Collinsworth Keith M, Goss Donald L
Keller Army Community Hospital, West Point, NY.
Baylor-KACH Division 1 Sport Physical Therapy, Waco, TX.
Med Acupunct. 2019 Aug 1;31(4):228-238. doi: 10.1089/acu.2019.1372. Epub 2019 Aug 19.
Opioid pain medications are commonly prescribed postsurgically for pain. Few studies have investigated the effects of Battlefield Acupuncture (BFA) on postsurgical pain and pain-medication use. To date, no studies have investigated BFA's effectiveness for reducing postoperative shoulder pain and pain-medication use post surgery. The objective of this study was to determine if adding BFA to a rehabilitation protocol was effective for reducing pain and use of prescribed pain medications, compared to that protocol alone after shoulder surgery. Forty Department of Defense beneficiaries (ages 17-55) were randomized to either a standard-of-care group or a standard-of-care + BFA group prior to shoulder surgery. The standard BFA protocol was administered with semipermanent acupuncture needles emplaced on the subjects' ears for 3-5 days within 24 hours after shoulder surgery in an outpatient physical therapy setting. BFA was reapplied, as needed, up to 6 weeks postsurgically for pain management in the intervention group. The primary outcomes were visual analogue scale (VAS) pain rating and daily pain medication use by each subject. Secondary outcome measures were the Global Rating of Change and Patient Specific Functional scale. Outcome measures were obtained at 24 hours, 72 hours, 1 week, 2 weeks, and 6 weeks post surgery. Significant differences in average and worst VAS pain change scores were noted between baseline and 7 days ( < 0.05). The main effect for time was significant (average and worst VAS pain) at all timepoints ( < 0.05), without time-group interactions seen. No significant differences between the groups in pain-medication use were observed ( > 0.05) BFA reduced postsurgical shoulder pain significantly between the groups' average and worst pain change scores between baseline and 7 days despite similar opioid and nonsteroidal anti-inflammatory drug use between the groups.
阿片类止痛药物常用于术后止痛。很少有研究调查战地针刺疗法(BFA)对术后疼痛及止痛药物使用的影响。迄今为止,尚无研究调查BFA在减轻术后肩部疼痛及术后止痛药物使用方面的有效性。本研究的目的是确定在肩部手术后,与仅采用康复方案相比,在康复方案中加入BFA是否能有效减轻疼痛及减少处方止痛药物的使用。40名国防部受益人(年龄17 - 55岁)在肩部手术前被随机分为标准治疗组或标准治疗 + BFA组。在门诊物理治疗环境中,于肩部手术后24小时内,用半永久性针灸针在受试者耳部实施标准BFA方案,持续3 - 5天。在干预组中,根据需要在术后长达6周内重新应用BFA以进行疼痛管理。主要结局指标是每个受试者的视觉模拟评分(VAS)疼痛评分和每日止痛药物使用情况。次要结局指标是总体变化评分和患者特定功能量表。在术后24小时、72小时、1周、2周和6周获取结局指标。在基线和7天之间,平均和最差VAS疼痛变化评分存在显著差异(<0.05)。在所有时间点,时间的主要效应均显著(平均和最差VAS疼痛)(<0.05),未观察到时间 - 组交互作用。在止痛药物使用方面,两组之间未观察到显著差异(>0.05)。尽管两组之间阿片类药物和非甾体抗炎药的使用情况相似,但BFA在基线和7天之间显著降低了两组之间平均和最差疼痛变化评分的术后肩部疼痛。