Department of Anesthesia, General Intensive Care and Pain Control, Medical University of Vienna, Vienna, Austria.
Minerva Anestesiol. 2011 Mar;77(3):298-304.
Acupuncture for postoperative pain remains controversial. Potential sources of bias are failures in patient-blinding and therapist-patient interactions. Our study investigates the effects of electrical auricular acupuncture (AA) on postoperative pain in patients undergoing laparoscopy with an emphasis on patient-blinding and the exclusion of therapist-patient interactions.
With institutional review board approval and written informed consent, we included 40 female patients undergoing laparoscopy. Patients were randomly assigned to receive AA (shen men, thalamus and one segmental organ-specific point) or electrodes only and an electrical stimulation device. All patients received this intervention under general anesthesia guaranteeing patient blinding and excluding therapist-patient interactions. Needles and devices were removed 72 hours postoperatively. Postoperatively, patients received 1,000 mg paracetamol every 6 hours. Additional piritramide was given on demand. A blinded observer obtained the VAS scores at 0, 2, 24, 48, and 72 hours as well as the postoperatively administered doses of piritramide.
There was no difference in VAS scores or the consumption of piritramide during the first 72 hours postoperatively between groups (acupuncture versus placebo: 2.32 [1.40-3.25] versus 2.62 [1.89-3.36] average pain on VAS 0-10; 15.3 [12.0-18.6] mg versus 13.9 [10.5-17.3] mg piritramide). Values are expressed as mean [CI].
Our study shows no reduction in postoperative pain or an opioid sparing effect of auricular acupuncture in women undergoing laparoscopic procedures. Because we emphasized blinding of the patients and the exclusion of therapist-patient interactions, our study suggests that electrical auricular acupuncture has no effect on postoperative pain.
针刺术后疼痛仍然存在争议。潜在的偏倚源是患者盲法和治疗师-患者互动的失败。我们的研究调查了电耳针（AA）对接受腹腔镜手术患者术后疼痛的影响，重点是患者盲法和排除治疗师-患者互动。
经机构审查委员会批准和书面知情同意，我们纳入了 40 名接受腹腔镜手术的女性患者。患者随机分配接受 AA（神门、丘脑和一个节段性器官特异性点）或仅电极和电刺激装置。所有患者均在全身麻醉下接受这种干预，以保证患者盲法并排除治疗师-患者互动。术后 72 小时内去除针和设备。术后，患者每 6 小时服用 1000 毫克扑热息痛。按需给予额外的哌替啶。一名盲法观察者在 0、2、24、48 和 72 小时获得 VAS 评分，并获得术后哌替啶的剂量。
术后 72 小时内，两组 VAS 评分或哌替啶用量无差异（针刺组与安慰剂组：0-10 VAS 平均疼痛分别为 2.32 [1.40-3.25] 与 2.62 [1.89-3.36]；哌替啶用量分别为 15.3 [12.0-18.6] 毫克与 13.9 [10.5-17.3] 毫克）。值表示为平均值[CI]。
我们的研究表明，在接受腹腔镜手术的女性中，耳针术后疼痛减轻或阿片类药物节省作用。由于我们强调了患者的盲法和治疗师-患者互动的排除，我们的研究表明，电耳针对术后疼痛没有影响。
