Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
HanseMerkur Center for Traditional Chinese Medicine at the University Hospital Hamburg-Eppendorf, Hamburg, Germany.
BJU Int. 2024 Jun;133(6):725-732. doi: 10.1111/bju.16288. Epub 2024 Feb 5.
To evaluate the advantages of adding acupuncture to standard postoperative pain management for open radical prostatectomy (RP).
A randomized controlled trial (1:1:1) comparing routine postoperative analgesic care (control [CON]) vs the addition of press tack needle acupuncture (ACU) or press tack placebo acupressure (SHAM) for pain management after open RP was performed. A total of 126 patients were enrolled between February 2020 and April 2021. After open RP, the CON group received standard postoperative analgesia, the ACU group received long-term acupuncture with press tacks at specific points (P-6, Shenmen and SP-6) along with standard analgesia, and the SHAM group received placebo press tacks at the same acupuncture points alongside standard analgesia. The primary endpoint was postoperative pain measured on a numeric rating scale, the NRS-11, calculated as the area under the curve. The cumulative use of routine postoperative analgesics, time to first defaecation, and quality of life were analysed using the Kruskal-Wallis rank sum test, Fisher's exact test, and Pearson's chi-squared test.
The ACU group reported significantly less postoperative pain compared to the SHAM (P = 0.007) and CON groups (P = 0.02). There were no significant difference in median (interquartile range) cumulative pain medication usage, time to first defaecation (CON: 37 [33, 44] h; SHAM: 37 [33, 42] h; ACU: 37 [33, 41] h; P > 0.9), or health status at discharge (EuroQol five-dimension, five-level general health assessment questionnaire: CON: 70 [65-83]; SHAM: 70 [60-80]; ACU: 70 [50-80]).
Incorporating acupuncture into postoperative pain management can improve patient postoperative outcomes.
评估在开放式根治性前列腺切除术（RP）的标准术后疼痛管理中加入针刺的优势。
进行了一项随机对照试验（1:1:1），比较了常规术后镇痛护理（对照组[CON]）与针刺（ACU）或针刺假按压（SHAM）联合治疗开放式 RP 术后疼痛管理。2020 年 2 月至 2021 年 4 月期间共纳入 126 例患者。开放式 RP 术后，CON 组接受标准术后镇痛，ACU 组在特定穴位（P-6、神门和 SP-6）接受长期按压针灸治疗，并联合标准镇痛，SHAM 组在相同穴位接受安慰剂按压针灸治疗，并联合标准镇痛。主要终点是术后疼痛，用数字评分量表（NRS-11）进行评估，计算曲线下面积。采用 Kruskal-Wallis 秩和检验、Fisher 确切检验和 Pearson 卡方检验分析常规术后镇痛药的累积使用量、首次排便时间和生活质量。
与 SHAM 组（P=0.007）和 CON 组（P=0.02）相比，ACU 组报告的术后疼痛明显减轻。三组患者的累积止痛药使用中位数（四分位距）、首次排便时间（CON：37[33，44]h；SHAM：37[33，42]h；ACU：37[33，41]h；P>0.9）或出院时的健康状况（EuroQol 五维，五水平一般健康评估问卷：CON：70[65-83]；SHAM：70[60-80]；ACU：70[50-80]）均无显著差异。
将针刺纳入术后疼痛管理可以改善患者的术后结局。
