for safety evaluation. All data in this trial will be analysed by the SPSS V.21.0 statistical software package. ETHICS AND DISSEMINATION Ethics approval was obtained from the Ethics Committee of the Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated to Shanghai University of Traditional Chinese Medicine (approval number: 2021-023). The results of this study will be distributed through peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04895852.
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Affiliation(s)
- Xindi Wu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
- Cardiothoracic Surgery Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Tongyu Chen
- Cardiothoracic Surgery Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Ke Wang
- Clinical Research Institute of Acupuncture and Anaesthetic, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Xuqiang Wei
- Clinical Research Institute of Acupuncture and Anaesthetic, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Jijie Feng
- Cardiothoracic Surgery Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
| | - Jia Zhou
- Cardiothoracic Surgery Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China
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Zagorulko OI, Medvedeva LA, Tsedinova YB, Kotenko KV. [Reflexology in patient rehabilitation with postoperative pain. (Literature review)]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2023; 100:103-106. [PMID: 38289312 DOI: 10.17116/kurort2023100061103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Postoperative pain is a pressing medical problem, as it significantly reduces the quality of life of patients after surgical treatment. Chronic postoperative pain further disables patients and impairs their functional activity. Being a widespread interdisciplinary problem, postoperative pain requires the integration of various pain management methods in complex multimodal pain management in the acute period and treatment programs for its chronicity. The paper examines the possibilities of reflexology methods for the relief of acute and treatment of chronic postoperative pain. Integration of reflex effects from the first days after surgery makes it possible to more effectively and safely solve the problems of acute and chronic postoperative pain.
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Affiliation(s)
- O I Zagorulko
- Petrovsky National Research Centre of Surgery, Moscow, Russia
| | - L A Medvedeva
- Petrovsky National Research Centre of Surgery, Moscow, Russia
| | - Yu B Tsedinova
- Petrovsky National Research Centre of Surgery, Moscow, Russia
| | - K V Kotenko
- Petrovsky National Research Centre of Surgery, Moscow, Russia
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Shah S, Godhardt L, Spofford C. Acupuncture and Postoperative Pain Reduction. Curr Pain Headache Rep 2022; 26:453-458. [PMID: 35482244 DOI: 10.1007/s11916-022-01048-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 12/19/2022]
Abstract
PURPOSE OF REVIEW Acupuncture is an analgesic technique that has long been utilized in Eastern medicine. In recent times, various acupuncture techniques have been used in integrated pain management approaches in Western medicine. It has even been adopted as an analgesic method in surgical patients. Currently, no review exists regarding various acupuncture techniques used in perioperative pain management and data describing the utility of these techniques. This paper synthesizes the latest literature regarding the role of acupuncture in perioperative pain management. The authors sought to describe various acupuncture modalities used to help manage surgical pain and synthesize the current body of literature to help readers make informed judgements on the topic. RECENT FINDINGS Patients undergoing abdominal, spine/neuro, and gynecologic pelvic surgery generally benefit from acupuncture. Out of the various acupuncture techniques, electroacupuncture, transcutaneous electric acupoint stimulation, and traditional total body acupuncture seem to be most promising as adjuncts to multimodal perioperative analgesia. Benefits include improved analgesia and/or reduced narcotic requirements, decrease in PONV, and shorter time to return of bowel function. Acupuncture is a low-risk method that has the potential to enhance perioperative analgesia, decrease opioid requirement, and reduce unwanted side effects of anesthesia, surgery, and opioid administration such as nausea/vomiting. Given the variety of patient populations, various acupuncture techniques, and small patient populations for most current studies; it remains difficult to determine which acupuncture method would most benefit specific patients. Future studies with more robust sample sizes and prospective comparison on acupuncture technique would help better characterize acupuncture's role in perioperative pain management.
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Affiliation(s)
- Shivani Shah
- Department of Anesthesiology, Medical College of Wisconsin, 9200 W. Wisconsin Ave; P347, Milwaukee, WI, 53226, USA
| | - Lisa Godhardt
- Department of Anesthesiology, Medical College of Wisconsin, 9200 W. Wisconsin Ave; P347, Milwaukee, WI, 53226, USA
| | - Christina Spofford
- Department of Anesthesiology, Medical College of Wisconsin, 9200 W. Wisconsin Ave; P347, Milwaukee, WI, 53226, USA.
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Hsu HC, Fang HY, Kuo CC, Su SF, Liang WM, Ma WF. The effectiveness of acupressure for managing postoperative pain in patients with thoracoscopic surgery: A randomized control trail. J Nurs Scholarsh 2021; 54:411-421. [PMID: 34854214 DOI: 10.1111/jnu.12751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/25/2021] [Accepted: 11/18/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE More than 86% patients experience moderate to severe pain after thoracoscopic surgery. A combination of diverse nonpharmacological pain relief methods is a developing trend for pain management. The purpose of this study was to explore the effect of acupressure in reducing pain after thoracoscopic surgery. DESIGN A Randomized controlled study with purpose sampling was used for this study. Patients who underwent thoracoscopic surgery at a medical center in central Taiwan were enrolled. Study data was collected from September 2020 to April 2021 after the approval of the institutional review board. A total of 100 participants were randomized into two groups (49 and 51 in the experimental and control groups, respectively). METHODS Participants in the experimental group received acupressure at the Neiguan (PC6) and Shenmen (HT7) acupoints thrice a day for 2 days, whereas those in the control group received routine treatment and did not receive acupressure. The measurement included questionnaires for the collection of general information, physiological information, and disease rating scale. The Visual Analogue Scale-Pain (VAS-P) was used to measure the severity of pain. SPSS statistical software was used for data analysis. Independent sample t-test and chi-squared test were used for descriptive statistics, and paired t-test and linear mixed model were used to examine the effect of acupressure in alleviating pain. FINDINGS After acupressure intervention, the pain score of the experimental group was lower than that of the control group, and this difference was significant β = 17.76, p < 0.001 on day 1 after intervention; β = 19.80, p < 0.001 on day 2 after intervention. The postoperative pain score in the experimental group on day 2 after intervention was significantly lower than that in the control group (t = 2.039, p = 0.044). After the subjects received acupressure, pain index significantly decreased after considering the interaction between time and group (p < 0.001). Regardless of the type of surgery, there were significant differences in pain index when the interaction between time and group was considered (p < 0.001). CONCLUSIONS This study provided an experimental basis that acupressure can help in pain management in patients after thoracoscopic surgery, and the pain relief results become more significant as the duration of intervention increases. CLINICAL RELEVANCE Acupressure is effective in relieving postoperative pain in any type of thoracoscopic surgery. Nurses can use acupressure to help control pain in patients after thoracoscopic surgery.
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Affiliation(s)
- Hsing-Chi Hsu
- Department of Nursing, HungKuang University, Taichung, Taiwan, R.O.C
| | - Hsin-Yuan Fang
- School of Medicine, China Medical University, Taichung, Taiwan, R.O.C.,Division of Thoracic Surgery, Department of Surgery, China Medical University Hospital, Taichung, Taiwan, R.O.C
| | - Chi-Chung Kuo
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan, R.O.C.,School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, Taiwan, R.O.C
| | - Shu-Fen Su
- Department of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan, R.O.C
| | - Wen-Miin Liang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan, R.O.C
| | - Wei-Fen Ma
- PhD Program for Health Science and Industry and School of Nursing, China Medical University, Taichung, Taiwan, R.O.C.,Department of Nursing, China Medical University Hospital, Taichung, Taiwan, R.O.C
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Park S, Lyu YR, Park SJ, Oh MS, Jung IC, Lee EJ. Electroacupuncture for post-thoracotomy pain: A systematic review and meta-analysis. PLoS One 2021; 16:e0254093. [PMID: 34234358 PMCID: PMC8263274 DOI: 10.1371/journal.pone.0254093] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 06/18/2021] [Indexed: 11/18/2022] Open
Abstract
Background Thoracotomy is an invasive surgical procedure that produces intense postoperative pain. Electroacupuncture has been used to induce analgesia in various situations, including after surgery. The aim of the following systematic review and meta-analysis was to evaluate the effect of electroacupuncture on post-thoracotomy pain. Methods The studies for the systematic review were searched using the following 9 databases: PubMed, Cochrane Library, EMBASE, MEDLINE Complete, Google Scholar, China National Knowledge Infrastructure (CNKI), Korean Medical Database (KMBASE), Koreanstudies Information Service System (KISS), and OASIS, without language restriction. Randomized controlled trials (RCTs) that met the inclusion criteria were selected. The quality assessment was performed using the Cochrane risk-of-bias tool, and RevMan 5.3 was used for meta-analysis. The review protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO) as CRD42019142157. Results Eleven randomized controlled trials were included in the systematic review. The meta-analysis was performed for two outcome measures: pain score 24 hours after surgery and total dose of opioid analgesics. A subgroup analysis was performed according to the control group: sham acupuncture and conventional analgesia group. Pain score 24 hours after surgery of electroacupuncture group showed a standard mean difference of -0.98 (95% CI: -1.62 to -0.35) compared to sham acupuncture. The standard mean difference was -0.94 (95% CI: -1.33 to -0.55) compared to conventional analgesia. The total dose of opioid analgesics of electroacupuncture group showed a standard mean difference values of -0.95 (95% CI: -1.42 to -0.47) compared to sham acupuncture. The standard mean difference was -1.96 (95% CI: -2.82 to -1.10) compared to conventional analgesia. Conclusion Current evidence suggests that electroacupuncture might provide useful pain relieving effect on post-thoracotomy patients. However, due to low quality and high heterogeneity of existing data, further rigorously designed studies should be performed to confirm the safety and efficacy.
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Affiliation(s)
- Sohyeon Park
- College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Yee Ran Lyu
- Clinical Trial Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, Republic of Korea
- Department of Korean Internal Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - So Jung Park
- Clinical Trial Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, Republic of Korea
- Department of Korean Internal Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Min Seok Oh
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - In Chul Jung
- Clinical Trial Center, Dunsan Korean Medicine Hospital of Daejeon University, Daejeon, Republic of Korea
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
- * E-mail: (ICJ); (E-JL)
| | - Eun-Jung Lee
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
- * E-mail: (ICJ); (E-JL)
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Short-term effect of electroacupuncture on rehabilitation after arthroscopic triangular fibrocartilage complex repair: a randomised study. J Orthop Surg Res 2021; 16:211. [PMID: 33761976 PMCID: PMC7988981 DOI: 10.1186/s13018-021-02361-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/18/2021] [Indexed: 11/20/2022] Open
Abstract
Background Electroacupuncture (EA) alleviates chronic pain and acute postoperative pain after several surgical procedures. However, whether EA facilitates postoperative functional recovery after arthroscopic surgery has yet to be determined. This study investigated the short-term effect of EA on a rehabilitation course after arthroscopic triangular fibrocartilage complex (TFCC) repair. Methods Forty-two patients undergoing arthroscopic TFCC repair were randomised to an EA group (n = 19) or control group (n = 23). In the EA group, patients received EA treatment and standard active rehabilitation for 4 weeks. In the control group, patients received standard active rehabilitation for 4 weeks. At the end of the treatment and at the follow-up visit 4 weeks after the treatment, Disabilities of the Arm, Shoulder, and Hand (DASH) scores, wrist range of motion (ROM), handgrip strength, and key pinch strength were collected and analysed. Results The EA group improved significantly than the control group in terms of DASH scores, all wrist motion arcs, and key pinch strength (P < 0.05) at the end of the 4-week treatment and the follow-up visit another 4 weeks later. Conclusion Patients treated with 4 weeks of EA after the arthroscopic TFCC repair had better wrist ROM and DASH scores than patients of control group Supplementary Information The online version contains supplementary material available at 10.1186/s13018-021-02361-1.
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Multicentre randomised controlled clinical trial of electroacupuncture with usual care for patients with non-acute pain after back surgery. Br J Anaesth 2020; 126:692-699. [PMID: 33341226 DOI: 10.1016/j.bja.2020.10.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 09/28/2020] [Accepted: 10/23/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The purpose of this study was to investigate the effectiveness and safety between electroacupuncture (EA) combined with usual care (UC) and UC alone for pain reduction and functional improvement in patients with non-acute low back pain (LBP) after back surgery. METHODS In this multicentre, randomised, assessor-blinded active-controlled trial, 108 participants were equally randomised to either the EA with UC or the UC alone. Participants in the EA with UC group received EA treatment and UC treatment twice a week for 4 weeks; those allocated to the UC group received only UC. The primary outcome was the VAS pain intensity score. The secondary outcomes were functional improvement (Oswestry Disability Index [ODI]) and the quality of life (EuroQol-5-dimension questionnaire [EQ-5D]). The outcomes were measured at Week 5. RESULTS Significant reductions were observed in the VAS (mean difference [MD] -8.15; P=0.0311) and ODI scores (MD -3.98; P=0.0460) between two groups after 4 weeks of treatment. No meaningful differences were found in the EQ-5D scores and incidence of adverse events (AEs) between the groups. The reported AEs did not have a causal relationship with EA treatment. CONCLUSIONS The results showed that EA with UC treatment was more effective than UC alone and relatively safe in patients with non-acute LBP after back surgery. EA with UC treatment may be considered as an effective, integrated, conservative treatment for patients with non-acute LBP after back surgery. CLINICAL TRIAL REGISTRATION KCT0001939.
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Ang JY, Bhojwani K, Chan HK, Chan AC. A Malaysian retrospective study of acupuncture-assisted anesthesia in breast lump excision. Acupunct Med 2020; 39:64-68. [PMID: 32539426 DOI: 10.1177/0964528420920307] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The objective of this retrospective study was to evaluate the effectiveness and safety of acupuncture-assisted anesthesia (AAA) in breast lump excision. METHODS The medical records of all patients who underwent breast lump excision under AAA in combination with electrical stimulation at traditional acupuncture points in 2016 were examined. All of them (n = 17) received electrostimulation (2-4 Hz) using single needles inserted at bilateral LI4 and PC6. They also underwent insertion of four acupuncture needles at the lump site, which were electrically stimulated at 30 Hz frequency. RESULTS All surgical procedures were successful with minimal use of analgesics and local anesthetic. The median pain score reported was 1/10 (interquartile range (IQR) = 2/10) at the first hour, and slightly increased to 2/10 (IQR = 2/10) between 24 and 48 h of the surgery. No major postoperative adverse events were documented, except for drowsiness in one case. CONCLUSION AAA was found to be generally safe and effective for anaesthesia and analgesia in breast lump excision. However, a large-scale randomized controlled study is required to verify the findings.
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Affiliation(s)
- Ju-Ying Ang
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health, Malaysia
| | - Kavita Bhojwani
- Department of Anaesthesiology and Intensive Care, Hospital Raja Permaisuri Bainun, Ministry of Health, Malaysia
| | - Huan-Keat Chan
- Clinical Research Centre, Hospital Sultanah Bahiyah, Ministry of Health, Malaysia
| | - Ai-Chen Chan
- Department of Surgery, Hospital Raja Permaisuri Bainun, Ministry of Health, Malaysia
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13
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Odejobi Y, Maneewat K, Chittithavorn V. Nurse‐led post‐thoracic surgery pain management programme: its outcomes in a Nigerian Hospital. Int Nurs Rev 2019; 66:434-441. [DOI: 10.1111/inr.12515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Y.O. Odejobi
- Faculty of Nursing Prince of Songkla University Songkla Thailand
| | - K. Maneewat
- Faculty of Nursing Prince of Songkla University Songkla Thailand
| | - V. Chittithavorn
- Faculty of Medicine Prince of Songkla University Songkla Thailand
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Park KM, Kim JH. Herbal medicine for the management of postoperative pain: A protocol for the systematic review of randomized controlled trials. Medicine (Baltimore) 2019; 98:e14016. [PMID: 30608450 PMCID: PMC6344157 DOI: 10.1097/md.0000000000014016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 12/13/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Postoperative pain is caused by surgical trauma and poses a significant challenge for health care providers. Opioid analgesics are commonly used to control postoperative pain. However, these drugs are associated with a number of negative side effects. This review will assess the clinical evidence for and against the use of herbal medicine formulas as a treatment for postoperative pain, especially after musculoskeletal surgery. METHODS Twelve databases will be searched from inception to March 2019. We will include randomized controlled trials (RCTs) assessing herbal medicine decoctions used to treat any type of postoperative pain. All RCTs of decoctions or modified decoctions will be included. The methodologic qualities of the RCTs will be assessed using the Cochrane Collaboration tool for assessing risk of bias, while confidence in the cumulative evidence will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation method. CONCLUSION This systematic review will be published in a peer-reviewed journal and disseminated electronically and in print. The review will be updated to inform and guide health care practices.Registration number: CRD42018094897.
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Affiliation(s)
| | - Ji Hwan Kim
- Department of Sasang Constitutional Medicine, College of Korean Medicine, Gachon University, Seongnam, Korea
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Moon SY, Kim JE, Kwon OJ, Kim AR, Kim DH, Kim JH, Hwang HS, Yang C. A novel taping therapy for pain after arthroscopic shoulder surgery: study protocol for a randomised controlled pilot trial. Trials 2018; 19:518. [PMID: 30249298 PMCID: PMC6154883 DOI: 10.1186/s13063-018-2866-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 08/20/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In recent years, the number of arthroscopic shoulder surgeries has increased given that the intervention is minimally invasive. However, postoperative pain is one of the most common symptoms of patients who undergo arthroscopic surgery. Although pharmacological treatments and brachial plexus blocks for reducing pain are currently used, the adherence rate of interventions is low, and adverse effects often occur. Chimsband, made up of silver and optic fibres, is a novel taping therapy that stimulates patients' acupoints and is expected to relieve pain with few adverse effects. The aim of this study is to explore the effectiveness of Chimsband to relieve pain following arthroscopic shoulder surgery. METHODS/DESIGN This is a randomised, parallel, controlled, exploratory clinical trial. Thirty participants who undergo arthroscopic shoulder surgery will be randomly allocated to an intervention or a control group. Both groups will receive 10 sessions of interferential current therapy within a period of 2 weeks, while the intervention group will additionally receive taping therapy after undergoing physical therapy. Two follow-up visits will be scheduled after the last treatment session. The primary outcome variable will be the difference in the visual analogue scale (VAS) scores between baseline and first follow-up evaluation after the end of 10 treatment sessions. The secondary outcomes will be VAS at the end of the second week, shoulder pain and disability index, range of motion, VAS while sleeping, questionnaire of blood stasis pattern identification at two follow-up visits, and number of bands used per visit. Outcomes will be evaluated at baseline, 2 weeks from visit 1 (+ within 6 days) after commencement, and at 4 weeks from visit 1 (+ within 6 days) follow-up. DISCUSSION This study will be the first clinical trial to explore the effect and safety of Chimsband on postoperative shoulder pain. It would provide clinical evidence to conduct further taping therapy studies for relieving musculoskeletal pain. TRIAL REGISTRATION Korean Clinical Trial Registry, KCT0002355 . Registered on 13 June 2017.
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Affiliation(s)
- Sun-Young Moon
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, Republic of Korea.,Korean Medicine Life Science, University of Science and Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, 34054, Republic of Korea
| | - Jung-Eun Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, Republic of Korea
| | - O-Jin Kwon
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, Republic of Korea
| | - Ae-Ran Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, Republic of Korea
| | - Da-Heui Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, Republic of Korea
| | - Jae-Hong Kim
- Department of Acupuncture & Moxibustion, DongShin University Gwangju Oriental Hospital, Gwangju, Republic of Korea
| | - Hwa Soo Hwang
- Chims-Saengvit Oriental Medicine Clinic, Seoul, Republic of Korea
| | - Changsop Yang
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, Republic of Korea.
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16
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Wang Z, Chen Y, Chen C, Zhao L, Chen P, Zeng L, Xie W. Pain management of surgical abortion using transcutaneous acupoint electrical stimulation: An orthogonal prospective study. J Obstet Gynaecol Res 2018; 44:1235-1242. [PMID: 29978542 PMCID: PMC6055762 DOI: 10.1111/jog.13661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 03/21/2018] [Indexed: 01/24/2023]
Abstract
Aim This study aimed to evaluate the optimal combination of parameters for the management of pain during surgical abortion using transcutaneous acupoint electrical stimulation (TEAS). Methods This study recruited patients scheduled for surgical abortion between October 2014 and August 2015. The treatment protocol was created using three levels for each factor (stimulating time, acupoints, age, and parity). The primary outcomes were intraoperative visual analog scale (VAS), postoperative VAS, cervical relaxation degree and intraoperative blood loss. The secondary outcomes were the vital signs. Results Stimulation time was associated with intraoperative VAS scores (P < 0.001), acupoints were associated with postoperative VAS scores (P = 0.037), and age was associated with postoperative VAS scores (P < 0.043). Parity (P = 0.025) was associated with heart rate. A comprehensive analysis of the parameters revealed the best levels for each (stimulation time: from 15 min before operation to immediate postoperative; acupoints: SP 6 and LR 3; patient age 25.1–30.0 years; and parity: G≥2P0A≥1). Seven patients did not complete follow‐up. The remaining 135 subjects did not show continuous vaginal bleeding, abdominal pain, fever or any other adverse effect. Conclusion During surgical abortion, TEAS stimulation from 15 min before operation to immediate postoperative, SP 6 and LR 3, age 25.1–30.0 years and G≥2P0A≥1 were associated with the best analgesic effect.
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Affiliation(s)
- Zedong Wang
- Department of Acupuncture and Physiotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yong Chen
- Department of Acupuncture and Physiotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chong Chen
- Department of Rehabilitation, The First Affiliated Hospital of Xinxiang Medical University, Henan, China
| | - Liang Zhao
- Key Laboratory of Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Pinjie Chen
- Department of Orthopedics and Traumatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Linchai Zeng
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Wenxia Xie
- Department of Acupuncture and Physiotherapy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Xie Y, Ma J, Wang D, Chai X, Gao C. Electro-acupuncture stimulation prevents remifentanil-induced postoperative hyperalgesia by suppressing spinal microglia in rats. Exp Ther Med 2018; 16:353-359. [PMID: 29896261 DOI: 10.3892/etm.2018.6161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/23/2018] [Indexed: 11/06/2022] Open
Abstract
The aim of the present study was to assess the effect of electro-acupuncture (EA) stimulation on remifentanil-induced postoperative hyperalgesia (RIPH) and the possible involvement of spinal microglia suppression. A model of RIPH was established using adult male Sprague-Dawley rats by administration of remifentanil at 0.08 mg/kg intravenously for 60 min. The Huantiao and Yanglingquan acupoints were stimulated continuously by EA (2 Hz, ~1 mA) for 90 min from before paw incision to the end of remifentanil administration. Sham acupoints were stimulated by EA in the sham group. Paw withdrawal threshold (PWT) and paw thermal withdrawal latency (PWL) were determined. Cluster of differentiation (CD)11b, tumor necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6 levels in spinal cord samples were measured using immunohistochemistry and ELISA. PWT and PWL values were decreased following the administration of remifentanill; however, following EA, PWT and PWL values increased compared with the sham group (P<0.05), indicating that EA alleviates remifentanil-induced RIPH. CD11b, TNF-α, IL-1β and IL-6 levels were increased following remifentanil administration and these effects were counteracted by EA (all P<0.05). In the sham group, no significant differences were observed in PWT and PWL values or CD11b, TNF-α, IL-1β and IL-6 levels compared with the control group, suggesting that EA was responsible for the reduction in CD11b and pro-inflammatory cytokine expression following remifentanil administration. The results of the present study demonstrated that EA at the Huantiao and Yanglingquan acupoints may reduce remifentanil-induced postoperative hyperalgesia, likely by inhibiting spinal microglia via reduction of CD11b and pro-inflammatory cytokine expression. However, these results are preliminary and require further validation.
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Affiliation(s)
- Yanhu Xie
- Department of Anesthesiology, Anhui Provincial Hospital Affiliated Anhui Medical University, Hefei, Anhui 230001, P.R. China
| | - Jun Ma
- Department of Anesthesiology, Anhui Provincial Hospital Affiliated Anhui Medical University, Hefei, Anhui 230001, P.R. China
| | - Di Wang
- Department of Anesthesiology, Anhui Provincial Hospital Affiliated Anhui Medical University, Hefei, Anhui 230001, P.R. China
| | - Xiaoqing Chai
- Department of Anesthesiology, Anhui Provincial Hospital Affiliated Anhui Medical University, Hefei, Anhui 230001, P.R. China
| | - Chen Gao
- Department of Anesthesiology, Anhui Provincial Hospital Affiliated Anhui Medical University, Hefei, Anhui 230001, P.R. China
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Abstract
This paper is the thirty-ninth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2016 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia, stress and social status, tolerance and dependence, learning and memory, eating and drinking, drug abuse and alcohol, sexual activity and hormones, pregnancy, development and endocrinology, mental illness and mood, seizures and neurologic disorders, electrical-related activity and neurophysiology, general activity and locomotion, gastrointestinal, renal and hepatic functions, cardiovascular responses, respiration and thermoregulation, and immunological responses.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and CUNY Neuroscience Collaborative, Queens College, City University of New York, Flushing, NY 11367, United States.
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Chen KB, Lu YQ, Chen JD, Shi DK, Huang ZH, Zheng YX, Jin XL, Wang ZF, Zhang WD, Huang Y, Wu ZW, Zhang GP, Zhang H, Jiang YH, Chen L. Transcutaneous electroacupuncture alleviates postoperative ileus after gastrectomy: A randomized clinical trial. World J Gastrointest Surg 2018; 10:13-20. [PMID: 29492186 PMCID: PMC5827033 DOI: 10.4240/wjgs.v10.i2.13] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/30/2018] [Accepted: 02/06/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the efficacy and safety of transcutaneous electroacupuncture (TEA) to alleviate postoperative ileus (POI) after gastrectomy.
METHODS From April 2014 to February 2017, 63 gastric cancer patients were recruited from the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. After gastrectomy, the patients were randomly allocated to the TEA (n = 33) or control (n = 30) group. The patients in the TEA group received 1 h TEA on Neiguan (ST36) and Zusanli (PC6) twice daily in the morning and afternoon until they passed flatus. The main outcomes were hours to the first flatus or bowel movement, time to nasogastric tube removal, time to liquid and semi-liquid diet, and hospital stay. The secondary outcomes included postoperative symptom assessment and complications.
RESULTS Time to first flatus in the TEA group was significantly shorter than in the control group (73.19 ± 15.61 vs 82.82 ± 20.25 h, P = 0.038), especially for open gastrectomy (76.53 ± 14.29 vs 87.23 ± 20.75 h, P = 0.048). Bowel sounds on day 2 in the TEA group were significantly greater than in the control group (2.30 ± 2.61/min vs 1.05 ± 1.26/min, P = 0.017). Time to nasogastric tube removal in the TEA group was earlier than in the control group (4.22 ± 1.01 vs 4.97 ± 1.67 d, P = 0.049), as well as the time to liquid diet (5.0 ± 1.34 vs 5.83 ± 2.10 d, P = 0.039). Hospital stay in the TEA group was significantly shorter than in the control group (8.06 ± 1.75 vs 9.40 ± 3.09 d, P = 0.041). No significant differences in postoperative symptom assessment and complications were found between the groups. There was no severe adverse event related to TEA.
CONCLUSION TEA accelerated bowel movements and alleviated POI after open gastrectomy and shortened hospital stay.
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Shin BC, Cho JH, Ha IH, Heo I, Lee JH, Kim KW, Kim MR, Jung SY, Kwon O, Kim NK, Son HM, Son DW, Shin KM. A multi-center, randomized controlled clinical trial, cost-effectiveness and qualitative research of electroacupuncture with usual care for patients with non-acute pain after back surgery: study protocol for a randomized controlled trial. Trials 2018; 19:65. [PMID: 29368636 PMCID: PMC5784658 DOI: 10.1186/s13063-018-2461-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 01/05/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Although pain after back surgery is known to be difficult to control, various treatment options are available to patients and physicians. A protocol for a confirmatory randomized controlled trial (RCT) on pain and function after back surgery was designed based on the results of a pilot trial. The aim of this study is to compare the effectiveness and safety of electroacupuncture (EA) with usual care (UC) versus UC alone on pain control and functional improvement after back surgery. METHODS/DESIGN This study is a multi-center, randomized, assessor-blinded trial with an active control conducted in conjunction with a cost-effectiveness analysis and qualitative research. Participants with non-acute low back pain with or without leg pain after back surgery who have a Visual Analogue Scale (VAS) pain intensity score ≥ 50 mm will be randomly assigned to either the EA with UC group (n = 54) or the UC group (n = 54). Following randomization, participants in both groups will receive the same UC treatment twice a week for a four-week treatment period. Participants assigned to the EA with UC group will additionally receive EA twice a week for the same four-week period. The primary outcome measure will be assessed using a VAS pain intensity score for low back pain. The secondary outcomes will include the Oswestry Disability Index, EuroQol 5-Dimension score, and drug intake. The primary and secondary outcomes will be measured at one, four, and eight weeks post randomization. DISCUSSION The results of this study will provide evidence of the effectiveness and cost-effectiveness of EA in managing postoperative pain following back surgery. In addition, the qualitative research results will help improve the quality of integrative medical interventions. TRIAL REGISTRATION Clinical Research Information Service (CRIS), Republic of Korea, KCT0001939 . Registered on 8 June 2016.
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Affiliation(s)
- Byung-Cheul Shin
- Spine & Joint Center, Department of Korean Rehabilitation Medicine, Pusan National University Korean Medicine Hospital, Yangsan, 50612 South Korea
- Division of Clinical Medicine, School of Korean Medicine, Pusan National University, Yangsan, 50612 South Korea
| | - Jae-Heung Cho
- Department of Korean Rehabilitation Medicine, Kyung Hee University, Seoul, 02447 South Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, 06017 South Korea
| | - In Heo
- School of Korean Medicine, Pusan National University, Yangsan, 50612 South Korea
| | - Jun-Hwan Lee
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054 South Korea
- Korean Medicine Life Science, Campus of Korea Institute of Oriental Medicine, University of Science & Technology (UST), Daejeon, 34054 South Korea
| | - Koh-Woon Kim
- Department of Korean Rehabilitation Medicine, Kyung Hee University, Seoul, 02447 South Korea
| | - Me-riong Kim
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, 06017 South Korea
| | - So-Young Jung
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054 South Korea
| | - Ojin Kwon
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054 South Korea
| | - Nam-Kwen Kim
- Department of Ophthalmology & Otolaryngology and Dermatology, School of Korean Medicine, Pusan National University, Yangsan, 50612 South Korea
| | - Haeng-Mi Son
- Department of Nursing, Ulsan University, Ulsan, 44610 South Korea
| | - Dong-Wuk Son
- Department of Neurosurgery, Yangsan Pusan National University Hospital, Yangsan, 50612 South Korea
| | - Kyung-Min Shin
- Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, 34054 South Korea
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Rosen DA, Unger K, Gustafson RA, Trieu C, Zeltzer LK, Lin YC. Electroacupuncture Addition to the Anesthesia Care of Pediatric Patients for Congenital Heart Surgery. J Cardiothorac Vasc Anesth 2017; 31:1497-1504. [PMID: 28526209 DOI: 10.1053/j.jvca.2017.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Indexed: 11/11/2022]
Affiliation(s)
- David A Rosen
- Department of Anesthesia and Pediatrics, West Virginia University, Morgantown, WV.
| | - Kendra Unger
- Department of Family Medicine, West Virginia University, Morgantown, WV
| | - Robert A Gustafson
- Department of Surgery and Pediatrics, West Virginia University, Morgantown, WV
| | - Christine Trieu
- Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Lonnie K Zeltzer
- Departments of Pediatrics, Anesthesiology, Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Yuan-Chi Lin
- Medical Acupuncture Service, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA
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Praveena Seevaunnamtum S, Bhojwani K, Abdullah N. Intraoperative Electroacupuncture Reduces Postoperative Pain, Analgesic Requirement and Prevents Postoperative Nausea and Vomiting in Gynaecological Surgery: A Randomised Controlled Trial. Anesth Pain Med 2016; 6:e40106. [PMID: 28975075 PMCID: PMC5560591 DOI: 10.5812/aapm.40106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/21/2016] [Accepted: 10/01/2016] [Indexed: 02/07/2023] Open
Abstract
Background Electroacupuncture (EA) is believed to modulate the pain pathway via the release of endogenous opioid substances and stimulation of descending pain inhibitory pathways. In this study, the use of intraoperative 2 Hertz EA stimulation is investigated to determine any opioid-sparing effect and reduction of postoperative nausea and vomiting (PONV) in patients undergoing gynaecological surgery. Patient and Methods This was a prospective, double blinded randomized study conducted in a tertiary hospital in Malaysia. Patients (n = 64) were randomly allocated to receive 2 Hertz EA and compared to a control group. EA was started intraoperatively till the end of the surgery (mean duration of surgery was 149.06 ± 42.64 minutes) under general anaesthesia. Postoperative numerical rating scale (NRS), the incidence of nausea, vomiting and usage of rescue antiemetics were recorded at 30 minutes, 2, 4, and 24 hours, respectively. The total morphine demand and usage from the patient-controlled analgesia Morphine (PCAM) were also recorded in the first 24 hours postoperatively. Results The mean NRS was 2.75 (SD = 2.34) at 30 minutes and 2.25 (SD = 1.80) at 2 hours postoperatively in the EA group that was significantly lower than the mean NRS in the control group as 4.50 (SD = 2.37) at 30 minutes and 3.88 (SD = 2.21) at 2 hours. The mean PCA morphine demand was 27.28 (SD = 21.61) times pressed in the EA group and 55.25 (SD = 46.85) times pressed in the control group within 24 hours postoperatively, which showed a significant reduction in the EA group than the control group. Similarly, total morphine requirement was significantly lower in the EA group with the value of 21.38 (SD = 14.38) mg compared to the control group with the value of 33.94 (SD = 20.24) mg within 24 hours postoperatively. Incidence of postoperative nausea also significantly reduced in the EA group at 30 minutes (15.6%) compared to the control group (46.9%). Conclusions It can be concluded that subjects receiving EA intraoperatively experienced less pain and PONV. Hence, it is plausible that EA has an opioid-sparing effect and can reduce PONV.
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Affiliation(s)
- S Praveena Seevaunnamtum
- Department of Anaesthesiology and Critical Care, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
- Corresponding author: S Praveena Seevaunnamtum, Department of Anaesthesiology and Critical Care, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia. Tel: +60-122275562, E-mail:
| | - Kavita Bhojwani
- Hospital Raja Permaisuri Bainun Ipoh, Jalan Hospital, 30990 Ipoh, Perak, Malaysia
| | - Nik Abdullah
- Department of Anaesthesiology and Critical Care, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Sima L, Fan B, Yan L, Shui Y. Effects of Electroacupuncture Treatment on Bone Cancer Pain Model with Morphine Tolerance. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2016; 2016:8028474. [PMID: 27672401 PMCID: PMC5031885 DOI: 10.1155/2016/8028474] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 08/09/2016] [Accepted: 08/22/2016] [Indexed: 12/02/2022]
Abstract
Objective. To explore the efficacy of electroacupuncture treatment in cancer induced bone pain (CIBP) rat model with morphine tolerance and explore changes of calcitonin-gene related peptide (CGRP) expression in dorsal root ganglion (DRG). Methods. Forty SD rats were divided into five groups: sham, CIBP (B), CIBP + morphine (BM), CIBP + electroacupuncture (BE), and CIBP + morphine + electroacupuncture (BME). B, BM, BE, and BME groups were prepared CIBP model. The latter three groups then accepted morphine, electroacupuncture, and morphine combined electroacupuncture, separately, nine days consecutively (M1 to M9). Mechanical withdraw threshold (MWT) was evaluated. Results. BE group only had differences in M1, M2, and M3 compared to B group (P < 0.01). From M5, BM group showed significantly decreased MWT. Electroacupuncture could obtain analgesic effects only at early stage (M1 to M5). From M5 to M9, BME had the differences with BM group (P < 0.01). IOD value of CGRP in BM and BME was substantially less than in B group. CGRP in BME was significantly lower than that in BM group (P < 0.01). Conclusion. When used in combination with electroacupuncture, morphine could result in improving analgesic effects and reducing tolerance. CGRP may be associated with pain behaviors.
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Affiliation(s)
- Lei Sima
- National Pain Management and Research Center, China-Japan Friendship Hospital, Beijing, China
| | - Bifa Fan
- National Pain Management and Research Center, China-Japan Friendship Hospital, Beijing, China
| | - Longtao Yan
- National Pain Management and Research Center, China-Japan Friendship Hospital, Beijing, China
| | - Yuan Shui
- National Pain Management and Research Center, China-Japan Friendship Hospital, Beijing, China
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