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Saraswati W, Wardani R, Suhatno S, Hartono P, Imandiri A. The Effect of Electroacupuncture Therapy on Pain, Plasma β-Endorphin, and Quality of Life of Stage III Cervical Cancer Patients: A Randomized Control Trial. J Acupunct Meridian Stud 2021; 14:4-12. [DOI: 10.51507/j.jams.2021.14.1.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/18/2020] [Accepted: 12/28/2020] [Indexed: 11/03/2022] Open
Affiliation(s)
- Wita Saraswati
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Ratih Wardani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Suhatno Suhatno
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Pudjo Hartono
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Ario Imandiri
- Department of Traditional Healer, Faculty of Vocations, Universitas Airlangga, Surabaya, Indonesia
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Lederer AK, Schmucker C, Kousoulas L, Fichtner-Feigl S, Huber R. Naturopathic Treatment and Complementary Medicine in Surgical Practice. DEUTSCHES ARZTEBLATT INTERNATIONAL 2019; 115:815-821. [PMID: 30678751 DOI: 10.3238/arztebl.2018.0815] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 01/02/2018] [Accepted: 09/06/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Many patients in Germany use naturopathic treatments and complementary medicine. Surveys have shown that many also use them as a concomitant treatment to surgery. METHODS Multiple databases were systematically searched for systematic reviews, controlled trials, and experimental studies concerning the use of naturopathic treatments and complementary medicine in the management of typical post-operative problems (PROSPERO CRD42018095330). RESULTS Of the 387 publications identified by the search, 76 fulfilled the inclusion criteria. In patients with abnormal gastrointestinal activity, acupuncture can improve motility, ease the passing of flatus, and lead to earlier defecation. Acupuncture and acupressure can reduce postoperative nausea and vomiting, as well as pain. More-over,aromatherapy and music therapy seem to reduce pain, stress and anxiety and to improve sleep. Further studies are needed to determine whether phytotherapeutic treatments are effective for the improvement of gastrointestinal function or the reduction of stress. It also remains unclear whether surgical patients can benefit from the methods of mind body medicine. CONCLUSION Certain naturopathic treatments and complementary medical methods may be useful in postoperative care and deserve more intensive study. In the publications consulted for this review, no serious side effects were reported.
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Affiliation(s)
- Ann-Kathrin Lederer
- Center for Complementary Medicine, Institute for Infection Prevention and Hospital Epidemiology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg; Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg; Department for General and Visceral Surgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg
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Effectiveness of Perioperative Auricular Therapy on Postoperative Pain after Total Hip Arthroplasty: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:2979780. [PMID: 30941191 PMCID: PMC6420993 DOI: 10.1155/2019/2979780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 01/25/2019] [Accepted: 02/14/2019] [Indexed: 11/25/2022]
Abstract
Auricular therapy (AT) is a conventional therapy in traditional Chinese medicine. However, the effectiveness of perioperative AT in pain treatment after total hip arthroplasty (THA) is still controversial. Nine randomised controlled trials (RCTs) involving 605 patients who have undergone THA with or without AT from inception to March 2018 were collected and included in this study by searching more than 12 databases (e.g., PubMed, Excerpta Medica Database, and Cochrane Library). A random-effects model that pooled seven articles showed that the visual analogue scale (VAS) in the AT group was lower than that of the control group at each postoperative time point in patients after THA, except at the time points of 6 and 36 h. The intraoperative body mass-adjusted fentanyl amount in the AT group was also lower than that of the control group in two trials. The other outcomes (time to first analgesic request and incidence of postoperative nausea and vomiting, perioperative bradycardia, and transitory hypotension) showed insignificant difference. Then, subgroup analysis showed similar results to those of the total articles with the term “VAS”. Regression analysis found that the prolonged time after the operation decreased the difference in VAS between the two groups. Although all the outcomes were assessed as very low to low in the GRADE system, evidence on the effectiveness of perioperative AT in pain treatment after total hip replacement was positive.
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Fernandez Rojas R, Liao M, Romero J, Huang X, Ou KL. Cortical Network Response to Acupuncture and the Effect of the Hegu Point: An fNIRS Study. SENSORS 2019; 19:s19020394. [PMID: 30669377 PMCID: PMC6359459 DOI: 10.3390/s19020394] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 11/16/2022]
Abstract
Acupuncture is a practice of treatment based on influencing specific points on the body by inserting needles. According to traditional Chinese medicine, the aim of acupuncture treatment for pain management is to use specific acupoints to relieve excess, activate qi (or vital energy), and improve blood circulation. In this context, the Hegu point is one of the most widely-used acupoints for this purpose, and it has been linked to having an analgesic effect. However, there exists considerable debate as to its scientific validity. In this pilot study, we aim to identify the functional connectivity related to the three main types of acupuncture manipulations and also identify an analgesic effect based on the hemodynamic response as measured by functional near-infrared spectroscopy (fNIRS). The cortical response of eleven healthy subjects was obtained using fNIRS during an acupuncture procedure. A multiscale analysis based on wavelet transform coherence was employed to assess the functional connectivity of corresponding channel pairs within the left and right somatosensory region. The wavelet analysis was focused on the very-low frequency oscillations (VLFO, 0.01–0.08 Hz) and the low frequency oscillations (LFO, 0.08–0.15 Hz). A mixed model analysis of variance was used to appraise statistical differences in the wavelet domain for the different acupuncture stimuli. The hemodynamic response after the acupuncture manipulations exhibited strong activations and distinctive cortical networks in each stimulus. The results of the statistical analysis showed significant differences (p<0.05) between the tasks in both frequency bands. These results suggest the existence of different stimuli-specific cortical networks in both frequency bands and the anaesthetic effect of the Hegu point as measured by fNIRS.
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Affiliation(s)
- Raul Fernandez Rojas
- Human-Centred Technology Research Centre, Faculty of Science and Technology, University of Canberra, Canberra 2617, Australia.
| | - Mingyu Liao
- Department of Industrial Engineering and Management, National Kaohsiung University of Science and Technology, Kaohsiung 80778, Taiwan.
| | - Julio Romero
- Human-Centred Technology Research Centre, Faculty of Science and Technology, University of Canberra, Canberra 2617, Australia.
| | - Xu Huang
- Human-Centred Technology Research Centre, Faculty of Science and Technology, University of Canberra, Canberra 2617, Australia.
| | - Keng-Liang Ou
- Department of Dentistry, Taipei Medical University Hospital, Taipei 110, Taiwan.
- Department of Dentistry, Taipei Medical University-Shuang Ho Hospital, New Taipei City 235, Taiwan.
- School of Dentistry, Health Sciences University of Hokkaido, Hokkaido 061-0293, Japan.
- Department of Prosthodontics, Faculty of Dentistry, Hasanuddin University, Makassar 90245, Indonesia.
- Department of Prosthodontics, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia.
- Department of Oral Hygiene Care, Ching Kuo Institute of Management and Health, Keelung 203, Taiwan.
- 3D Global Biotech Inc., New Taipei City 221, Taiwan.
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Darbois N, Evain JN, Guillaud A, Lilot M, Pinsault N. [Open heart surgery under acupuncture ? Decrypting a program broadcast on France 2]. SANTE PUBLIQUE 2018; 30:455-464. [PMID: 30540134 DOI: 10.3917/spub.185.0455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To analyze a clip from the program ? Acupuncture, osteopathy, hypnosis: do complementary medicines have superpowers ? about acupuncture as an anesthetic for surgical procedures in China. To propose a rational explanation for the phenomena observed. To describe the processes leading a public service broadcasting channel to offer this type of content at prime time and the potential consequences in terms of public health. METHOD Analysis using critical thinking attitudes and skills, along with a bibliographical search of Medline, Google Scholar and Cochrane Library databases. RESULTS The information delivered in the television clip is ambiguous. It does not allow the viewer to form an informed opinion on the relevance of acupuncture as an anesthetic for surgical procedures. It is reasonable to assume that the clip shows surgery performed with undisclosed epidural anesthesia coupled with mild intravenous anesthesia, sometimes performed in other countries. What needs to be highlighted here is the overestimation of acupuncture added to the protocol. The media tend to exaggerate the risks and expected effects of the treatments they report on, which can lead patients to turn to unproven therapies. CONCLUSION Broadcasting such a clip at prime time underlines the urgent need for the public and all health professionals to be trained in sorting and critically analyzing health information.
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Lux EA, Wahl G, Erlenwein J, Wiese C, Wirz S. [Is supplemental ear acupuncture for surgical tooth removal with local anesthesia effective? : A pilot study]. Schmerz 2017; 31:489-498. [PMID: 28315017 DOI: 10.1007/s00482-017-0212-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The application of ear acupuncture can contribute to a reduction of acute pain. Data on the application of ear acupuncture following oral surgery in odontology is insufficient. OBJECTIVE This study investigated the effectiveness of ear acupuncture as an auxiliary analgesic treatment in addition to local anesthesia for operative tooth removal. METHODS In this prospective open non-randomized pilot study (in accordance with the CONSORT publication) 2 cohorts of 50 patients each with the indications for an operative tooth removal either with or without the application of ear acupuncture in addition to local anesthesia with articain were observed. Patients were allocated to the groups according to their preference. Pain intensity while resting and while chewing was recorded as the primary parameter for a period of 10 days. The secondary parameters were the subjective experience of anxiety and symptoms, such as headaches, dizziness and nausea. RESULTS The two groups did not differ significantly with respect to demographic variables or the use of local anesthetics. At the various measurement intervals, pain intensity while resting or chewing differed significantly between the two groups (ANOVA, p = 0.004, p = 0.007, respectively). Furthermore, the experience of anxiety (ANOVA, p = 0.0001), the number of patients taking analgesics (χ2-test, p = 0.017) and the total postoperative consumption of analgesics (t-test, 0.001) revealed significant differences. In both groups the numerical rating scales (NRS) for postoperative headaches, dizziness and nausea were low. DISCUSSION AND CONCLUSION Despite a potential bias and methodological limitations of the study design, the results of this investigation suggest that ear acupuncture influences the experience of pain and anxiety in the postoperative period after tooth removal. As a treatment method with low adverse effects ear acupuncture can contribute to postoperative pain control, especially in patients with preoperative anxiety.
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Affiliation(s)
- E A Lux
- Klinik für Schmerz- und Palliativmedizin, Katholisches Klinikum Lünen-Werne GmbH, Fakultät für Gesundheit - Private Universität Witten-Herdecke, Lünen, Deutschland
| | - G Wahl
- Poliklinik für Chirurgische Zahn-, Mund- und Kieferheilkunde, Universitätsklinikum Bonn, Bonn, Deutschland
| | - J Erlenwein
- Klinik für Anästhesiologie, GF Schmerzmedizin, Universitätsmedizin Göttingen, Georg-August-Universität, Göttingen, Deutschland
| | - C Wiese
- Klinik für Anästhesiologie, Herzogin Elisabeth Hospital, Braunschweig, Deutschland
| | - S Wirz
- Abteilung für Anästhesiologie, Intensivmedizin, Schmerzmedizin/Palliativmedizin, Zentrum für Schmerzmedizin, GFO CURA - Katholisches Krankenhaus im Siebengebirge, Schülgenstr.15, 53604, Bad Honnef, Deutschland.
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Karst M, Fink M. Acupuncture—A Biomedical Information Therapy: A Translational Analysis. Med Acupunct 2016. [DOI: 10.1089/acu.2016.1196] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Matthias Karst
- Pain Clinic, Department of Anesthesiology and Intensive Care, Hannover Medical School, Hannover, Germany
| | - Matthias Fink
- Department of Physical Medicine and Rehabilitation, Hannover Medical School, Hannover, Germany
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Acar HV. Acupuncture and related techniques during perioperative period: A literature review. Complement Ther Med 2016; 29:48-55. [DOI: 10.1016/j.ctim.2016.09.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 03/22/2016] [Accepted: 09/11/2016] [Indexed: 12/18/2022] Open
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In vivo Monitoring of Serotonin by Nanomaterial Functionalized Acupuncture Needle. Sci Rep 2016; 6:28018. [PMID: 27301303 PMCID: PMC4908407 DOI: 10.1038/srep28018] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 05/27/2016] [Indexed: 12/17/2022] Open
Abstract
Acupuncture treatment is amazing but controversial. Up to now, the mechanism of treating diseases by acupuncture and moxibustion is still unclear, especially the occurrence of the molecular events in local acupoints. Herein, we report an extremely stable microsensor by modifying carbon nanotube (CNT) to the tip surface of acupuncture needle and applying this CNT-modified acupuncture needle for real time monitoring of serotonin (5-HT) in vivo. To stabilize CNT modification on the needle tip surface, poly(3,4-ethylenedioxythiophene)(PEDOT) was employed as glue water to stick CNT on the needle. The detection limit of the CNT-modified needle was found to be approximately 50 nM and 78 nM in the PBS and the cell medium, respectively. In addition, the needle showed good selectivity to some inflammatory mediators and some electroactive molecules. For the first time, the CNT-modified needle could be directly probed into rat body for real time monitoring of 5-HT in vivo, showing a great potential for better understanding the mechanism of acupuncture treatment.
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Tabassi KT, Amini P, Mohammadi S, Razavizadeh RT, Golchian A. The effect of acupuncture on pain score after open kidney surgery. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2016; 12:241-4. [PMID: 25924232 DOI: 10.1515/jcim-2014-0071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 04/14/2015] [Indexed: 01/05/2023]
Abstract
BACKGROUND The pain after nephrectomy, just as any other surgery, is one of the problems that surgeons confront. The aim of this study was to evaluate the relieving effect of acupuncture on the pain experienced after nephrectomy. METHODS This was a clinical trial that was performed on 30 patients with mean age of 40.8 ± 12.54 who were candidates for nephrectomy. After matching for gender and age, the patients were divided into either acupuncture or control group. In acupuncture group, four points were stimulated for 30 minutes, and in control group, other points were stimulated ineffectively for 30 min. Then, the pain experienced in the first six hours after the surgery was registered by a blind observer based on visual analog scale. Data were analyzed using SPSS software and the t-test. RESULTS Our results showed that the severity of pain in the acupuncture group was significantly lower than that in the control group. Also, there were six patients who required opioids in the acupuncture group, but there were 12 such patients in the control group. The mean opiate used in the control group was significantly greater than the mean for the acupuncture group. CONCLUSIONS Acupuncture can reduce the severity of pain and the demand for opioids in patients who have undergone nephrectomy.
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Lu Z, Dong H, Wang Q, Xiong L. Perioperative acupuncture modulation: more than anaesthesia. Br J Anaesth 2015; 115:183-93. [DOI: 10.1093/bja/aev227] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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Dalamagka M, Mavrommatis C, Grosomanidis V, Karakoulas K, Vasilakos D, Samara M, Saros C, Crommydas G. Postoperative analgesia after low-frequency electroacupuncture as adjunctive treatment in inguinal hernia surgery with abdominal wall mesh reconstruction. Acupunct Med 2015; 33:360-7. [PMID: 26040491 DOI: 10.1136/acupmed-2014-010689] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2015] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To determine whether an electroacupuncture (EA) technique that was developed for a surgical population under general anaesthesia reduces pain after mesh inguinal hernia open repair. METHODS A total of 54 patients with right or left inguinal hernia were randomised to group I (preoperative, intraoperative, postoperative EA), group II (preoperative, postoperative EA), or a sham control group (group III; preoperative and postoperative placement of needles, but without skin penetration). The Visual Analogue Scale (VAS) (primary outcome) and the State-Trait Anxiety Spielberger Inventory were evaluated preoperatively and at 30 min, 90 min, 10 h and 24 h after surgery. Pain threshold and tolerance were evaluated using an algometer at these same time points and preoperatively before and after EA. Levels of the stress hormones cortisol, corticotrophin and prolactin were determined at 30 min, 90 min and 10 h after surgery and preoperatively before and after EA. RESULTS The results showed significant differences between the true EA and control groups. The true EA groups (I and II) showed statistically significantly greater improvements in the primary (VAS pain, p<0.05) and secondary outcome measures (Anxiety scale; algometer measurements, p<0.05 and stress hormones, p<0.01) compared to the control group. There were no statistically significant differences between groups I and II. CONCLUSIONS Electroacupuncture reduces postoperative pain after mesh inguinal hernia repair and decreases stress hormone levels and anxiety during the postoperative period. TRIAL REGISTRATION NUMBER ClinicalTrials.gov identifier NCT01722253.
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Affiliation(s)
- Maria Dalamagka
- Anaesthesiology Department, General Hospital of Edessa, Edessa, Greece
| | | | - Vassilios Grosomanidis
- Department of Αnaesthesiology and Ιntensive care medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Konstantinos Karakoulas
- Department of Αnaesthesiology and Ιntensive care medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
| | - Dimitrios Vasilakos
- Department of Αnaesthesiology and Ιntensive care medicine, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
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Crespin DJ, Griffin KH, Johnson JR, Miller C, Finch MD, Rivard RL, Anseth S, Dusek JA. Acupuncture provides short-term pain relief for patients in a total joint replacement program. PAIN MEDICINE 2015; 16:1195-203. [PMID: 25586769 DOI: 10.1111/pme.12685] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Given the risks of opioid medications, nonpharmacological strategies should be considered for total joint replacement patients. We investigated acupuncture as an adjunct therapy for postsurgical pain management in a total joint replacement program by examining which total hip and knee replacement patients elected to receive acupuncture and the effect of acupuncture on short-term pain. DESIGN A total joint replacement program using fast-track physiotherapy offered elective postsurgical acupuncture to all patients, at no additional cost, as an adjunct therapy to opioids for pain management. SETTING The Joint Replacement Center at Abbott Northwestern Hospital, a 630-bed teaching and specialty hospital in Minneapolis, Minnesota from 2010 to 2012. SUBJECTS Our sample included 2,500 admissions of total hip (THR) and total knee replacement (TKR) patients. METHODS Self-reported pain was assessed before and after acupuncture using a 0-10 scale and categorized as none/mild (0-4) and moderate/severe pain (5-10). RESULTS Seventy-five percent of admissions included acupuncture. Women (Odds Ratio: 1.48, 95% Confidence Interval (CI): 1.22, 1.81) had higher odds of receiving acupuncture compared to men, and nonwhite patients (Odds Ratio: 0.55, 95% CI: 0.39, 0.78) had lower odds of receiving acupuncture compared to white patients. Average short-term pain reduction was 1.91 points (95% CI: 1.83, 1.99), a 45% reduction from the mean prepain score. Forty-one percent of patients reported moderate/severe pain prior to receiving acupuncture, while only 15% indicated moderate/severe pain after acupuncture. CONCLUSIONS Acupuncture may be a viable adjunct to pharmacological approaches for pain management after THR or TKR.
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Affiliation(s)
- Daniel J Crespin
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Kristen H Griffin
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota
| | - Jill R Johnson
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota
| | - Cynthia Miller
- Penny George Institute for Health and Healing, Allina Health, Abbott Northwestern Hospital, Minneapolis, Minnesota
| | - Michael D Finch
- Medical Industry Leadership Institute, Carlson School of Management, University of Minnesota, Minneapolis, Minnesota
| | - Rachael L Rivard
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota
| | | | - Jeffery A Dusek
- Integrative Health Research Center, Penny George Institute for Health and Healing, Allina Health, Minneapolis, Minnesota
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Fleckenstein J, Baeumler PI, Gurschler C, Weissenbacher T, Simang M, Annecke T, Geisenberger T, Irnich D. Acupuncture for post anaesthetic recovery and postoperative pain: study protocol for a randomised controlled trial. Trials 2014; 15:292. [PMID: 25047046 PMCID: PMC4223649 DOI: 10.1186/1745-6215-15-292] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 07/01/2014] [Indexed: 11/30/2022] Open
Abstract
Background We report on the design and implementation of a study protocol entitled Acupuncture randomised trial for post anaesthetic recovery and postoperative pain - a pilot study (ACUARP) designed to investigate the effectiveness of acupuncture therapy performed in the perioperative period on post anaesthetic recovery and postoperative pain. Methods/Design The study is designed as a randomised controlled pilot trial with three arms and partial double blinding. We will compare (a) press needle acupuncture, (b) no treatment and (c) press plaster acupressure in a standardised anaesthetic setting. Seventy-five patients scheduled for laparoscopic surgery to the uterus or ovaries will be allocated randomly to one of the three trial arms. The total observation period will begin one day before surgery and end on the second postoperative day. Twelve press needles and press plasters are to be administered preoperatively at seven acupuncture points. The primary outcome measure will be time from extubation to ‘ready for discharge’ from the post anaesthesia care unit (in minutes). The ‘ready for discharge’ end point will be assessed using three different scores: the Aldrete score, the Post Anaesthetic Discharge Scoring System and an In-House score. Secondary outcome measures will comprise pre-, intra- and postoperative variables (which are anxiety, pain, nausea and vomiting, concomitant medication). Discussion The results of this study will provide information on whether acupuncture may improve patient post anaesthetic recovery. Comparing acupuncture with acupressure will provide insight into potential therapeutic differences between invasive and non-invasive acupuncture techniques. Trial registration NCT01816386 (First received: 28 October 2012)
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Affiliation(s)
- Johannes Fleckenstein
- Multidisciplinary Pain Centre, Department of Anaesthesiology, University of Munich, Pettenkoferstrasse 8 A, 80336 München, Germany.
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Abstract
AIM Several systematic reviews (SRs) of acupuncture for surgical conditions have recently been published with sometimes contradicting results. The aim of this overview was to summarise recent SRs of acupuncture for surgical conditions. METHOD Thirteen electronic databases were searched for relevant reviews published since 2000. Data were extracted by two independent reviewers according to predefined criteria. RESULTS Twelve SRs met our inclusion criteria. They related to the prevention or treatment of postoperative nausea and vomiting as well as to surgical or postoperative pain. Their results were far from uniform, and several caveats need to be considered. CONCLUSION The evidence is insufficient to suggest that acupuncture is an effective intervention in surgical settings. More rigorous research seems warranted. This protocol was registered with PROSPERO database (registration number: CRD42013004817).
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Affiliation(s)
- M S Lee
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
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The effect of complementary therapies on post-operative pain control in ambulatory knee surgery: a systematic review. Complement Ther Med 2013; 21:529-34. [PMID: 24050592 DOI: 10.1016/j.ctim.2013.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 06/11/2013] [Accepted: 06/20/2013] [Indexed: 11/22/2022] Open
Abstract
Ambulatory knee surgery is a common procedure with over 100,000 knee arthroscopies performed in the U.K. in 2010-2011. Pain after surgery can decrease patient satisfaction, delay discharge, and decrease cost effectiveness. Multi-modal therapies, including complementary therapies, to improve pain control after surgery have been recommended. However, a comprehensive review of the literature regarding the use of complementary therapies to enhance pain control after ambulatory knee surgery is lacking, and this article aims to address this deficit. CINHAL, EMBASE, MEDLINE, AMED and CENTRAL databases were searched. Only Randomised Controlled Trials were included. All eligible papers were quality assessed using the Jadad system, and data was extracted using piloted forms. Two independent reviewers performed each stage of the review. Full details of the study methodology can be found on Prospero, a systematic review register. Five studies satisfied our eligibility criteria: three reporting on acupuncture, one on homeopathy, and one on acupoints. Acupoint pressure was the only study that demonstrated reduced pain compared with placebo. This study was the least methodologically robust. Arnica, although demonstrating a significant reduction in swelling, did not affect post-operative pain. Acupuncture did not affect post-operative pain; however, a reduction in ibuprofen use was demonstrated in two studies. Before recommending complementary therapy for routine use in ambulatory knee surgery, further work is required. Two areas of future research likely to bear fruit are demonstrating robust evidence for the effect of acupoint pressure on post-operative pain, and quantifying the positive effect of homeopathic arnica on post-operative swelling.
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Lam DS, Zhao J, Chen LJ, Wang Y, Zheng C, Lin Q, Rao SK, Fan DS, Zhang M, Leung PC, Ritch R. Adjunctive Effect of Acupuncture to Refractive Correction on Anisometropic Amblyopia. Ophthalmology 2011; 118:1501-11. [DOI: 10.1016/j.ophtha.2011.01.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 01/06/2011] [Accepted: 01/06/2011] [Indexed: 10/18/2022] Open
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Ernst E, Lee MS, Choi TY. Acupuncture: does it alleviate pain and are there serious risks? A review of reviews. Pain 2011; 152:755-764. [PMID: 21440191 DOI: 10.1016/j.pain.2010.11.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Revised: 11/01/2010] [Accepted: 11/03/2010] [Indexed: 12/17/2022]
Abstract
Acupuncture is commonly used for pain control, but doubts about its effectiveness and safety remain. This review was aimed at critically evaluating systematic reviews of acupuncture as a treatment of pain and at summarizing reports of serious adverse effects published since 2000. Literature searches were carried out in 11 databases without language restrictions. Systematic reviews were considered for the evaluation of effectiveness and case series or case reports for summarizing adverse events. Data were extracted according to predefined criteria. Fifty-seven systematic reviews met the inclusion criteria. Four were of excellent methodological quality. Numerous contradictions and caveats emerged. Unanimously positive conclusions from more than one high-quality systematic review existed only for neck pain. Ninety-five cases of severe adverse effects including 5 fatalities were included. Pneumothorax and infections were the most frequently reported adverse effects. In conclusion, numerous systematic reviews have generated little truly convincing evidence that acupuncture is effective in reducing pain. Serious adverse effects continue to be reported. Numerous reviews have produced little convincing evidence that acupuncture is effective in reducing pain. Serious adverse events, including deaths, continue to be reported.
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Affiliation(s)
- E Ernst
- Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, UK Division of Standard Research, Korea Institute of Oriental Medicine, Daejeon, South Korea
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Streitberger K, Shi J, Pfab F, Huang W, Witt CM, Duan Y, Willich SN. Acupuncture assisted anesthesia for nasal surgery as an example for integrative medicine in China. Eur J Integr Med 2010. [DOI: 10.1016/j.eujim.2010.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Shaikh SH, Malik F, James H, Abdul H. Trends in the use of complementary and alternative medicine in Pakistan: a population-based survey. J Altern Complement Med 2009; 15:545-50. [PMID: 19422284 DOI: 10.1089/acm.2008.0232] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The objective of this study was to evaluate the extent of use of complementary and alternative systems of medicine by different segments of society and to identify the diseases in which they have been found to be effective. METHODS This was a questionnaire-based descriptive study carried out from April 2002 to March 2004, in selected urban and rural areas of four provinces of Pakistan representing general strata of population from various socioeconomic conditions. RESULTS The overall trend in Pakistan shows that 51.7% (CI 54.3-49.1) chose complementary and alternative medicine (CAM) while 48.3% (CI 50.71-48.89) chose biomedicine. Of those who chose CAM, 20% (CI 21-19) also used biomedicine as well; 16% (CI 16.8-15.2) homeopathy, 12.4% (CI 13.02-11.78) unani medicine, 2.1% (CI 2.20-1.99) mind-body medicine (faith healing), 0.9% biologically based practices (home remedies, diet and nutrition) 0.05% energy medicine (Reiki), 0.05% Traditional Chinese Medicine, and 0.02% aromatherapy. CONCLUSIONS About half of the studied population used CAM. The population estimates of use of CAM are within the range reported elsewhere. It reflects an increasing popularity of CAM in Pakistan as well. Combined use of biomedicine with CAM was common and often patients did not reveal the use of CAM to the biomedicine practitioners.
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Zhang D, Ding G, Shen X, Yao W, Zhang Z, Zhang Y, Lin J, Gu Q. Role of mast cells in acupuncture effect: a pilot study. Explore (NY) 2008; 4:170-7. [PMID: 18466847 DOI: 10.1016/j.explore.2008.02.002] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2006] [Indexed: 11/15/2022]
Abstract
To better understand the therapeutic effectiveness of acupuncture, questions about the underlying mechanisms need to be addressed. Here we describe the impact of manual stimulation by an acupuncture needle of zusanli (stomach 36 [ST36]) on analgesia in rats. The analgesic effect was more pronounced after stimulation of ST36 than after stimulation of a sham point near the acupuncture point. At the same time, we determined in tissue slices the density of mast cells in the acupuncture points and nearby points, as well as the degree of degranulation before and after stimulation. We found that the density of mast cells from the ST36 of rats was higher than that from a nearby sham point. In addition, acupuncture resulted in a remarkable increase in degranulation of the mast cells. Pretreatment of the acupuncture point with disodium chromoglycate not only counteracted the phenomenon of degranulation but also reduced analgesic effect of acupuncture. Our experiments on inhibition of degranulation of mast cells in tissue from acupuncture points demonstrates the possible role of mast cells in acupuncture effects.
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Affiliation(s)
- Di Zhang
- Shanghai Research Center of Acupuncture and Meridians, Department of Mechanics and Engineering Science, Fudan University, Shanghai, China
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Zhao ZQ. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol 2008; 85:355-75. [PMID: 18582529 DOI: 10.1016/j.pneurobio.2008.05.004] [Citation(s) in RCA: 676] [Impact Index Per Article: 42.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2007] [Revised: 03/19/2008] [Accepted: 05/30/2008] [Indexed: 12/16/2022]
Abstract
Acupuncture has been accepted to effectively treat chronic pain by inserting needles into the specific "acupuncture points" (acupoints) on the patient's body. During the last decades, our understanding of how the brain processes acupuncture analgesia has undergone considerable development. Acupuncture analgesia is manifested only when the intricate feeling (soreness, numbness, heaviness and distension) of acupuncture in patients occurs following acupuncture manipulation. Manual acupuncture (MA) is the insertion of an acupuncture needle into acupoint followed by the twisting of the needle up and down by hand. In MA, all types of afferent fibers (Abeta, Adelta and C) are activated. In electrical acupuncture (EA), a stimulating current via the inserted needle is delivered to acupoints. Electrical current intense enough to excite Abeta- and part of Adelta-fibers can induce an analgesic effect. Acupuncture signals ascend mainly through the spinal ventrolateral funiculus to the brain. Many brain nuclei composing a complicated network are involved in processing acupuncture analgesia, including the nucleus raphe magnus (NRM), periaqueductal grey (PAG), locus coeruleus, arcuate nucleus (Arc), preoptic area, nucleus submedius, habenular nucleus, accumbens nucleus, caudate nucleus, septal area, amygdale, etc. Acupuncture analgesia is essentially a manifestation of integrative processes at different levels in the CNS between afferent impulses from pain regions and impulses from acupoints. In the last decade, profound studies on neural mechanisms underlying acupuncture analgesia predominately focus on cellular and molecular substrate and functional brain imaging and have developed rapidly. Diverse signal molecules contribute to mediating acupuncture analgesia, such as opioid peptides (mu-, delta- and kappa-receptors), glutamate (NMDA and AMPA/KA receptors), 5-hydroxytryptamine, and cholecystokinin octapeptide. Among these, the opioid peptides and their receptors in Arc-PAG-NRM-spinal dorsal horn pathway play a pivotal role in mediating acupuncture analgesia. The release of opioid peptides evoked by electroacupuncture is frequency-dependent. EA at 2 and 100Hz produces release of enkephalin and dynorphin in the spinal cord, respectively. CCK-8 antagonizes acupuncture analgesia. The individual differences of acupuncture analgesia are associated with inherited genetic factors and the density of CCK receptors. The brain regions associated with acupuncture analgesia identified in animal experiments were confirmed and further explored in the human brain by means of functional imaging. EA analgesia is likely associated with its counter-regulation to spinal glial activation. PTX-sesntive Gi/o protein- and MAP kinase-mediated signal pathways as well as the downstream events NF-kappaB, c-fos and c-jun play important roles in EA analgesia.
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Affiliation(s)
- Zhi-Qi Zhao
- Institute of Neurobiology, Institutes of Brain Science and State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China.
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Kou W, Gareus I, Bell JD, Goebel MU, Spahn G, Pacheco-López G, Bäcker M, Schedlowski M, Dobos GJ. Quantification of DeQi sensation by visual analog scales in healthy humans after immunostimulating acupuncture treatment. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2008; 35:753-65. [PMID: 17963316 DOI: 10.1142/s0192415x07005247] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Acupuncture is the most popular component of traditional Chinese medicine in Western countries. However, the mechanisms of its effects remain unclear. The therapeutic effect of acupuncture appears when a sensation of DeQi is achieved. We previously reported that repeated, but not single acupuncture treatment affected leukocyte circulation and blood pressure in healthy young humans. The objective of this study was to quantify DeQi sensation by using visual analog scales (VASs) and, to test whether DeQi induction is an important factor for the therapeutic effects of acupuncture in the same cohort. After either acupuncture or sham-acupuncture (placebo) treatment, a questionnaire containing five individual VASs was given to subjects to evaluate their DeQi sensation, including numbness, pressure, heaviness, warmth, and radiating paraesthesia, respectively. A separate VAS to measure their levels of anxiety during the treatment was also included. Our results showed that acupuncture significantly induced higher VAS values for numbness, pressure, warmth, and radiating paraesthesia, but not for heaviness than the placebo across three treatment sessions. Additionally, acupuncture did not induce higher anxiety levels than the placebo. These data confirm that VAS is an objective and reliable way to quantify DeQi sensation and, indicate that DeQi is unique to verum acupuncture treatment. Furthermore, either acupuncture-induced therapeutic effects or DeQi sensation should not be attributed to the stress-mediated effects. In summary, the induction of DeQi in each treatment session is an important factor for the physiological outcomes of repeated acupuncture treatment, and VASs offer objective, an easy and reliable way to assess it.
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Affiliation(s)
- Wei Kou
- Institute for Medical Psychology and Behavioral Immunobiology, Medical Faculty, University of Duisburg-Essen, Essen, Germany.
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Wong RHL, Lee TW, Sihoe ADL, Wan IYP, Ng CSH, Chan SKC, Wong WWL, Liang YM, Yim APC. Analgesic effect of electroacupuncture in postthoracotomy pain: a prospective randomized trial. Ann Thorac Surg 2007; 81:2031-6. [PMID: 16731125 DOI: 10.1016/j.athoracsur.2005.12.064] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2005] [Revised: 12/21/2005] [Accepted: 12/21/2005] [Indexed: 11/29/2022]
Abstract
BACKGROUND The role of electroacupuncture in postthoracotomy pain control is uncertain. We conducted a pilot study to evaluate the role of electroacupuncture in the management of early postthoracotomy wound pain. METHODS A total of 27 patients with operable non-small cell lung carcinoma who received thoracotomy were recruited and randomized to receive either electroacupuncture or sham acupuncture in addition to routine oral analgesics and patient-controlled intravenous analgesia for postoperative pain control. All patients received acupuncture twice daily with visual analog pain score recorded for the first 7 postoperative days. Specific chest acupoints (LI 4, GB 34, GB 36, and TE 8) were targeted. Patient-controlled analgesia was used for the first 3 postoperative days in all patients, and the cumulative dosage used was recorded. RESULTS Two patients were excluded after randomization because of complications unrelated to acupuncture. Interventions and data collection were completed for the remaining 25 patients (13 in the electroacupuncture group; 12 in the sham acupuncture group). There was a trend for lower visual analog scale pain scores in the electro-acupuncture group between postoperative days 2 and 6, although this did not reach statistical significance. The cumulative dose of patient-controlled analgesia morphine used on postoperative day 2 was significantly lower in the electroacupuncture group (7.5 +/- 5 mg versus 15.6 +/- 12 mg; p < 0.05). Such delay of onset of pain control may be related to the frequency of electroacupuncture used. CONCLUSIONS Electroacupuncture may reduce narcotic analgesic usage in the early postoperative period. A prospective randomized controlled trial using different electroacupuncture frequency is warranted to verify this benefit.
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Affiliation(s)
- Randolph H L Wong
- Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong, SAR, China
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Hao W, Zhu X, Zhang H, Tian B. Study on a mechanical acupuncture instrument with computer aided controlled. CONFERENCE PROCEEDINGS : ... ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL CONFERENCE 2007; 2005:4259-62. [PMID: 17281175 DOI: 10.1109/iembs.2005.1615405] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Acupuncture relies on the use of fine needles being inserted into specific points with varying amounts of manual or external stimulation. The gate control theory states that acupuncture closes the gate to pain and blocks pain perception in the brain via stimulation of large nerve fibers. The particular research develops a mechanical manipulation of acupuncture to simulate physician with the insertion of acupuncture needles which may produce similar therapy effect. Adopting two stepper motors, the mechanical acupuncture instrument is designed with synthesized movements of lifting, thrusting and twirling. The working process can be controlled by the command strings. The mechanical acupuncture instrument possesses several manipulations of acupuncture just as physician does, and the needle can be adjusted quantitatively and reliably. With quite effective therapy function of animal experiment, the mechanical acupuncture instrument can replace physician to a certain extent.
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Acupuncture. Obstet Gynecol 2006. [DOI: 10.1097/01.aog.0000239498.38595.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
Acupuncture and related techniques are increasingly practised in anaesthesia. This paper reviews the current evidence and applicability of acupuncture and related techniques for anaesthetic procedures and postoperative nausea and vomiting. Recent evidence suggests that manual acupuncture is effective for reducing preoperative anxiety and for postoperative pain relief. Current available data do not support the use of acupuncture as an adjunct to the general anaesthetic in the intraoperative setting. There are extensive and good quality data to support the use of P6 acupoint stimulation techniques for preventing postoperative nausea and vomiting in combination with or as an alternative to conventional anti-emetics. The use of acupuncture for labour pain management appears promising but requires further research. Patient selection, acupoint selection, needling techniques, and mode of acupuncture need to be considered when applying acupuncture and related techniques in the perioperative setting. There are guidelines for the conduct and reporting of acupuncture research, and these should be followed to improve the quality of studies.
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Affiliation(s)
- Anna Lee
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong, China.
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Abstract
Thirty years ago, the integration of complementary medicine into cancer care almost was dismissed as quackery. Today, a whole range of complementary and alternative medicine (CAM) techniques have been integrated into the management of cancer, which are often of benefit to patients, when conventional treatment is deemed to have failed or caused intolerable side effects. Health care workers need to inquire about the use of CAM in their patients routinely in a sensitive and nonjudgmental way, and may need to advise patients to stop certain therapies. Yet in advanced cancer, a sensible balance needs to be struck between fear about adverse effects and interactions and the importance of making the remaining weeks/days/months as comfortable and enjoyable as possible.
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Abstract
Even though widely used in today's clinical practice, acupuncture has remained a controversial subject. Many reviews are currently available but most lack a critical stance and some are overtly promotional. The aim of this overview is to provide a balanced, critical analysis of the existing evidence. Some of the original concepts of traditional acupuncture are not supported by good scientific evidence. Several plausible theories attempt to explain how acupuncture works but none are proved beyond doubt. The clinical effectiveness of acupuncture continues to attract controversy. Many controlled clinical trials and numerous systematic reviews of these studies have been published. Considerable problems are encountered when interpreting these data. Heterogeneity is a significant drawback of both clinical trials and systematic reviews. Some of the controversies may be resolved through the use of the new 'placebo needles' which enable researchers to adequately control for placebo effects of acupuncture. The majority of studies using such devices fails to show effects beyond a placebo response. Acupuncture has been associated with serious adverse events but most large-scale studies suggest that these are probably rare. Nonserious adverse effects occur in 7-11% of all patients. In conclusion, acupuncture remains steeped in controversy. Some findings are encouraging but others suggest that its clinical effects mainly depend on a placebo response.
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Affiliation(s)
- E Ernst
- Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, UK.
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Affiliation(s)
- Andrew Moore
- Pain Research, The Churchill, Oxford OX3 7LJ, UK.
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Affiliation(s)
- Bengt H Sjölund
- Department Community Medicine, Rehabilitation, Rehabilitation Medicine, Umea University, By 9A, NUS, 901 85 Umea, Sweden
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