Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA.
Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, USA.
J Integr Complement Med. 2024 Aug;30(8):776-782. doi: 10.1089/jicm.2023.0168. Epub 2024 Jan 12.
Postoperative pain management and postoperative nausea and vomiting are a persistent challenge for both health care providers and patients. Acupuncture is an effective and safe modality for the management of pain and nausea, and has the potential to play a key role in postoperative pain management. This study explores the utility and feasibility of acupuncture in the immediate postoperative setting. In a retrospective case-control study, 22 patients who underwent elective surgeries and received acupuncture in the post-anesthesia care unit (PACU) were compared with 88 case controls. Indications for acupuncture therapy included persistent pain, nausea, or anxiety. Patient satisfaction and symptom improvement after acupuncture were assessed. PACU nurses and patients were queried on their perspectives on using this therapy. Demographic data, perioperative opioid consumption, pain score in the PACU, incidence of postoperative nausea, PACU length of stay, and unintended hospital admission were assessed. The groups with/without acupuncture were compared using Wilcoxon rank sum test or Fisher's exact test as appropriate. A total of 78.9% of patients receiving acupuncture felt improvement in their symptoms. 94.7% of recovery nurses who cared for patients who received acupuncture felt that it was helpful and 78.9% did not believe it was disruptive. Patients who opted for acupuncture had a statistically significant higher overall median (interquartile range) pain score in the PACU (7.0 [5.2, 9.5] vs. 5.0 [3.0, 7.0], = 0.009) and higher postoperative opioid consumption (22.5 [9.8, 44.8] vs. 15.0 [0.0, 30.0], = 0. 03). There was no difference between total perioperative opioid consumption between groups ( = 0.94). Most patients who received acupuncture therapy in the PACU were satisfied with their therapy and would recommend it to future patients undergoing surgery. Most recovery nurses felt it was helpful, was not disruptive, and would like to see it utilized in the PACU.
术后疼痛管理和术后恶心呕吐一直是医疗保健提供者和患者面临的挑战。针灸是一种有效且安全的疼痛和恶心治疗方法,具有在术后疼痛管理中发挥关键作用的潜力。本研究探讨了针灸在术后即刻环境中的效用和可行性。 在一项回顾性病例对照研究中,将 22 名在麻醉后护理单元 (PACU) 接受针灸治疗的择期手术患者与 88 名病例对照进行比较。针灸治疗的适应症包括持续性疼痛、恶心或焦虑。评估了患者对针灸治疗的满意度和症状改善情况。询问了 PACU 护士和患者对使用这种治疗方法的看法。评估了人口统计学数据、围手术期阿片类药物的使用、PACU 疼痛评分、术后恶心的发生率、PACU 停留时间和非计划住院情况。使用 Wilcoxon 秩和检验或 Fisher 确切检验比较有/无针灸组。 接受针灸治疗的患者中有 78.9%的人感觉症状有所改善。护理接受针灸治疗的患者的康复护士中,有 94.7%的人认为这很有帮助,78.9%的人认为这不会造成干扰。选择接受针灸治疗的患者在 PACU 中的总体中位数(四分位距)疼痛评分更高(7.0 [5.2, 9.5] 比 5.0 [3.0, 7.0],= 0.009),术后阿片类药物使用量更高(22.5 [9.8, 44.8] 比 15.0 [0.0, 30.0],= 0.03)。两组之间的总围手术期阿片类药物使用量无差异(= 0.94)。 在 PACU 接受针灸治疗的大多数患者对他们的治疗感到满意,并会向未来接受手术的患者推荐。大多数康复护士认为它有帮助,不会造成干扰,并希望在 PACU 中使用它。