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Cheng SI, Swamidoss CP, Soffin EM. Perioperative Acupuncture: A Novel and Necessary Addition to ERAS Pathways for Total Joint Arthroplasty. HSS J 2024; 20:122-125. [PMID: 38356751 PMCID: PMC10863582 DOI: 10.1177/15563316231204308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 02/16/2024]
Affiliation(s)
- Stephanie I Cheng
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA
- Department of Anesthesiology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
| | - Cephas P Swamidoss
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA
- Department of Anesthesiology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
| | - Ellen M Soffin
- Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY, USA
- Department of Anesthesiology, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA
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Zhang M, Cairen Z, Liu X, Deng J, Mu X, Wang Y, Lu Z. Transcutaneous electric acupoint stimulation reduced consumption of profopol in patients undergoing laparoscopic surgery: A randomized clinical trial. Medicine (Baltimore) 2024; 103:e35730. [PMID: 38277549 PMCID: PMC10817147 DOI: 10.1097/md.0000000000035730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 09/29/2023] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Propofol is a common regimen for general anesthesia maintenance. But propofol can dose-dependently generate cardiopulmonary depression. Thus, any strategy to reduce propofol dosage during laparoscopic surgery may have underlying beneficial effect for patient prognosis. Previous studies indicated both analgesic and sedative effect of acupoint stimulation. However, its main sedative effect on patients under general anesthesia remains unclear. OBJECTIVE The aim of this study was to investigate the sedative effect of transcutaneous electrical acupoint stimulation (TEAS) on patients scheduled for laparoscopic surgery under general anesthesia. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS In this randomized clinical trial, patients scheduled for laparoscopic surgery under general anesthesia in Xijing hospital were randomly assigned to 3 groups, receiving electrical stimulation at the Shenmen (HT7)/Ximen (PC4) (TEAS group), stimulation at the shoulder (non-acupoint group) or no stimulation (control group), respectively. MAIN OUTCOME MEASURES One hundred sixty-two patients completed the study. The primary outcome was the consumption of propofol, and secondary outcomes included features of recovery after surgery, major complications after surgery and by 1 year after surgery. RESULTS In patients undergoing laparoscopic surgery, the doses of propofol decreased significantly in the TEAS group compared (0.10 ± 0.02 mg·kg-1·min-1) with the other 2 groups (both 0.12 ± 0.02 mg·kg-1·min-1, P < .001). The mean differences (95% confidence interval) for non-acupoint versus TEAS and control versus TEAS were 0.021 (0.012, 0.030) and 0.024 (0.013, 0.034), respectively. Time to awake and to extubation were not significantly different among the groups. The incidences of major complications after surgery and by 1 year after surgery were not significantly different among the groups. CONCLUSION TEAS could induce additional sedative effect in patients during laparoscopic surgery and reduce propofol consumption.
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Affiliation(s)
- Minjuan Zhang
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Airforce Medical University, Xi’an, Shaanxi, China
| | - Zhuoma Cairen
- Department of Anesthesiology, Qinghai Provincial People’s Hospital, Xijing, Qinghai, China
| | - Xiaoyu Liu
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Airforce Medical University, Xi’an, Shaanxi, China
| | - Jiao Deng
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Airforce Medical University, Xi’an, Shaanxi, China
| | - Xiaoxiao Mu
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Airforce Medical University, Xi’an, Shaanxi, China
| | - Yun Wang
- Department of Anesthesiology, Qinghai Provincial People’s Hospital, Xijing, Qinghai, China
| | - Zhihong Lu
- Department of Anesthesiology and Perioperative Medicine, Xijing Hospital, Airforce Medical University, Xi’an, Shaanxi, China
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Rubin L, Avraham Y, Sharabi-Nov A, Shebly T, Ben Natan M, Rothem DE. Acupuncture Effect on Analgesic Consumption and Cortisol Levels Following Total Knee Arthroplasty: A Randomized Controlled Trial. Med Acupunct 2023; 35:230-235. [PMID: 37920858 PMCID: PMC10618810 DOI: 10.1089/acu.2023.0024] [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: 11/04/2023] Open
Abstract
Objective Pain following total knee arthroplasty (TKA) is common. Various modalities of treating orthopedic postoperative pain (POP) exist; however, the optimal management of POP remains unclear. The purpose of this study was to examine acupuncture's effect on postoperative analgesic consumption and cortisol levels in patients undergoing TKA. Materials and Methods In this randomized controlled trial, 80 patients scheduled for elective TKA surgery were recruited and randomly assigned to 2 groups: (1) an intervention group, receiving acupuncture treatment on days 1 and 2 in addition to standard POP management (n = 40) and a control group, who received standard POP management only (n = 40). Results There was no statistical difference between the groups in analgesic consumption on days 1 and 3 postoperatively. On day 5 postoperatively, lower analgesic consumption was seen in the intervention group, compared to the control group. However, this difference was not statistically significant (1.4 versus 2.3, respectively; P = 0.215). There was no statistical difference between the groups in cortisol levels on day 1 postoperatively. In contrast, on day 2 postoperatively, cortisol level was significantly lower in the intervention group, compared to the control group (296 nmol/L versus 400 nmol/L, respectively; P < 0.05). Conclusions The findings suggest that acupuncture may have some effect on patients' analgesic consumption short-term after TKA. Further studies with larger samples are required for establishing these results.This trial was registered at ClinicalTrials.gov (Registration #: NCT03415204).
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Affiliation(s)
- Littal Rubin
- Orthopedics Surgery Department, Ziv Medical Center, Safed, Israel
| | - Yaniv Avraham
- Orthopedics Surgery Department, Ziv Medical Center, Safed, Israel
| | - Adi Sharabi-Nov
- Orthopedics Surgery Department, Ziv Medical Center, Safed, Israel
- Tel-Hai Academic College, Kiryat Shemona, Israel
| | - Tanous Shebly
- Orthopedics Surgery Department, Ziv Medical Center, Safed, Israel
| | - Merav Ben Natan
- Pat Matthews Academic School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
| | - David E. Rothem
- Orthopedics Surgery Department, Ziv Medical Center, Safed, Israel
- Azrieli Faculty of Medicine, Bar -Ilan University, Safed, Israel
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Ben-Arye E, Segev Y, Galil G, Marom I, Gressel O, Stein N, Hirsh I, Samuels N, Schmidt M, Schiff E, Lurie I, Lavie O. Acupuncture during gynecological oncology surgery: A randomized controlled trial assessing the impact of integrative therapies on perioperative pain and anxiety. Cancer 2023; 129:908-919. [PMID: 36647622 DOI: 10.1002/cncr.34542] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/28/2022] [Accepted: 05/12/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND In this study, the impact of a multimodal integrative oncology pre- and intraoperative intervention on pain and anxiety among patients undergoing gynecological oncology surgery was explored. METHODS Study participants were randomized to three groups: Group A received preoperative touch/relaxation techniques, followed by intraoperative acupuncture; Group B received preoperative touch/relaxation only; and a control group (Group C) received standard care. Pain and anxiety were scored before and after surgery using the Measure Yourself Concerns and Wellbeing (MYCAW) and Quality of Recovery (QOR-15) questionnaires, using Part B of the QOR to assess pain, anxiety, and other quality-of-life parameters. RESULTS A total of 99 patients participated in the study: 45 in Group A, 25 in Group B, and 29 in Group C. The three groups had similar baseline demographic and surgery-related characteristics. Postoperative QOR-Part B scores were significantly higher in the treatment groups (A and B) when compared with controls (p = .005), including for severe pain (p = .011) and anxiety (p = .007). Between-group improvement for severe pain was observed in Group A compared with controls (p = .011). Within-group improvement for QOR depression subscales was observed in only the intervention groups (p <0.0001). Compared with Group B, Group A had better improvement of MYCAW-reported concerns (p = .025). CONCLUSIONS A preoperative touch/relaxation intervention may significantly reduce postoperative anxiety, possibly depression, in patients undergoing gynecological oncology surgery. The addition of intraoperative acupuncture significantly reduced severe pain when compared with controls. Further research is needed to confirm these findings and better understand the impact of intraoperative acupuncture on postoperative pain. PLAIN LANGUAGE SUMMARY Integrative oncology programs are increasingly becoming part of supportive/palliative care, with many working within the Society for Integrative Oncology. This study examined the impact of a multimodal integrative oncology program on pain and anxiety among 99 patients undergoing gynecological oncology surgery. Participants were randomized to three groups: preoperative touch/relaxation treatments, followed by intraoperative acupuncture; preoperative touch/relaxation without acupuncture; and a control group receiving standard care only. The preoperative touch/relaxation intervention significantly reduced perioperative anxiety, with the addition of intraoperative acupuncture significantly reducing severe pain as well, when compared with controls. Further research is needed to confirm these findings.
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Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, The Oncology Service, Lin, Zebulun, and Carmel Medical Centers, Clalit Health Services, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Yakir Segev
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel
| | - Galit Galil
- Integrative Oncology Program, The Oncology Service, Lin, Zebulun, and Carmel Medical Centers, Clalit Health Services, Haifa, Israel
| | - Inbal Marom
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel
| | - Orit Gressel
- Integrative Oncology Program, The Oncology Service, Lin, Zebulun, and Carmel Medical Centers, Clalit Health Services, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Nili Stein
- Department of Community Medicine and Epidemiology, Carmel Medical Center, Haifa, Israel
| | - Irena Hirsh
- Department of Anesthesiology, Critical Care and Pain Medicine, Carmel Medical Center, Haifa, Israel
| | - Noah Samuels
- Center for Integrative Complementary Medicine, Shaarei Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Meirav Schmidt
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel
| | - Elad Schiff
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Internal Medicine & Integrative Medicine Service, Bnai-Zion, Hospital, Haifa, Israel
| | - Irina Lurie
- Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel
| | - Ofer Lavie
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel
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Jiang SL, Jiang XM, Zheng QX, Liu XW. Auricular bean embedding improves urination in epidural labor analgesia: A single center randomized controlled study. Technol Health Care 2023:THC220660. [PMID: 36776083 PMCID: PMC10357180 DOI: 10.3233/thc-220660] [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: 02/10/2023]
Abstract
BACKGROUND Acupoint buried beans on the auricle is a feasible method to prevent and treat postpartum urinary retention. OBJECTIVE This study investigated the effect of auricular acupoint buried beans on postpartum urination and maternal and fetal outcomes following epidural analgesia for labor. METHODS Two hundred forty primiparas underwent vaginal trial labor analgesia from May 2020 to January 2021 and were randomly placed into the intervention and control groups. Both groups received epidural labor analgesia. Maternal urination during labor, 2 h postpartum, and the time for first postpartum urination were recorded as primary outcomes, with maternal and infant outcomes documented as secondary results. Statistical analysis was performed using the independent sample t-test, non-parametric rank-sum, or chi-square test using the SPSS Statistics 25.0 software. RESULTS Two hundred eight study participants were subsequently included in the results, i.e., 105 patients in the intervention group and 103 in the control group. The intervention group comprised a significantly lower number of patients with excessive residual urine volume at cervical dilatation of 5-6 cm (P< 0.05). The total postpartum score of the intervention group was lower than in the control group (P< 0.01), and the time to first urination was shorter compared with the control group (P< 0.05). In the intervention group, the time of labor analgesia, the duration of the first stage of labor, and the total labor time were shorter compared with the control group (P< 0.01). CONCLUSION Auricular acupoint embedded beans can improve the urination status at cervical dilatation of 5-6 cm and 2 h postpartum, as well as significantly shorten the duration of labor.
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Affiliation(s)
- Sheng Li Jiang
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China.,Labor Room, School of Nursing, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics, Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Xiu Min Jiang
- Nursing Department, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics, Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Qing Xiang Zheng
- Nursing Department, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics, Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
| | - Xiu Wu Liu
- Labor Room, School of Nursing, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics, Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian, China
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Groopman DS, Elkiss M. Energetic Medicine and Long COVID. Med Acupunct 2022; 34:154-156. [DOI: 10.1089/acu.2022.29209.editorial] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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