Department of Surgery, University Medicine Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Langenbecks Arch Surg. 2023 Oct 10;408(1):391. doi: 10.1007/s00423-023-03051-8.
Optimal pain management is one of the core elements of Enhanced Recovery After Surgery (ERAS®) protocols and remains a challenge. Acupuncture (AC) is an effective treatment for various pain conditions. Systematic and personalized allocation of acupoints may be decisive for efficacy.
Based on the predominant pressure sensitivity of six gastrointestinal (GI) checkpoints (G1-G6), we devised a method to detect personalized patterns of pain and a corresponding set of acupoints. We performed a single AC treatment with semi-permanent needles and assessed the visual analogue scale (VAS) score, pain threshold based on pressure algometry (PA), and temperature changes on abdominal skin areas before and 5 min after AC.
Between April and June 2021, thirty-eight patients were prospectively included in this pilot study. The mean reduction in subjective pain sensation as assessed by VAS was 86%, paralleled by an augmentation of the pain threshold as measured by PA by 64%. A small but significant increase in the skin temperature was observed above the abdominal surface. These effects were independent of the type of surgery.
Checkpoint acupuncture may be a complementary tool for postoperative pain management. Further investigations are needed to explore this analgesic effect.
优化疼痛管理是增强术后恢复（ERAS®）方案的核心要素之一，但仍然具有挑战性。针刺（AC）是治疗各种疼痛病症的有效方法。系统且个性化的穴位分配可能对疗效具有决定性作用。
基于六个胃肠道（GI）检查点（G1-G6）的主要压痛敏感性，我们设计了一种检测个性化疼痛模式和相应穴位集的方法。我们使用半永久性针进行单次 AC 治疗，并在治疗前和治疗后 5 分钟评估视觉模拟量表（VAS）评分、基于压力测痛法（PA）的疼痛阈值以及腹部皮肤区域的温度变化。
在 2021 年 4 月至 6 月期间，前瞻性纳入了 38 名患者参与本试点研究。VAS 评估的主观疼痛感觉平均降低了 86%，PA 测量的疼痛阈值增加了 64%。腹部表面上方的皮肤温度略有显著升高。这些效果与手术类型无关。
穴位针刺可能是术后疼痛管理的一种补充工具。需要进一步研究来探索这种镇痛效果。
