Korean hand therapy for tonsillectomy pain in children

The effect of acupuncture on postoperative pain, nausea and vomiting after pediatric tonsillectomy: a systematic review

INTRODUCTION

Tonsillectomy is one of the most commonly performed surgical procedures among children around the world and management of post tonsillectomy complications are very important.

OBJECTIVES

The aim of this study was to evaluate the effects of acupuncture on the amount of pain, nausea and vomiting after tonsillectomy in children.

METHODS

In this study, two researchers searched individually for qualified articles on the effects of acupuncture on post-tonsillectomy pain, nausea and vomiting using PubMed, Cochrane Library, Embase, Google scholar and Ovid databases by September 2018.

RESULTS

After critically appraising the searched studies, 12 studies were selected and entered into a systematic review. Among the studies, various acupuncture methods were used.

CONCLUSION

This systematic review shows that acupuncture as a complementary method can prevent and reduce the severity of complications surrounding tonsillectomy.

Treating pediatric post-tonsillectomy pain and nausea with complementary and alternative medicine

OBJECTIVES

Although tonsillectomy is a common and largely safe procedure, pain management in children remains a controversial topic. In addition to the challenge of choosing appropriate analgesia, there is often low parent and child adherence. This article presents a review, and evaluates the potential role, of a range of complementary and alternative therapies that may be sought out by parents.

METHODS

A literature review of complementary and alternative interventions performed using PubMed, Cochrane Library, and EMBASE, supplemented by searches from Google and hand searches of cross-references of selected articles, yielded 32 studies for qualitative analysis.

RESULTS

The studies included for analysis investigated a wide variety of alternative treatment modalities: acupuncture and related therapies, aromatherapy, homeopathy, honey, intravenous fluid, speech therapy, hyaluronic acid, behavioral therapies, ice/cold, hydrogen peroxide rinse, and chewing gum.

CONCLUSION

At this time, stronger conclusions cannot be made about the therapies investigated because there are many methodology limitations of the studies analyzed. However, our results suggest merit for these treatments as adjuvant therapies that can enhance analgesia and decrease requirements of controversial medications. Honey and acupuncture have the greatest amount of evidence for postoperative pain and nausea; however, all interventions examined were cost-effective and safe. We recommend against hydrogen peroxide rinses and chewing gum. Laryngoscope, 2625-2634, 2018.

Efficacy of Parietal Acupoint Therapy: Scalp Acupuncture for Neck/Shoulder Stiffness with Related Mood Disturbance

Objectives: Yamamoto New Scalp Acupuncture is a quick and effective microsystem of acupuncture used for treating various symptoms for which the somatotopic area is the scalp. This article describes Parietal Acupoint Therapy (PAPT), which is another approach, using a different scalp somatotopy, and to evaluate PAPT's effect on neck/shoulder stiffness and related mood disturbances. Materials and Methods:Subjects: Forty-six volunteers suffering from chronic neck/shoulder stiffness with various symptoms (headache, dizziness, and related mood disturbance) participated in this study and were randomly divided into 2 groups: treatment (26 subjects) and control (20 subjects). Interventions: PAPT, PC points, and PL points were used. Outcome Measures: Immediately before and after treatment, to evaluate the patients' psychobiologic and mood states, salivary alpha amylase (sAA) levels were determined and the Profile of Mood States Second Edition (POMS 2)-Short Form scale was administered. Neck/shoulder stiffness was evaluated using a visual analogue scale (VAS) score immediately before and after, and at 3 and 7 days post-therapy. Results: sAA levels were not significantly different in either group after versus before the intervention. There were significant decreases in mean scores in the POMS 2 subscales Anger/Hostility (P < 0.001), Confusion/Bewilderment (P < 0.001), Depression/Dejection (P < 0.01), Fatigue/Inertia (P < 0.001), Tension/Anxiety (P < 0.001), and Total Mood Disturbance (P < 0.001) post-therapy in the treatment group, but not in the control group. The mean VAS score significantly improved in the treatment group post-therapy, which persisted during the observation period. Conclusions: PAPT treatment on PC points ameliorated neck/shoulder stiffness and related mood disturbance. PAPT has the potential to be as effective as other scalp acupuncture types.

Effects of Korean hand acupressure on opioid-related nausea and vomiting, and pain after caesarean delivery using spinal anaesthesia

OBJECTIVE

This study examined the effects of Korean hand acupressure on opioid-related nausea and vomiting, and pain after caesarean delivery.

METHODS

Fifty participants were randomly assigned to an acupressure group or a control group. Korean hand acupressure discs were applied for 24 h onto 12 acupressure points (K-9, F-4 for nausea and vomiting; M-3, M-4, L-4, H-2, H-3, H-7 for abdominal pain; and I-38, J-2 for back pain). Nausea and vomiting incidences, the opioid-related symptom distress scale scores, and pain scores were analysed using chi-square test, Fisher's exact test, Mann-Whitney U test, or the repeated-measures analysis of variance.

RESULTS

The acupressure group had lower incidences of nausea and vomiting, as well as significant improvements in the opioid-related symptom distress scores for nausea, vomiting, and pain. The acupressure group required fewer rescue antiemetics and analgesics.

CONCLUSION

Korean hand acupressure can relieve nausea and vomiting, as well as pain after caesarean delivery.

Why We Need Minimum Basic Requirements in Science for Acupuncture Education

As enthusiasm for alternatives to pharmaceuticals and surgery grows, healthcare consumers are turning increasingly to physical medicine modalities such as acupuncture. However, they may encounter obstacles in accessing acupuncture due to several reasons, such as the inability to locate a suitable practitioner, insufficient reimbursement for treatment, or difficulty gaining a referral due to perceived lack of evidence or scientific rigor by specialists. Claims made about a range of treatment paradigms outstrip evidence and students in acupuncture courses are thus led to believe that the approaches they learn are effective and clinically meaningful. Critical inquiry and critical analysis of techniques taught are often omitted, leading to unquestioning acceptance, adoption, and implementation into practice of approaches that may or may not be rational and effective. Acupuncture education for both licensed physicians (DOs and MDs) and non-physicians needs to include science (i.e., explanation of its effects based on contemporary explanations of biological processes), evidence, and critical thinking. Erroneous notions concerning its mechanisms such as moving "stuck Qi (Chi)" or "energy" with needles and that this energy stagnates at specific, tiny locations on the body called acupuncture points lead to mistakes in methodologic design. For example, researchers may select sham and verum point locations that overlap considerably in their neural connections, leading to nonsignificant differences between the two interventions. Furthermore, attributing the effects of acupuncture to metaphorical and arcane views of physiology limits both acceptance and validation of acupuncture in both research and clinical settings. Finally, the content and quality of education and clinical exposure across acupuncture programs varies widely, with currently no minimum basic educational requirements in a scientific methodology. Considering the pressures mounting on clinicians to practice in an evidence-based and scientific manner that also demonstrates cost-effectiveness, acupuncture schools and continuing medical education (CME) courses need to provide their students a strong foundation in rational approaches supported by research.