Auricular Acupuncture in Postoperative Pain
Condition: Acupuncture
MeSH terms: Pain, Postoperative
Study type: Interventional
Phase: Phase 4

Summary: 
      The effect of acupuncture for postoperative pain control remains controversial. We therefore
      studied the effects of electrical auricular acupuncture (AA) on postoperative opioid
      consumption in a randomized, patient-blinded clinical trial.

      40 female patients undergoing laparoscopy were included. Anaesthetized patients were randomly
      assigned to receive AA (shen men, thalamus and one segmental organ-specific point) or
      electrodes and electrical stimulation for 72 hours. Postoperatively patients received 1 g
      paracetamol every 6 hours and additional piritramide on demand. A blinded observer obtained
      the doses of piritramide and the visual analogue pain scores (VAS) at 0, 2, 24, 48, and 72
      hours.

      It was the aim of our study to find out, whether auricular acupuncture reduces postoperative
      pain.
    

Detailed description: 
      Postoperative pain treatment is a major issue in management of surgical patients. Goal of the
      treatment is a maximal effect with minimal side effects. There are various treatment options,
      including conventional pharmacological and complementary approaches. Acupuncture is a system
      with an empirical basis, which has been used in the treatment for centuries. The mechanisms
      can be partly explained in terms of endogenous pain inhibitory systems. Its use for pain
      relief has been supported by clinical trials and this has facilitated its use in pain clinics
      in most countries. Needle acupuncture and other forms of sensory stimulation produce similar
      physiological changes in humans and mammals, e.g. rhythmic discharges in nerve fibres, and
      the release of endogenous opioids. Besides acupuncture points located on "meridians" all over
      the body acupuncture points are also described on the ear. The stimulation of acupuncture
      points can be achieved by pressure, a mechanical action of needling, or electrical point
      stimulation. In chronic pain treatment acupuncture has been found to be more effective than
      other non-pharmacological therapies. Furthermore, continuous electrical stimulation of
      auricular acupuncture points improves the treatment of chronic cervical pain patients.
      Finally, acupuncture represents not only a therapeutically beneficial, but also a
      cost-effective treatment option. Auricular acupuncture is also known to be effective in
      treatment of acute postoperative pain.

      The aim of our study is to investigate in a randomized, prospective, double - blind, and
      controlled design whether continuous electrical stimulation of auricular acupuncture points
      results in reduction of postoperative pain.
    

Intervention name(s): electrical auricular acupuncture; P-Stim™ devices were applied without electrical stimulation and acupuncture.
Intervention type(s): Device; Device
Intervention description(s): Patients in the acupuncture group received titan disposable needles (27-gauge, 3 mm length; Biegler GmbH, Mauerbach, Austria), which were inserted in the dominant ear at the following acupuncture points: shen men, thalamus and one segmental organ-specific point [2]. Acupuncture points were identified by measuring skin resistance, using an electrical conductance meter (multipoint selection pen™, Biegler GmbH, Mauerbach, Austria). The needles were connected to the P-Stim™ device and received continuous low frequency electro acupuncture using P-Stim™ (constant current: 1 Hz biphasic, 2 mA) for 72 hours postoperatively. Acupuncture was performed by a specialist with 15 years experience in this technique.; Patients in the control group received electrodes without needles and the P-Stim™ devices were applied without electrical stimulation.
Other intervention name(s): P-Stim® The stimulator consists of a microcontroller and a bit-coded ST62T60BM6 interface, which produce defined waves of electrical stimuli
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: auricular acupuncture; postoperative pain; opioid consumption; laparoscopic surgery; ACUPUNCTURE THERAPY (IM) + EAR, EXTERNAL (IM)