Department of Chinese Medicine, Linsen Chinese Medicine and Kunming Branch, Taipei City Hospital, Taipei, Taiwan, R.O.C.
Medicine (Baltimore). 2022 Jul 15;101(28):e29653. doi: 10.1097/MD.0000000000029653.
Enhanced recovery pathways can be further improved for postoperative sore throat (POST) that occurs after surgery under general anesthesia. Medications have shown some effectiveness in preventing POST, but acupuncture or related techniques with better safety and lower cost can be used as an alternative or adjuvant therapy to treat perioperative symptoms by stimulating acupuncture point (acupoint). Therefore, we aimed to conduct a meta-analysis to assess whether acupoint stimulation helps patients prevent POST in adults undergoing tracheal intubation for general anesthesia.
Publications in PubMed, the Cochrane Central Register, ScienceDirect, and ClinicalTrial.gov were surveyed from January 2000 through August 2020. Studies that compared interventions between true acupoint stimulation and no or sham acupoint stimulation were included. The primary outcomes were the incidence and severity of POST at 24h.
Four randomized control trials and 1 comparative study involving 1478 participants were included. Compared with the no or sham acupoint stimulation, the true acupoint stimulation was associated with a reduced incidence (risk ratio, 0.32; 95% confidence interval (CI), 0.18-0.55; P < .001) and decreased severity (standardized mean difference, -2.79; 95% CI, -4.59 to - 0.99; P = .002) of POST. There were no significant adverse events related to acupoint stimulation. The finding for POST was assured by subgroup, sensitivity, and trial sequential analyses.
Acupoint stimulation may reduce the occurrence of POST. It can be considered as one of nonpharmacological methods to prevent POST in enhanced recovery pathways. Further rigorous studies are needed to determine the effectiveness of acupoint stimulation.
全麻术后发生的术后咽喉痛(POST)可通过增强康复途径进一步改善。药物已被证明在预防 POST 方面具有一定效果,但针刺或相关技术以更好的安全性和更低的成本,可作为替代或辅助疗法,通过刺激穴位(穴位)来治疗围手术期症状。因此,我们旨在进行荟萃分析,以评估在接受全身麻醉行气管插管的成年人中,穴位刺激是否有助于预防 POST。
检索 2000 年 1 月至 2020 年 8 月期间在 PubMed、Cochrane 中央注册处、ScienceDirect 和 ClinicalTrials.gov 发表的文献。纳入比较真实穴位刺激与非穴位刺激或假穴位刺激干预措施的研究。主要结局为 24 小时时 POST 的发生率和严重程度。
纳入了 4 项随机对照试验和 1 项比较研究,共涉及 1478 名参与者。与非穴位刺激或假穴位刺激相比,真穴位刺激与 POST 发生率降低(风险比,0.32;95%置信区间,0.18-0.55;P<0.001)和严重程度降低(标准化均数差,-2.79;95%置信区间,-4.59 至-0.99;P=0.002)相关。与穴位刺激相关的不良事件无显著差异。亚组、敏感性和试验序贯分析均保证了 POST 的结果。
穴位刺激可能会降低 POST 的发生。它可以被认为是增强康复途径中预防 POST 的非药物方法之一。需要进一步进行严格的研究以确定穴位刺激的有效性。