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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva
Minerva Anestesiologica 2011 Marzo;77(3):298-304
Auricular acupuncture for postoperative pain after gynecological surgery: a randomized controlled trail
Holzer B. A. 1, Leitgeb U. 1, Spacek A. 1, Wenzl R. 2, Herkner H. 3, Kettner S. 1 ✉
1 Department of Anesthesia, General Intensive Care and Pain Control, Medical University of Vienna, Vienna, Austria;
2 Department of Obstetrics and Gynaecology, Medical University of Vienna, Vienna, Austria;
3 Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria
BACKGROUND: Acupuncture for postoperative pain remains controversial. Potential sources of bias are failures in patient-blinding and therapist-patient interactions. Our study investigates the effects of electrical auricular acupuncture (AA) on postoperative pain in patients undergoing laparoscopy with an emphasis on patient-blinding and the exclusion of therapist-patient interactions.
METHODS: With institutional review board approval and written informed consent, we included 40 female patients undergoing laparoscopy. Patients were randomly assigned to receive AA (shen men, thalamus and one segmental organ-specific point) or electrodes only and an electrical stimulation device. All patients received this intervention under general anesthesia guaranteeing patient blinding and excluding therapist-patient interactions. Needles and devices were removed 72 hours postoperatively. Postoperatively, patients received 1,000 mg paracetamol every 6 hours. Additional piritramide was given on demand. A blinded observer obtained the VAS scores at 0, 2, 24, 48, and 72 hours as well as the postoperatively administered doses of piritramide.
RESULTS: There was no difference in VAS scores or the consumption of piritramide during the first 72 hours postoperatively between groups (acupuncture versus placebo: 2.32 [1.40-3.25] versus 2.62 [1.89-3.36] average pain on VAS 0-10; 15.3 [12.0-18.6] mg versus 13.9 [10.5-17.3] mg piritramide). Values are expressed as mean [CI].
CONCLUSION: Our study shows no reduction in postoperative pain or an opioid sparing effect of auricular acupuncture in women undergoing laparoscopic procedures. Because we emphasized blinding of the patients and the exclusion of therapist-patient interactions, our study suggests that electrical auricular acupuncture has no effect on postoperative pain.