Description In patients undergoing hysterectomy the following points were used: GV2, GV4 in the midline and BL32, BL23, LI4 and PC6, bilaterally. In patients undergoing laparoscopic cholecystect- omy, the following points were used: LR3, SP6, LI4 and PC6, all bilaterally.
Experimental Description
107 patients who were undergoing abdominal hysterectomy or laparascopic cholecystectomy were randomised to receive either electroacupuncture (n = 56) or no additional treatment (n = 46) during the operative period.
Sample Count
107
Age
≥18
Control
Std
no additional treatment(n=46)
Experiment
electroacupuncture (n=56)
Indicator
Use of PCIARecovery timesTime in painPostoperative Nausea and Vomiting(PONV)Sedation score
Auxiliary Medication
Diazepam 5-10 mg was given orally 1 h before operation according to the weight of the patient (5 mg for patients below 60 kg and 10 mg for patients above 60 kg). Propofol was the induction agent, and a standard dose of droperidol 1 mg was given to all patients as a baseline antiemetic. Tracheal intubation was facilitated by using atracurium, or another muscle relaxant (vecuronium, rocuronium or cisatracurium), in dosage according to the body weight. Anaesthesia was maintained by nitrous oxide 50-60%, oxygen 40-50% and isoflurane 1-2%. At the end of the operation, muscle relaxation was reversed using a suitable dose of neostigmine and glycopyrrolate. Intravenous morphine was given intraoperatively just before skin incision, 100 mg/kg body weight. During the first 24 h of postoperative care, all patients received morphine sulphate via the PCA route. The concentration of morphine in the PCA pump was 1 mg/ml; the lock-out time was 5 minutes. Any medication which the patient was taking prior to surgery was recommenced as soon as was practicable, in line with the individual treatment regime.
Stimulation Method
EA
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
IC-4107
RDG Medical Ltd, Croydon, UK
10 Hz
-
the intensity was 7/10 on the intensity scale of the electroacupuncture unit.
The acupuncture needles inserted after induction of anaesthesia. Stimulation was stopped and needles removed before the patient was transferred to the recovery room.
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
1 or 0.16×30 mm
Seirin, Japan
-
Description The points were selected on the bases of guidelines from Chaitow.11 Needles (size 1 or 0.16 6 30 mm, Seirin) were attached to the acupuncture stimulator (Medical Electro- Acupuncture Unit, IC-4107, RDG Medical Ltd, Croydon, UK) for the duration of the operation. The needles were connected in the following pairs: GV2 with BL32, GV4 with BL23, LI4 with PC6, and LR3 with SP6. The frequency used was 10 Hz, and the intensity was 7/10 on the intensity scale of the electroacu- puncture unit. Occasional muscle twitches were noticed (suggesting that muscle relaxation was not optimal). After the needles were connected to the electroacupuncture stimulator, they were secured by adhesive tape. No local anaesthetics were used at the end of surgery. Stimulation was stopped and needles removed before the patient was transferred to the recovery room.
Anesthesia Method
AAA
Clinical Trial Type
random
Contraindications
Pregnant
Effector
The electroacupuncture group had a longer duration of operation but the difference was not statistically significant. There were no significant differ- ences between the groups for the requirement for patient-controlled analgesia or total time in recovery. Pain scores were marginally lower in the acupuncture group, but not significantly, and there were no differences between the groups in nausea or sedation scores. Electroacupuncture at 10 Hz given under general anaesthetic has no effect on postoperative nausea or analgesic requirement. Future studies should investigate acupuncture given before or after surgery.
"Effect of intraoperative electroacupuncture on postoperative pain, analgesic requirements, nausea and sedation: a randomised controlled trial."
Abstract
BACKGROUND: Acupuncture has potential value in producing analgesia in the postoperative period, but previous trials have inconsistent results. We aimed to study the effect of electroacupuncture on pain and nausea and the requirement for postoperative analgesia via patient-controlled analgesia. METHOD: 107 patients who were undergoing abdominal hysterectomy or laparascopic cholecystectomy were randomised to receive either electroacupuncture (n = 56) or no additional treatment (n = 46) during the operative period. We measured the use of patient-controlled analgesia and time in recovery as well as pain, postoperative nausea and vomiting, and sedation. 102 patients were included in the analysis. The majority of patients were female: the laparoscopic cholecystectomy group included 10 males. Adhesive dressings were placed over all acupuncture points in both groups, to ensure blinding of patients and assessors during the recovery period. RESULTS: The electroacupuncture group had a longer duration of operation but the difference was not statistically significant. There were no significant differences between the groups for the requirement for patient-controlled analgesia or total time in recovery. Pain scores were marginally lower in the acupuncture group, but not significantly, and there were no differences between the groups in nausea or sedation scores. CONCLUSION: Electroacupuncture at 10 Hz given under general anaesthetic has no effect on postoperative nausea or analgesic requirement. Future studies should investigate acupuncture given before or after surgery."
