Department of surgical oncology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Qinhuai District, Nanjing, Jiangsu 210029, China.
Department of Nursing, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, 155 Hanzhong Road, Qinhuai District, Nanjing, Jiangsu 210029, China.
Explore (NY). 2022 Jan-Feb;18(1):36-43. doi: 10.1016/j.explore.2021.09.007. Epub 2021 Oct 3.
INTRODUCTION: Auricular acupuncture is widely used in the treatment of pain. Recently, the most commonly used method of auricular acupuncture is to embed an intradermal needle into the skin to enhance analgesia through continuous stimulation. We aimed to explore the efficacy and feasibility of this form of auricular acupuncture in the treatment of postoperative movement-evoked pain. METHODS: This single-blind randomized controlled pilot trial was conducted between 23/8/2019 and 10/1/2020. Forty patients were recruited and randomised to either the control group (n = 20) or the experimental group (n = 20). Patients in the control group received sham auricular acupuncture, while patients in the experimental group received auricular acupuncture. A standard routine analgesia was performed in both groups. The patients with NRS score≥4 were given rescue analgesia. Postoperative pain, use of opioids and other analgesics, postoperative recovery and patient's satisfaction were recorded. RESULTS: The credibility and feasibility of auricular acupuncture for postoperative pain were high in both groups. After auricular acupuncture, the scores of the postoperative movement-evoked pain had a tendency to decrease, but no significant difference was observed between two groups at any time point (P = 0.234∼0.888). The data on postoperative pain at rest confirmed that no significant difference was observed between two groups within 48 h of surgery (P = 0.134∼0.520), and the postoperative pain at rest scores decreased over time; however, from the third day, the pain at rest scores of the experimental group were decreased, and significant differences were observed between the two groups (P = 0.039∼0.047). As for use of rescue analgesic, total opioid consumption and the incidence of postoperative nausea and vomiting, there were no significant differences between the two groups (P = 0.311, P = 0.101, P = 0.661) . In terms of patients' satisfaction, the score of the experimental group was higher than that of the control group, and a significant difference was observed between the two groups (P = 0.000). As for adverse events, two participants reported pain and one patient reported discomfort at the insertion sites during the process of auricular acupuncture intervention, but they both were minor and tolerable. CONCLUSION: Auricular acupuncture may have a relief effect on mild postoperative pain at rest with pain score below 3, suggesting that it may be a feasible adjuvant method to relieve mild pain at rest. However, more multi-centre and large-sample studies are needed to verify this result.
引言:耳针在疼痛治疗中被广泛应用。目前,最常用的耳针方法是将皮内针埋入皮肤,通过持续刺激来增强镇痛效果。我们旨在探讨这种形式的耳针在治疗术后运动诱发性疼痛中的疗效和可行性。
方法:这是一项于 2019 年 8 月 23 日至 2020 年 1 月 10 日进行的单盲随机对照试验。共招募了 40 名患者,并将其随机分为对照组(n=20)和实验组(n=20)。对照组接受假性耳针治疗,而实验组接受耳针治疗。两组均采用标准常规镇痛。NRS 评分≥4 的患者给予解救性镇痛。记录术后疼痛、阿片类药物和其他镇痛药的使用、术后恢复和患者满意度。
结果:两组患者对耳针治疗术后疼痛的可信度和可行性均较高。耳针后,运动诱发性疼痛评分呈下降趋势,但两组在任何时间点均无显著差异(P=0.234∼0.888)。术后静息疼痛数据证实,两组术后 48 小时内无显著差异(P=0.134∼0.520),且静息疼痛评分随时间下降;然而,从第三天开始,实验组的静息疼痛评分下降,两组间有显著差异(P=0.039∼0.047)。至于解救性镇痛药物的使用、总阿片类药物用量和术后恶心呕吐的发生率,两组间无显著差异(P=0.311,P=0.101,P=0.661)。在患者满意度方面,实验组的评分高于对照组,两组间有显著差异(P=0.000)。至于不良事件,两名患者在耳针干预过程中报告了穿刺部位疼痛和不适,但均为轻微且可耐受。
结论:耳针对疼痛评分低于 3 的轻度静息性术后疼痛可能有缓解作用,提示其可能是缓解轻度静息性疼痛的一种可行辅助方法。然而,还需要更多的多中心和大样本研究来验证这一结果。
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