Cook County Health, Chicago, IL 60612, USA.
Cook County Health, Chicago, IL 60612, USA.
Am J Emerg Med. 2023 Dec;74:196.e5-196.e7. doi: 10.1016/j.ajem.2023.10.006. Epub 2023 Oct 6.
Treating shoulder dislocations is common in the emergency department and often requires procedural sedation. The use of acupuncture for treatment of chronic pain has been shown to be successful in various outpatient settings, and some EDs have recently incorporated acupuncture as an analgesia adjunct for chronic painful conditions to avoid opioid therapy. Limited data describe acupuncture to facilitate ED procedures. Here we present two cases of acute shoulder dislocation that were successfully treated with acupuncture as an alternative to parenteral pharmacologic procedural sedation. A 50 year old male sustained an anterior shoulder dislocation after an altercation, and a 59 year old female sustained an anterior dislocation after a fall. Instead of using conventional pharmacologic sedation and analgesia during shoulder reduction, both were treated with acupuncture in the ED. Reduction in both cases was rapid, safe, and avoided use of any parenteral medications, procedural sedation monitoring, or prolonged nurse observation. Using acupuncture as alternative to opioids for ED procedures deserves future study for orthopedic and other common ED procedures.
治疗肩部脱位在急诊科很常见，通常需要进行程序性镇静。针灸治疗慢性疼痛已在各种门诊环境中被证明是成功的，最近一些急诊科已将针灸作为慢性疼痛疾病的辅助镇痛手段，以避免使用阿片类药物治疗。有限的数据描述了针灸以促进急诊科的程序。在这里，我们介绍了两例急性肩部脱位的病例，这些病例成功地通过针灸治疗来替代静脉内药物程序性镇静。一名 50 岁男性在争吵后发生前肩脱位，一名 59 岁女性在跌倒后发生前脱位。在肩部复位过程中，这两人都没有使用常规的药物镇静和镇痛，而是在急诊科接受了针灸治疗。两种情况下的复位都迅速、安全，避免了使用任何静脉内药物、程序性镇静监测或延长护士观察。将来需要进一步研究针灸作为急诊科程序的替代阿片类药物的方法，适用于骨科和其他常见的急诊科程序。
