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Lim Y, Park H. The Effects of Auricular Acupressure on Low Back Pain, Neuropathy and Sleep in Patients with Persistent Spinal Pain Syndrome (PSPS): A Single-Blind, Randomized Placebo-Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1705. [PMID: 36767071 PMCID: PMC9913948 DOI: 10.3390/ijerph20031705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/15/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: Various procedures were performed on patients with persistent spinal pain syndrome (PSPS), but the clinical effect and safety were insufficient. The study was to examine the effects of auricular acupressure (AA) on low back pain, neuropathy, and sleep in patients on PSPS. (2) Methods: This was a randomized, single-blind, placebo-controlled study conducted from 1 March 2022 to 31 July 2022. The participants who had at least one lumbar surgery were randomly assigned to either the experimental group (n = 26) or the placebo control group (n = 25). All participants received 6 weeks of AA intervention. To validate the effects of the intervention, pressure pain thresholds (PPT), the Visual Analogue Scale (VAS), douleur neuropathique 4 (DN4) questions, the Pittsburgh Sleep Quality Index (PSQI), and actigraphy with a Fitbit Alta were conducted. The data were analyzed with SPSS/WIN ver. 27.0, using a t-test and repeated-measures ANOVA. (3) Results: The findings showed that there were significant differences in pain (back VAS p = 0.003, leg VAS p = 0.002, PPT p = 0.008), neuropathy (DN4 p = 0.034), and sleep actigraphy (sleep efficiency p = 0.038, number of awake p = 0.001, deep sleep stage p = 0.017). (4) Conclusions: We conclude that AA is an effective, safe, cost-effective, non-invasive nursing intervention that can improve pain, neuropathy, and sleep in patients on PSPS.
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Affiliation(s)
- Yunmi Lim
- Department of Spine Center, Samsung Medical Center, Seoul 06351, Republic of Korea
| | - Hyojung Park
- College of Nursing, Ewha Womans University, Seoul 03760, Republic of Korea
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Xu MM, Tian Q, Yu L, Yang S, Liu YT, Yu SH, Cao ML, Zhang W. The effectiveness of auricular acupressure on pain management during labor: A systematic review and meta-analysis of randomized controlled trials. Jpn J Nurs Sci 2023; 20:e12512. [PMID: 36134507 DOI: 10.1111/jjns.12512] [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: 03/01/2022] [Revised: 08/03/2022] [Accepted: 08/23/2022] [Indexed: 01/05/2023]
Abstract
AIM This meta-analysis aimed to systematically evaluate the effectiveness of auricular acupressure on pain management during labor. METHODS Six English and three Chinese electronic databases were comprehensively searched from inception to 6 November 2021. The PRISMA checklist was followed. The methodological quality of the included studies was assessed with the Cochrane Collaboration Bias Risk Assessment Tool. The meta-analysis was performed using Review Manager 5.3 software. Heterogeneity between studies was calculated using I2 . RESULTS Five studies comprising 312 participants were included. The labor pain scores of the auricular acupressure group were significantly lower than those of the usual care group at cervix dilations of 6, 8, and 10 cm, with mean differences (95% confidence intervals) of -1.05 (-1.41, -0.69), -1.44 (-2.07, -0.82), and -1.96 (-3.30, -0.61), respectively. Auricular acupressure can thus effectively improve the labor pain perception at cervix dilations of 6, 8, and 10 cm. Moreover, auricular acupressure shortened the active phase, and had the trend of shortening the second and third stages of labor. There was no evidence that auricular acupressure had an effect on the rate of cesarean section or the 1 and 5 min Apgar scores. CONCLUSION Effective labor pain relief, better labor pain perception, and the lack of adverse effects support the use of auricular acupressure. More high-quality and rigorous trials are needed to verify our findings before we can make strong recommendations.
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Affiliation(s)
- Meng-Meng Xu
- Nursing School, Jilin University, Jilin Province, China
| | - Qi Tian
- Nursing School, Jilin University, Jilin Province, China
| | - Lin Yu
- Nursing School, Jilin University, Jilin Province, China
| | - Shu Yang
- Nursing School, Jilin University, Jilin Province, China
| | - Yan-Tong Liu
- Nursing School, Jilin University, Jilin Province, China
| | - Shuang-Han Yu
- Nursing School, Jilin University, Jilin Province, China
| | - Ming-Lu Cao
- Nursing School, Jilin University, Jilin Province, China
| | - Wei Zhang
- Nursing School, Jilin University, Jilin Province, China
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Yang HH, Chung YC, Szeto PP, Yeh ML, Lin JG. Laser acupuncture combined with auricular acupressure improves low-back pain and quality of life in nurses: A randomized controlled trial. JOURNAL OF INTEGRATIVE MEDICINE 2023; 21:26-33. [PMID: 36402666 DOI: 10.1016/j.joim.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/01/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Low-back pain (LBP) in nurses is a major health concern that affects their quality of life and ability to work, with consequences for their economic status. OBJECTIVE This study evaluates the effect of low-level laser acupuncture combined with auricular acupressure (LAA) on pain intensity, pain interference and quality of life in nurses with LBP. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS This randomized controlled trial recruited a convenience sample of hospital-based nurses from one teaching hospital in Taiwan, China. Participants were randomly assigned to the LAA group (n = 38) receiving low-level laser acupuncture and auricular acupressure for 4 weeks, and the control group (n = 38) receiving only sham laser acupuncture treatment without laser energy output. MAIN OUTCOME MEASURES Data were collected for the primary pain outcome using the Short Form of the Brief Pain Inventory, while the secondary outcome, quality of life, was evaluated using the Roland-Morris Disability Questionnaire. Both primary and secondary outcomes were scored before the intervention, and after 2-week and 4-week intervention. The rate of LBP recurrence was evaluated at the 4th week and 8th week after the end of intervention. RESULTS After controlling for prior pain, the result of linear mixed model analysis showed trends in significant between-group differences in the level of current pain occurring in week 4 (P < 0.001), worst pain in week 2 (P < 0.001) and week 4 (P < 0.001), least pain in week 2 (P = 0.032) and week 4 (P < 0.001), pain interference in week 2 (P = 0.009) and week 4 (P < 0.001), and in the life dysfunction in week 2 (P < 0.001) and week 4 (P < 0.001). Recurrence rates of LBP at the 4th and 8th weeks after the end of intervention were 0% and 36.89% in the LAA group, and 69.44% and 36.11% in the control group. CONCLUSION This study shows that 4-week LAA intervention reduced pain intensity and pain interference, and improved quality of life for hospital-based nurses with LBP. These effects were maintained continuously for at least 4 weeks after the intervention. The nonpharmacological intervention, LAA, may be another efficacious, feasible, noninvasive, analgesic intervention for LBP. TRIAL REGISTRATION This study is registered at Clinicaltrials.gov (registration number NCT04423445).
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Affiliation(s)
- Hsueh-Hua Yang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan, China; Nursing Department, En Chu Kong Hospital, New Taipei 23702, Taiwan, China
| | - Yu-Chu Chung
- Department of Nursing, Yuanpei University of Medical Technology, Hsinchu 30015, Taiwan, China
| | - Pai-Pei Szeto
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan, China
| | - Mei-Ling Yeh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan, China; Cochrane Taiwan, Taipei Medical University, Taipei 11031, Taiwan, China.
| | - Jaung-Geng Lin
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan, China.
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Efficacy of Acupuncture Combined with Patient-Controlled Analgesia in the Treatment of Acute Pain after Back Surgery: A Meta-Analysis. Pain Res Manag 2022. [DOI: 10.1155/2022/2551591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives. Acupuncture is used worldwide to relieve both acute and chronic pain. Patient-controlled analgesia (PCA) is also frequently used for postoperative pain relief. However, there are few meta-analyses of the efficacy of acupuncture with PCA in reducing acute postoperative pain. This meta-analysis aimed to assess the effectiveness of acupuncture with PCA in relieving acute pain after back surgery. Methods. We searched seven databases (Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure (CNKI), Wanfang database, Chongqing VIP (VIP), and Chinese BioMedical Literature Database (CBM)-from 1949 until now) without language restrictions for randomized controlled trials, including patients undergoing back surgery and receiving PCA alone or treated with acupuncture/sham acupuncture + PCA for pain relief. This meta-analysis assessed pain intensity, with visual analogue scale (VAS) score and postoperative opioid dosage as primary outcomes. Results. A total of 12 randomized controlled trials (n = 904) met the inclusion criteria. Compared with the control group (standard mean difference (SMD) = ‒0.42, 95% CI = ‒0.60 to ‒0.25,
) or sham acupuncture + PCA (SMD = ‒0.7, 95% CI = ‒0.94 to ‒0.46,
), acupuncture + PCA treatment reduced the VAS score in patients after back surgery. Acupuncture + PCA decreased the use of opioids after surgery compared to sham acupuncture + PCA (SMD = −0.35, 95% CI = ‒0.63 to ‒0.07,
) or control group (SMD = ‒0.82, 95% CI = ‒1.03 to ‒0.61,
). Furthermore, the use of acupuncture with PCA reduced the incidence of postoperative PCA-related total complications (odds ratio = 0.44, 95% CI = 0.23 to 0.85,
), but may not reduce the incidence of postoperative nausea and vomiting (odds ratio =0.82 , 95% CI =0.49 to 1.36,
). Conclusion. This systematic review found that acupuncture with PCA relieved acute pain after back surgery more effectively than PCA alone and could reduce opioid use and the incidence of postoperative PCA-related total complications
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Zhang X, He B, Wang H, Sun X. Auricular acupressure for treating early stage of knee osteoarthritis: a randomized, sham-controlled prospective study. QJM 2022; 115:525-529. [PMID: 34463759 DOI: 10.1093/qjmed/hcab230] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/15/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE We examined whether auricular acupressure (AA) at four specifically preselected AA points can alleviate knee pain and decrease non-steroidal anti-inflammatory drugs (NSAIDs) consumption and its adverse effects for osteoarthritis patients. METHODS Sixty-two patients (more than 40 years) with knee osteoarthritis of Kellgren-Lawrence grades of I or II upon radiographic classification were enrolled in this randomized, sham-controlled prospective study, and divided into two groups (AA group and control group). The AA group received true AA by embedding vaccaria seeds at four specific AA points (knee joint, shenmen, subcortex and sympathesis) ipsilateral to the knee osteoarthritis site, while the control group received four nonacupuncture points on the auricular helix. Visual analog scale (VAS), the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, the number of patients who needed celecoxib pills and adverse effects were recorded. RESULTS VAS and WOMAC scores in the AA group were significantly lower than that in the control group (P < 0.05) at Days 3 and 7 postsugery. The VAS and WOMAC score were significantly decreased after the treatment in the AA group compared with that before the treatment (P < 0.05). The use of celebrex is significantly lower in the AA group than in the control group (P < 0.05), no major side effects were observed during the auricular acupressure treatment. CONCLUSION Auricular acupressure plays a role in analgesic effect and can effectively decrease NSAIDs requirements without causing adverse events for the treatment of human knee osteoarthritis.
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Affiliation(s)
- X Zhang
- From the Department of Orthopedics, Zhejiang Rongjun Hospital, Jiaxing 314001, China
- Jiaxing Key Laboratory for Minimally Invasive Surgery in Orthopedics & Skeletal Regenerative Medicine, Zhejiang Rongjun Hospital, Jiaxing 314001, China
| | - B He
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 314001, China
| | - H Wang
- Department of Orthopedics, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing 314001, China
| | - X Sun
- From the Department of Orthopedics, Zhejiang Rongjun Hospital, Jiaxing 314001, China
- Jiaxing Key Laboratory for Minimally Invasive Surgery in Orthopedics & Skeletal Regenerative Medicine, Zhejiang Rongjun Hospital, Jiaxing 314001, China
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Huang CH, Yeh ML, Chen FP, Wu D. Low-level laser acupuncture reduces postoperative pain and morphine consumption in older patients with total knee arthroplasty: A randomized placebo-controlled trial. JOURNAL OF INTEGRATIVE MEDICINE 2022; 20:321-328. [PMID: 35459599 DOI: 10.1016/j.joim.2022.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Patients commonly develop postoperative pain after total knee arthroplasty (TKA). Acupuncture-related techniques and low-level laser therapy could be beneficial for pain management for older individuals. OBJECTIVE To examine the effect of low-level laser acupuncture (LA) in reducing postoperative pain, pain-related interference in daily life, morphine consumption, and morphine-related side effects in older patients with knee osteoarthritis who underwent TKA. DESIGN, SETTING, PARTICIPANTS AND INTERVENTION A single-blind randomized placebo-controlled trial was conducted. Patients (N = 82) were recruited and randomly assigned via a computer-generated list to the LA group or a placebo group. The LA group received low-level laser therapy at Sanyinjiao (SP6), Taixi (KI3), Kunlun (BL60), Fengshi (GB31), Futu (ST32) and Neiguan (PC6) after TKA, while the placebo acupuncture group received the same treatment procedure without laser energy output. MAIN OUTCOME MEASURES The primary outcome was postoperative pain intensity, and it was measured at baseline and hours 2, 6, 10, 24, 48 and 72 after TKA. The secondary outcomes, including relative pain, postoperative pain-related interference in daily life and morphine consumption, were measured at hours 24, 48 and 72 after TKA. RESULTS Generalized estimating equations revealed significant between-group differences in pain intensity (P = 0.01), and trend differences in pain intensity for the LA group starting at hours 10 to 72 (P < 0.05) and morphine consumption at hours 48 and 72 (P < 0.05). The changes in pain-related interference in daily life were significant (P < 0.05) at 72 h, with the exception of the parameters for worst pain, mood, and sleep. Nausea and vomiting side effects from morphine had significant between-group differences at hours 10 and 24 (P < 0.05). CONCLUSION Low-level LA gradually reduced older patients' postoperative pain intensity and morphine consumption within the first 72 h after their TKA for osteoarthritis. Low-level LA may have benefits as an adjuvant pain management technique for clinical care. TRIAL REGISTRATION ClinicalTrials.gov registration number NCT03995446.
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Affiliation(s)
- Chiung-Hui Huang
- Department of Nursing, Taipei Veterans General Hospital, Taipei City 11217, Taiwan, China
| | - Mei-Ling Yeh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City 11219, Taiwan, China.
| | - Fang-Pey Chen
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei City 11217, Taiwan, China; Scool of Nursing, National Taipei University of Nursing and Health Sciences and School of Medicine, Taipei City 11217, Taiwan, China
| | - Daphne Wu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei City 11219, Taiwan, China
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Wu P, Zhu L, Zheng SY, Li JX, Wu MD, Wang WJ, Hou YC, Li J, Wu HG. Transcutaneous Electrical Acupoint Stimulation for Moderate to Severe Pain in Hepatocellular Carcinoma: A Protocol for a Randomized Controlled Trial. J Pain Res 2022; 15:1889-1896. [PMID: 35832212 PMCID: PMC9271907 DOI: 10.2147/jpr.s361821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/21/2022] [Indexed: 11/25/2022] Open
Abstract
Background Cancer-related pain is one of the primary symptoms of patients with hepatocellular carcinoma (HCC). Previous studies have shown that transcutaneous electrical acupoint stimulation (TEAS) is effective in treating patients with acute or chronic pain. In China, it is indispensable to evaluate the efficacy of TEAS in combination with opioids for the treatment of moderate to severe HCC-related pain. Methods/Design This is a single-center clinical, prospective randomized controlled clinical trial protocol. 104 patients will be randomly divided into the observation group and the control group in a ratio of 1:1.In addition to routine cancer pain medication, the two groups of patients will receive TEAS treatment twice a day for one week. Acupoints will include bilateral Hegu(LI4), Neiguan(PC6), Zusanli(ST36), Taichong(LR3), Ganshu(BL18), Geshu(BL17), Qimen(LR14), and Zhangmen(LR13). The treatment time is from 9:00 a.m. to 11:00 p.m. and from 4:00 p.m. to 6:00 p.m. The primary outcome measures are the Numerical Rating Scale (NRS) and the secondary outcome measures include the Brief Pain Inventory(BPI), dosage and administration duration of opioid drugs, frequency of nausea, vomiting and defecation, Karnofsky Performance Status Scale (KPS), Quality of life scale (QOL), Brief Fatigue Inventory (BFI). The outcome measures will be evaluated at baseline, during treatment and 1 week after treatment. Discussion Results of this trial are expected to clarify the value of TEAS stimulation performed on specific points in the management of moderate to severe pain in HCC. Trial registration Chinese clinical trial registry, ChiCTR2100044615 (http://www.chictr.org.cn), Registered on 24 March 2021.
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Affiliation(s)
- Pin Wu
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Lu Zhu
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Shi-Yu Zheng
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Jun-Xiong Li
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Meng-Die Wu
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Wen-Jia Wang
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Yu-Chao Hou
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Jing Li
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
- Correspondence: Jing Li, Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, No. 110 Ganhe Road, Hongkou District, Shanghai, 200437, People’s Republic of China, Tel +021-65161782, Email
| | - Huan-Gan Wu
- Department of Acupuncture, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
- Department of Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
- Huan-Gan Wu, Department of Key Laboratory of Acupuncture and Immunological Effects, Shanghai University of Traditional Chinese Medicine, No. 650 South Wanping Road, Xuhui District, Shanghai, 200437, People’s Republic of China, Tel +021-64383453, Email
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Fan Q, Lei C, Wang Y, Yu N, Wang L, Fu J, Dong H, Lu Z, Xiong L. Transcutaneous Electrical Acupoint Stimulation Combined With Auricular Acupressure Reduces Postoperative Delirium Among Elderly Patients Following Major Abdominal Surgery: A Randomized Clinical Trial. Front Med (Lausanne) 2022; 9:855296. [PMID: 35783617 PMCID: PMC9240658 DOI: 10.3389/fmed.2022.855296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPostoperative delirium is common in elderly patients following major surgery. This study aimed to assess the effect of transcutaneous electrical acupoint stimulation combined with auricular acupressure on the incidence of postoperative delirium among older patients undergoing major abdominal surgery.MethodsIn this single-center, randomized controlled clinical trial, 210 patients aged 65 years or older undergoing major abdominal surgery were randomized to receive either intervention treatment (transcutaneous electrical acupoint stimulation started at 30 min before anesthesia until the end of the surgery, followed by intermittent auricular acupressure in the first three postoperative days; n = 105) or standard care (n = 105). The primary outcome was the incidence of delirium at the first seven postoperative days or until hospitalization depended on which came first. Secondary outcomes included delirium severity, opioid consumption, postoperative pain score, sleep quality, length of postoperative hospital stay, and postoperative 30-day complications. Enrollment was from April 2019 to March 2020, with follow-up ending in April 2020.ResultsAll of the 210 randomized patients [median age, 69.5 years, 142 (67.6%) male] completed the trial. The incidence of postoperative delirium was significantly reduced in patients received intervention treatment (19/105 (18.1%) vs. 8/105 (7.6%), difference, –10.5% [95% CI, –1.5% to –19.4%]; hazard ratio, 0.41 [95% CI, 0.18 to 0.95]; P= 0.023). Patients in the control group had a higher postoperative Memorial Delirium Assessment Scale (4 vs. 3; difference, –1; 95% CI, –1 to 0; P = 0.014) and a greater increase in Pittsburgh Sleep Quality Index score from baseline to postoperative day three (2.5 vs. 2.0; difference, –1; 95% CI, –2 to –1; P < 0.001) than patients in the intervention group. No significant difference was observed as of other secondary outcomes.ConclusionIn elderly patients undergoing major abdominal surgery, transcutaneous electrical acupoint stimulation combined with auricular acupressure reduced the incidence of postoperative in-hospital delirium compared with standard care. A multicenter, randomized clinical trial with a larger sample size is necessary to verify these findings.Clinical Trial Registration[https://clinicaltrials.gov], identifier [NCT03726073].
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Affiliation(s)
- Qianqian Fan
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Chong Lei
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, China
- *Correspondence: Chong Lei,
| | - Yonghui Wang
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Nannan Yu
- Department of Traditional Chinese Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Lini Wang
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Jingwen Fu
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Hailong Dong
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Zhihong Lu
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, China
| | - Lize Xiong
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, China
- Department of Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
- Lize Xiong,
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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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Acupuncture at the P6 Acupoint to Prevent Postoperative Pain after Craniotomy: A Randomized, Placebo-Controlled Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6619855. [PMID: 33815553 PMCID: PMC7994087 DOI: 10.1155/2021/6619855] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/30/2021] [Accepted: 02/28/2021] [Indexed: 02/05/2023]
Abstract
Objective Acute pain management after craniotomy can be challenging. Previous studies have shown inadequate pain control following the procedure. Oral medication can sometimes be delayed by postoperative nausea, and use of anesthetics may impair the assessment of brain function. We conducted this prospective study to evaluate the effect of acupuncture at the P6 acupoint on postoperative pain, nausea, and vomiting in patients undergoing craniotomy. Methods The authors conducted a randomized, placebo-controlled trial among 120 patients scheduled for craniotomy under general anesthesia. 120 patients were randomly assigned into an acupuncture group or a sham acupuncture group. All patients received standardized anesthesia and analgesia treatment. Acupuncture was executed in the recovery room after surgery. For the acupuncture group, the P6 points on each wrist were punctured perpendicularly to a depth of 20 mm. Needles were retained for 30 min and stimulated every 10 min to maintain the De-Qi sensation. For the sham acupuncture group, sham points on each wrist were punctured perpendicularly to a depth of 5 mm. Needles were retained for 30 min with no stimulation during the duration. The postoperative pain scores, PONV, and dose of tramadol were assessed 24 h, 48 h, and 72 h after surgery. Results A total of 117 patients completed the study. There was no statistically significant difference in baseline data between the two groups (P > 0.05). The VAS pain score of the acupuncture group was lower than that of the sham acupuncture group, and this difference was statistically significant (P=0.002). There was no difference in pain scores between the two groups during 0-24 h and 48-72 h (P > 0.05). The incidence of vomiting in the acupuncture group was lower than that in the sham acupuncture group during the 0-24 h period (13.8% vs. 28.8%, P=0.048). There was no difference in vomiting, however, during the 24-72 h period (P > 0.05). No significant differences were found in the degree of nausea and the dose of tramadol between the two groups at either time point in the acupuncture group and sham acupuncture group. Conclusion The use of acupuncture at the P6 acupoint in neurosurgery patients did result in significantly lower pain scores and reduction in the incidence of vomiting after craniotomy. There were no significant side effects. Acupuncture at the P6 acupoint was well tolerated and safe in this patient population.
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Huang CH, Yeh ML, Chen FP, Kuo M. A randomised controlled trial of laser acupuncture improves early outcomes of osteoarthritis patients' physical functional ability after total knee replacement. Complement Ther Clin Pract 2021; 43:101340. [PMID: 33677172 DOI: 10.1016/j.ctcp.2021.101340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 02/20/2021] [Accepted: 02/21/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND PURPOSE Total knee replacement is the most effective intervention for late-stage osteoarthritis; however, a major concern is postoperative recovery of physical function. This randomised controlled trial evaluated the effects of acupuncture with low-level laser therapy (ALLLT) on early outcomes of physical function after total knee replacement. MATERIALS AND METHODS Eighty-two osteoarthritis patients were recruited and randomly assigned to the experimental group receiving ALLLT or the control group receiving sham ALLLT without laser beam output. Physical function was evaluated by assessing knee joint flexion and stiffness on days 1, 2, and 3 after total knee replacement. RESULTS Generalised estimating equations revealed a significant difference between the two groups in joint flexion. The experimental group displayed better joint flexion and less stiffness on days 2 and 3 than did the control group. CONCLUSION ALLLT can facilitate the recovery of physical function, as evidenced by knee joint flexion and stiffness, in patients receiving total knee replacement.
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Affiliation(s)
- Chiung-Hui Huang
- Integration of Traditional Chinese Medicine with Western Nursing, National Taipei University of Nursing and Health Sciences, Nurse, Department of Nursing, Taipei Veterans General Hospital, 201, Sec. 2, Shipai Rd., Taipei City, 11217, Taiwan.
| | - Mei-Ling Yeh
- Department of Nursing, National Taipei University of Nursing and Health Sciences, 365, Minte Rd., Taipei City, 11219, Taiwan.
| | - Fang-Pey Chen
- Center for Traditional Medicine, Taipei Veterans General Hospital and Adjunct Professor, National Taipei University of Nursing and Health Sciences, 201, Sec. 2, Shipai Rd., Taipei City, 11217, Taiwan.
| | - Matthew Kuo
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Student, Taipei American School, 800, Sec. 6, Zhongshan N. Rd., Taipei City, 11152, Taiwan.
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12
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Sun R, Dai W, Liu Y, Liu C, Liu Y, Gong Y, Sun X, Shi T, Song M. Non-needle acupoint stimulation for prevention of nausea and vomiting after breast surgery: A meta-analysis. Medicine (Baltimore) 2019; 98:e14713. [PMID: 30855464 PMCID: PMC6417514 DOI: 10.1097/md.0000000000014713] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Breast disease has been a global serious health problem, among women. Surgery is the main treatment for the patients suffering from breast disease. Postoperative nausea and vomiting are still disturbing. Acupoint stimulation, an effective treatment of traditional Chinese medicine, has been used to reduce postoperative nausea and vomiting. Recently, non-needle acupoint stimulation becomes a new intervention. Though several clinical trials have been done, there is still no final conclusion on the efficacy. This Meta-Analysis aims at evaluating the efficacy of non-needle acupoint stimulation for prevention of nausea and vomiting after breast surgery. METHODS Systematic searches were conducted in PubMed, Embase, Cochrane, and Wanfang Med Online databases for studies. The review period covered from the inception of databases to December 31, 2017. The outcome measures of interest were frequency of nausea, frequency of vomiting, frequency of PONV, verbal rating scale of nausea, and use of rescue antiemetic. Data extraction and risks of bias evaluation were accomplished by 2 independent reviewers using the Cochrane Collaboration Review Manager software (RevMan 5.3.5). RESULTS Fourteen randomized controlled trials with a total of 1009 female participants in the non-needle acupoint stimulation group and control group met the inclusion criteria. Although the therapeutically effect on vomiting within postoperative 2 hours was not obvious, non-needle acupoint stimulation still had an important role in reducing nausea and vomiting within postoperative 48 hours. According to Jadad scale, there was moderate quality evidence for the pooled analysis results in this study. In addition, stimulating acupoint by wristband acupressure was more likely to cause adverse reactions. CONCLUSION Non-needle acupoint stimulation can be used for female patients undergoing breast surgery to reduce postoperative nausea and vomiting. Into consideration, we recommend transcutaneous acupoint electrical stimulation on PC6 from 30 minutes before induction of anesthesia to the end of surgery for application. This non-pharmaceutical approach may be promising to promote the recovery of patients after breast surgery.
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Affiliation(s)
- Ran Sun
- Department of Nursing
- Operation room, the First Affiliated Hospital of Dalian Medical University
| | - Wei Dai
- Department of Nursing
- Operation room, the First Affiliated Hospital of Dalian Medical University
| | - Yang Liu
- Health management and physical examination Center, the Affiliated Hospital of Qingdao University, Qingdao, Shandong
| | - Changli Liu
- Department of Nursing
- Operation room, the First Affiliated Hospital of Dalian Medical University
| | - Yongning Liu
- Department of Nursing
- Operation room, the First Affiliated Hospital of Dalian Medical University
| | - Ying Gong
- Department of Nursing
- Department of Orthopaedics, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning
| | - Xiaohong Sun
- Department of Nursing
- Department of Orthopaedics, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning
| | | | - Mingzhi Song
- Department of Orthopaedics, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning
- Department of Orthopaedics, the Third Affiliated Hospital of Dalian Medical University, Jinpu New Area, Liaoning, People's Republic of China
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13
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You E, Kim D, Harris R, D'Alonzo K. Effects of Auricular Acupressure on Pain Management: A Systematic Review. Pain Manag Nurs 2018; 20:17-24. [PMID: 30340870 DOI: 10.1016/j.pmn.2018.07.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 07/03/2018] [Accepted: 07/27/2018] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Nearly half of hospitalized patients in the United States have reported experiencing pain even while undergoing treatment for pain. Analgesic use is the most common type of treatment for pain management. Many patients who experience pain seek nonpharmacologic interventions to manage their pain, including forms of complementary or alternative medicine such as auricular acupressure (AA). DESIGN This study conducted the first systematic review of the studies that have evaluated the effect of AA as an adjunct on pain management. DATA SOURCES We searched PubMed, CINAHL, Embase, Google Scholar, and Wiley for randomized controlled trials on AA. REVIEW/ANALYSIS METHODS The pain outcomes were pain severity and analgesic consumption. Methodologic quality was also evaluated. Fifteen randomized controlled trials were included in this analysis. RESULTS Twelve studies reported statistically significant improvement in the pain outcomes of AA treatment compared with the sham or standard care groups. When methodologic quality was assessed, the selected studies had medium quality, but there was a lack of high quality. This supports that the use of AA for patients may enhance self-management for their pain. However, the small number of studies and the lack of consistent rigorous methodology across the studies preclude definitive statements regarding the effectiveness of AA. CONCLUSION The nursing implications based on this review is that education about AA and complementary or alternative medicine therapies for health care providers may assist them in providing pain control for their patients. In addition, we need to continue research to build on evidence on the effect of AA on pain management.
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Affiliation(s)
| | - David Kim
- Rutgers University Medical School, New Brunswick, New Jersey
| | - Ryan Harris
- University of North Carolina, Charlotte, North Carolina
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Zhao C, Zhao J, Yang Q, Ye Y. Cobra neurotoxin produces central analgesic and hyperalgesic actions via adenosine A 1 and A 2A receptors. Mol Pain 2018; 13:1744806917720336. [PMID: 28758541 PMCID: PMC5542074 DOI: 10.1177/1744806917720336] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Cobra neurotoxin, a short-chain peptide isolated from snake venom of Naja naja atra, showed both a central analgesic effect and a hyperalgesic effect in mice tests. In order to explore mechanisms, a hypothesis is put forward that cobra neurotoxin takes effect through adenosine receptor pathway. The central effects of cobra neurotoxin were evaluated using the hot plate test (a model of acute pain) and the spinal cord injury (a model of central pain) in mice and using A1 receptor antagonist (DPCPX) and A2A receptor antagonist (ZM241385); behaviors were scored and signal molecules such as reactive oxygen species and adenosine triphosphate levels and mitogen-activated protein kinases/extracellular signal-regulated protein kinase expression were measured. Low dose of cobra neurotoxin (25 µg/kg) had analgesic effects which were inhibited by DPCPX, while high dose of cobra neurotoxin (100 µg/kg) had hyperalgesic effects which were blocked by ZM241385. Cobra neurotoxin reduced reactive oxygen species and increased adenosine triphosphate in brain tissues, and extracellular signal-regulated protein kinase expression was markedly inhibited by cobra neurotoxin. Cobra neurotoxin may take effect through mitogen-activated protein kinases/extracellular signal-regulated protein kinase pathway inhibition by activating adenosine A1Rs and cause changes of reactive oxygen species and adenosine triphosphate through feedback mechanisms. Overdose cobra neurotoxin further activates the adenosine A2ARs to generate pain sensitization. This research proposes a new central analgesic mechanism of cobra neurotoxin and discloses dual regulation of pain.
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Affiliation(s)
- Chuang Zhao
- Department of Pharmaceutical Engineering, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, China
| | - Jun Zhao
- Department of Pharmaceutical Engineering, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, China
| | - Qian Yang
- Department of Pharmaceutical Engineering, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, China
| | - Yong Ye
- Department of Pharmaceutical Engineering, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, China
- Key Laboratory of Functional Molecular Engineering of Guangdong Province, Guangzhou, China
- Yong Ye, Department of Pharmaceutical Engineering, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou 510640, China.
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15
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Ünülü M, Kaya N. The Effect of Neiguan Point (P6) Acupressure With Wristband on Postoperative Nausea, Vomiting, and Comfort Level: A Randomized Controlled Study. J Perianesth Nurs 2017; 33:915-927. [PMID: 30449440 DOI: 10.1016/j.jopan.2017.09.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 09/06/2017] [Accepted: 09/17/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To determine how usage of wristband acupressure at pericardium 6 (P6) Neiguan point application affects nausea, vomiting, and comfort level in the postoperative period. DESIGN A randomized controlled experimental study. METHODS The study was implemented at an obstetrics hospital. The study was conducted on 97 patients (47 experimental and 50 control subjects) who underwent gynecologic surgery other than caesarian section. In the experimental group, wristband acupressure was applied during the first 12 hours after operation. The control group received antiemetics during and after operation. FINDINGS Although P6 acupressure application was effective at preventing vomiting, its effect on nausea intensity was even better. Also, the P6 acupressure application enhanced patient comfort. CONCLUSIONS Because of its effectiveness and feasibility, wristband P6 acupuncture point acupressure application is a great alternative to pharmacologic methods in the gynecologic surgery population.
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16
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Yang Q, Zhao C, Zhao J, Ye Y. Photoresponsive nanocapsulation of cobra neurotoxin and enhancement of its central analgesic effects under red light. Int J Nanomedicine 2017; 12:3463-3470. [PMID: 28496322 PMCID: PMC5422569 DOI: 10.2147/ijn.s132510] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Cobra neurotoxin (CNT), a peptide isolated from snake venom of Naja naja atra, shows central analgesic effects in our previous research. In order to help CNT pass through blood–brain barrier (BBB) and improve its central analgesic effects, a new kind of CNT nanocapsules were prepared by double emulsification with soybean lecithin and cholesterol as the shell, and pheophorbide as the photosensitizer added to make it photoresponsive. The analgesic effects were evaluated by hot plate test and acetic acid-induced writhing in mice. The CNT nanocapsules had an average particle size of 229.55 nm, zeta potential of −53.00 mV, encapsulation efficiency of 84.81% and drug loading of 2.98%, when the pheophorbide content was 1% of lecithin weight. Pheophorbide was mainly distributed in outer layer of the CNT nanocapsules and increased the release of the CNT nanocapsules after 650 nm illumination. The central analgesic effects were improved after intraperitoneal injection of CNT at 25 and 50 µg·kg−1 under 650 nm irradiation for 30 min in the nasal cavity. Activation of pheophorbide by red light generated reactive oxygen species which opened the nanocapsules and BBB and helped the CNT enter the brain. This research provides a new drug delivery for treatment of central pain.
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Affiliation(s)
- Qian Yang
- Department of Pharmaceutical Engineering, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, People's Republic of China
| | - Chuang Zhao
- Department of Pharmaceutical Engineering, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, People's Republic of China
| | - Jun Zhao
- Department of Pharmaceutical Engineering, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, People's Republic of China
| | - Yong Ye
- Department of Pharmaceutical Engineering, School of Chemistry and Chemical Engineering, South China University of Technology, Guangzhou, People's Republic of China
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Mehta P, Dhapte V, Kadam S, Dhapte V. Contemporary acupressure therapy: Adroit cure for painless recovery of therapeutic ailments. J Tradit Complement Med 2017; 7:251-263. [PMID: 28417094 PMCID: PMC5388088 DOI: 10.1016/j.jtcme.2016.06.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 06/12/2016] [Accepted: 06/15/2016] [Indexed: 12/20/2022] Open
Abstract
Since time immemorial, complementary and alternative medicines (CAM) have played a significant role in human health care. CAM is known to have a strong reputation and reliability within every culture to provide basic health care treatment for patients. CAM acts as a better therapeutic option in human being for treating various diseases and improving quality of life with apt consideration to the economic aspects. Acupressure, one of the known CAM, originated in ancient China is based on the principal of acupoints activation across the meridians which correct the imbalance between Qi. Activation of specific points on the meridians is known to facilitate reduction of pain at the local sites. It also reduces the pain from other body parts. This review outlines various types, devices and mechanisms involved in the acupressure treatment.
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Affiliation(s)
- Piyush Mehta
- Department of Quality assurance, Bharati Vidyapeeth University, Poona College of Pharmacy, Pune 38, India
| | - Vishwas Dhapte
- Department of Chemistry, Bharati Vidyapeeth University, Yashwantrao Mohite College, Pune 38, India
| | - Shivajirao Kadam
- Bharati Vidyapeeth University, Bharati Vidyapeeth Bhavan, Lal Bahadur Shastri Marg, Pune 38, India
| | - Vividha Dhapte
- Department of Pharmaceutics, Poona College of Pharmacy, Bharati Vidyapeeth University, Pune, India
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18
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Perioperative Transcutaneous Electrical Acupoint Stimulation for Postoperative Pain Relief Following Laparoscopic Surgery. Clin J Pain 2017; 33:340-347. [DOI: 10.1097/ajp.0000000000000400] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
This paper is the thirty-eighth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2015 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 Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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20
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Electroacupuncture Reduces Postoperative Pain and Analgesic Consumption in Patients Undergoing Thoracic Surgery: A Randomized Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:2126416. [PMID: 27073400 PMCID: PMC4814664 DOI: 10.1155/2016/2126416] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 02/15/2016] [Accepted: 02/24/2016] [Indexed: 01/07/2023]
Abstract
The aim of this study was to evaluate the effect of electroacupuncture (EA) on postoperative pain management in patients undergoing thoracic surgery. A randomized study was conducted. Ninety-two thoracic surgical patients were randomly divided into an EA group and a sham group. Postoperative intravenous analgesia was applied with a half dose of the conventional drug concentration in both groups. In the EA group, EA treatment was administered for three consecutive days after the surgery with 6 sessions of 30 min each. Compared with the sham group, patients in the EA group had a lower visual analogue scale (VAS) score at 2, 24, 48, and 72 hours and consumed less analgesic after surgery. The incidence of opioid-related adverse effects of nausea was lower in the EA group. The time to first flatus and defecation was also shorter in the EA group. Furthermore, the plasma β-endorphin (β-EP) level was higher by radioimmunoassay and the plasma 5-hydroxytryptamine (5-HT) level was lower in the EA group by enzyme-linked immunosorbent assay during the first 72 hr after thoracic surgery. Therefore, EA is suitable as an adjunct treatment for postoperative pain management after thoracic surgery.
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Liu XL, Tan JY, Molassiotis A, Suen LKP, Shi Y. Acupuncture-Point Stimulation for Postoperative Pain Control: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2015; 2015:657809. [PMID: 26568767 PMCID: PMC4620376 DOI: 10.1155/2015/657809] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 08/19/2015] [Accepted: 09/03/2015] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to evaluate the effectiveness of Acupuncture-point stimulation (APS) in postoperative pain control compared with sham/placebo acupuncture or standard treatments (usual care or no treatment). Only randomized controlled trials (RCTs) were included. Meta-analysis results indicated that APS interventions improved VAS scores significantly and also reduced total morphine consumption. No serious APS-related adverse effects (AEs) were reported. There is Level I evidence for the effectiveness of body points plaster therapy and Level II evidence for body points electroacupuncture (EA), body points acupressure, body points APS for abdominal surgery patients, auricular points seed embedding, manual auricular acupuncture, and auricular EA. We obtained Level III evidence for body points APS in patients who underwent cardiac surgery and cesarean section and for auricular-point stimulation in patients who underwent abdominal surgery. There is insufficient evidence to conclude that APS is an effective postoperative pain therapy in surgical patients, although the evidence does support the conclusion that APS can reduce analgesic requirements without AEs. The best level of evidence was not adequate in most subgroups. Some limitations of this study may have affected the results, possibly leading to an overestimation of APS effects.
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Affiliation(s)
- Xian-Liang Liu
- 10th People's Hospital of Tongji University, 301 Yanchang Road, Shanghai 200072, China
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, 1100 Nudgee Road, Banyo, Brisbane, QLD 4014, Australia
- School of Nursing, Jinggangshan University, 28 Xueyuan Road, Ji'an 343009, China
| | - Jing-Yu Tan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Lorna K. P. Suen
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Yan Shi
- 10th People's Hospital of Tongji University, 301 Yanchang Road, Shanghai 200072, China
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Hsiung WT, Chang YC, Yeh ML, Chang YH. Acupressure improves the postoperative comfort of gastric cancer patients: A randomised controlled trial. Complement Ther Med 2015; 23:339-46. [PMID: 26051568 DOI: 10.1016/j.ctim.2015.03.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 01/07/2015] [Accepted: 03/29/2015] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE This pilot study evaluated whether acupressure affected the postoperative comfort of gastric cancer patients following a subtotal gastrectomy. METHODS A randomised controlled trial was conducted. Sixty patients were recruited from 141-bed general surgery ward at a 3000-bed medical centre in Northern Taiwan. Participants were randomly assigned to either a control group receiving regular postoperative care or to the experimental group receiving additional acupressure at acupoints of Neiquan (P6) and Zusanli (ST36) for 3 consecutive days. RESULTS The similarities between two groups were in postoperative pain and the onset of postoperative nausea and vomiting (PONV) at the baseline. Following acupressure, significant differences were found in postoperative pain (P=.03) and time of first flatus (P=.04); but not PONV (P=.49), nor the time of first defecation (P=.34). CONCLUSIONS Acupressure is a simple, noninvasive, safe, and economical procedure for improving the comfort of patients who undergo surgery for gastric cancer. Acupressure at the P6 and ST36 acupoints can improve postoperative comfort by alleviating pain and decreasing the time until first flatus. However, additional research is necessary to elucidate how acupressure can improve postoperative outcomes.
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Affiliation(s)
- Wan-Ting Hsiung
- Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC
| | - Yi-Chuan Chang
- Department of Nursing, Fooyin University, Taiwan, ROC; National Taipei University of Nursing and Health Sciences, Taiwan, ROC
| | - Mei-Ling Yeh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan, ROC.
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