Wu Shelley, Sapru Anil, Stewart Mary A, Milet Meredith J, Hudes Mark, Livermore Luanne F, Flori Heidi R
Department of Anesthesia & Perioperative Care, University of California, San Francisco, CA, USA.
Pediatr Crit Care Med. 2009 May;10(3):291-6. doi: 10.1097/PCC.0b013e318198afd6.
Clinical study to determine the acceptability and feasibility of acupuncture for acute postoperative pain control in hospitalized children.
Nonrandomized clinical trial.
A single, tertiary referral pediatric intensive care unit.
A total of 20 patients aged 7 months to 18 years. Eleven of the patients had posterior spinal fusion surgery and the remaining nine patients had other surgical diagnoses.
Two 10- to 15-minute sessions of acupuncture 24-48 hours apart.
The treatment was highly accepted (27 patients were approached and 4 patients refused; of the 23 patients enrolled, 20 patients completed the study). Acupuncture was well tolerated by patients without adverse events related to treatment. In follow-up interviews, 70% of both parents and patients believed acupuncture helped the child's pain. Eighty-five percent of the parents said they would pay out of pocket for acupuncture if not covered by insurance. The pain scores, vital signs, and narcotic usage were recorded before and several times after acupuncture. In posterior spinal fusion patients, the mean pain scores (0-10) immediately before and 4 and 24 hours after acupuncture were: 3.7, 1.7, and 3.1, respectively, after the first acupuncture session and 3.7, 2.2, and 3.1, respectively, after the second session. In the other surgical cohort, the mean pain scores immediately before and 4 and 24 hours after the first session of acupuncture were 2.5, 0.3, and 1.6, respectively.
Our results support that acupuncture is highly accepted and feasible in critically ill, postoperative pediatric patients with acute pain. Our findings suggest that acupuncture may be a potentially useful adjunctive tool for acute pediatric postoperative pain management. A randomized, controlled clinical trial is warranted to confirm these findings.
进行临床研究以确定针刺疗法用于控制住院儿童术后急性疼痛的可接受性和可行性。
非随机临床试验。
一家单一的三级转诊儿科重症监护病房。
共20名年龄在7个月至18岁之间的患者。其中11名患者接受了后路脊柱融合手术，其余9名患者有其他手术诊断。
间隔24 - 48小时进行两次每次10至15分钟的针刺治疗。
该治疗方法接受度很高（共接触27名患者，4名患者拒绝；在纳入研究的23名患者中，20名患者完成了研究）。患者对针刺疗法耐受性良好，未出现与治疗相关的不良事件。在随访访谈中，70%的家长和患者认为针刺疗法有助于缓解孩子的疼痛。85%的家长表示，如果保险不覆盖，他们愿意自掏腰包支付针刺治疗费用。在针刺前后多次记录疼痛评分、生命体征和麻醉药物使用情况。在后路脊柱融合手术患者中，第一次针刺治疗前、针刺后4小时和24小时的平均疼痛评分（0 - 10分）分别为：3.7分、1.7分和3.1分；第二次针刺治疗后分别为3.7分、2.2分和3.1分。在其他手术队列中，第一次针刺治疗前、针刺后4小时和24小时的平均疼痛评分分别为2.5分、0.3分和1.6分。
我们的结果支持针刺疗法在患有急性疼痛的重症术后儿科患者中具有高度可接受性和可行性。我们的研究结果表明，针刺疗法可能是一种用于小儿术后急性疼痛管理的潜在有用辅助工具。有必要进行一项随机对照临床试验来证实这些发现。
