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电针治疗内镜鼻窦手术后疼痛:一项随机对照试验。

Electroacupuncture for Pain Relief After Endoscopic Sinus Surgery: A Randomized Controlled Trial.

机构信息

Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China; School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

出版信息

J Pain. 2023 Nov;24(11):2014-2023. doi: 10.1016/j.jpain.2023.06.010. Epub 2023 Jun 20.

DOI:10.1016/j.jpain.2023.06.010
PMID:37348776
Abstract

Postoperative pain is a common problem after endoscopic sinus surgery (ESS). Electroacupuncture (EA) is proven to be effective in relieving postoperative pain. However, EA has not been studied in patients undergoing ESS. This study was designed to evaluate the efficacy and safety of EA compared to a sham control in relieving pain after ESS. A total of 62 patients were randomly allocated to receive either EA (n = 31) or sham EA (n = 31) for 5 sessions, 30 minutes per session for 4 days (2 hours before and 2 hours after surgery, and 3 sessions daily for the following 3 days). There were no significant differences between the 2 groups with regard to demographic characteristics. Compared to the sham EA group, the EA group showed a significantly greater reduction in the pain intensity of single daily scoring with a numerical rating scale at the day following surgery (postoperative day 1, POD1) (-1.35; 95% confidence interval [CI], -1.74 to -0.97; P < .001) and POD2 (-1.16; 95% CI, -1.55 to -0.77; P < .001), whereas no significant between-group difference was detected at the day of surgery (POD0), POD3 or POD6. Intraoperative heart rate and mean blood pressure in the EA group showed a more stable trend. A significant improvement was found for an actigraphy-measured average time of night wakings, recovery time from anesthesia, and quality of recovery-15 in the EA group. No severe adverse events occurred during the trial. Our results demonstrate that EA can serve as an effective adjuvant therapeutic tool for pain relief after ESS. PERSPECTIVE: This randomized sham-controlled, patient-and-assessor blinded trial provided evidence for the first time that EA can relieve postoperative pain and other symptom management in patients after ESS. TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry, ChiCTR1900024183, http://www.chictr.org.cn/showproj.aspx?proj=40573.

摘要

术后疼痛是内镜鼻窦手术后(ESS)的常见问题。电针(EA)已被证明可有效缓解术后疼痛。然而,在接受 ESS 的患者中尚未对 EA 进行研究。本研究旨在评估 EA 与 sham 对照在缓解 ESS 后疼痛方面的疗效和安全性。共有 62 名患者被随机分配接受 EA(n=31)或 sham EA(n=31)治疗,共 5 次,每次 30 分钟,持续 4 天(手术前 2 小时和后 2 小时,以及术后 3 天每天 3 次)。两组患者在人口统计学特征方面无显著差异。与 sham EA 组相比,EA 组在术后第 1 天(术后第 1 天,POD1)(-1.35;95%置信区间 [CI],-1.74 至-0.97;P<0.001)和 POD2(-1.16;95%CI,-1.55 至-0.77;P<0.001)的单次每日评分疼痛强度降低更为显著,而在手术当天(POD0)、POD3 或 POD6 时两组间无显著差异。EA 组术中心率和平均血压显示出更稳定的趋势。EA 组的活动记录仪测量的夜间醒来平均时间、麻醉恢复时间和 15 项恢复质量评分均有显著改善。试验过程中未发生严重不良事件。我们的研究结果表明,EA 可以作为缓解 ESS 后疼痛的有效辅助治疗工具。观点:这项随机 sham 对照、患者和评估者盲法试验首次提供了证据,证明 EA 可以缓解 ESS 后患者的术后疼痛和其他症状管理。试验注册:中国临床试验注册中心,ChiCTR1900024183,http://www.chictr.org.cn/showproj.aspx?proj=40573。

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