Description Du2 (yao shu, median line, location of hiatus sacralis), Du20 (bai hui, in the middle of the both apices auriculae), Bi30 (bai han shu, region foramen sacrale, right-sided paravertebral point at L2 level), Bi57 (cheng shan, hollow between the both gastrognemial muscules), Ma44 (nei ting, interdigital between the second and third toe of the left foot) and Pe6 (nei guan, between tendons of flexor carpi radialis and palmaris longus on the distal forearm).
Experimental Description
50 patients were allocated to three groups. Conventional drug therapy (oral diclofenac and metamizol, local lidocaine) served as baseline analgesia. In the control group (n = 17) only this regimen was used. In addition to baseline analgesia, 17 patients received verum acupuncture. Sham acupuncture was performed on 16 patients.
Sample Count
50
Age
＞18
Control
Sham
Std
control group(n=17);Sham acupuncture(n=16)
Experiment
verum acupuncture(n=17)
Indicator
Pain intensityNumeric rating scale(NRS)Total number of days on rescue analgesicsHeart rate(HR)Blood pressure(BP)Complications
Auxiliary Medication
Anaesthesia started with premedication (midazolam 7.5 mg orally) and followed a standard protocol. For induction of total intravenous anaesthesia, propofol (4 mg/kg bodyweight) and fentanyl (0.1–0.2 mg/kg bodyweight) were administered intravenously (IV). If necessary, anaesthesia was prolonged using additional doses of remifentanyl. If patients reported pain in the postoperative recovery unit, they received morphine (5–15 mg IV) and metamizol (1–2.5 g IV). After surgery, all patients received the same analgesic drug regimen, which consisted of diclofenac at 50 mg orally three times a day and metamizol 500 mg orally four times a day. Furthermore, 5% lidocaine ointment was applied locally. This medication was discontinued if the patient was discharged from hospital or was pain-free. In addition to this regular baseline analgesia, the following rescue analgesics could be applied, if a patient reported strong pain and requested additional therapy: oxycodone (10–20 mg orally, depending on body weight) or piritramide (15 mg IV as a slow infusion over 30 min).
Stimulation Method
MS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
-
-
-
-
-
20-30 min
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
0.3×30 mm
Seirin Co. Ltd, Shizuoka City, Japan
15 mm
Description Acupuncture was first performed on the day of surgery at 4 p.m. and then repeated every morning and afternoon on postoperative days 1 and 2. Sterile disposable stainless-steel needles of 30 mm length and 0.3 mm diameter (size no. 5; Seirin Co. Ltd, Shizuoka City, Japan) were used for acupuncture. Nee- dles were passed quickly through the epidermis and inserted perpendicular to the skin down to a depth of about 15 mm. An acupuncture sensation (also known as de qi) was aimed for. Needles were removed after about 20–30 min.
Anesthesia Method
GA
Clinical Trial Type
a randomized controlled trial
Adverse Effects
Specifically, no nausea, vomiting or acupuncture site reactions were observed.
Effector
After verum acupuncture, pain intensity was not significantly lower when compared with conven- tional analgesia (primary hypothesis, P = 0.057), but was when compared to sham acupuncture (P = 0.007). In the afternoon of postoperative day 1, for example, NRS was 2.7 (SD 1.5) in the verum group, but 4.0 (1.0) in the sham group and 4.1 (1.9) under conventional analgesia. Furthermore, significantly fewer rescue analgesics were necessary if verum acupuncture was applied. Cardiovascular parameters were stable in all three groups, and no complications were recorded. In posthaemorrhoidectomy patients, acu- puncture appears to be an effective adjunct to conventional analgesia. Further studies are necessary to confirm these observations and to refine the acupuncture technique.
Randomized sham-controlled trial of acupuncture for postoperative pain control after stapled haemorrhoidopexy.
Abstract
AIM: Haemorrhoidectomy usually causes moderate to strong postoperative pain. Chinese studies have found that acupuncture may have an analgesic effect in posthaemorrhoidectomy patients. This is the first Western study aiming assess the efficacy of acupuncture as an adjunct analgesic therapy after stapled haemorrhoidopexy. METHOD: In a randomized controlled trial, 50 patients were allocated to three groups. Conventional drug therapy (oral diclofenac and metamizol, local lidocaine) served as baseline analgesia. In the control group (n = 17) only this regimen was used. In addition to baseline analgesia, 17 patients received verum acupuncture. Sham acupuncture was performed on 16 patients. Being the primary outcome measure, pain was measured twice daily using the numerical rating scale (NRS) and compared statistically by repeated-measures analysis of variance. The study was registered (DRKS00003116). Results After verum acupuncture, pain intensity was not significantly lower when compared with conventional analgesia (primary hypothesis, P = 0.057), but was when compared to sham acupuncture (P = 0.007). In the afternoon of postoperative day 1, for example, NRS was 2.7 (SD 1.5) in the verum group, but 4.0 (1.0) in the sham group and 4.1 (1.9) under conventional analgesia. Furthermore, significantly fewer rescue analgesics were necessary if verum acupuncture was applied. Cardiovascular parameters were stable in all three groups, and no complications were recorded. CONCLUSIONS: In posthaemorrhoidectomy patients, acupuncture appears to be an effective adjunct to conventional analgesia. Further studies are necessary to confirm these observations and to refine the acupuncture technique."
