A Cumulative Review of the Range and Incidence of Significant Adverse Events Associated with Acupuncture

Abstract

Objective To summarise the range and frequency of significant adverse events associated with acupuncture in order to provide evidence on which to base continuing efforts to improve the safety of acupuncture practice. Methods Searches were conducted of computerised databases, previous reviews of case reports, population surveys, prospective surveys of acupuncture practice and relevant sections of textbooks for primary and secondary reports to indicate the range of significant adverse events associated with acupuncture. Data from prospective surveys of acupuncture were combined to estimate the incidence of serious adverse events. Results A total of 715 adverse events was included. There were 90 primary reports of trauma, and 186 secondary reports; the most common were pneumothorax and injury to the central nervous system. Infection accounted for 204 primary reports and 91 secondary reports. Over 60% of these cases were hepatitis B. The next most common infection was of the external ear, as a complication of auricular acupuncture. The 144 miscellaneous events mainly comprised seizures and drowsiness judged severe enough to cause a traffic hazard. There were 12 primary reports of deaths. According to the evidence from 12 prospective studies which surveyed more than a million treatments, the risk of a serious adverse event with acupuncture is estimated to be 0.05 per 10 000 treatments, and 0.55 per 10 000 individual patients. Conclusions The risk of serious events occurring in association with acupuncture is very low, below that of many common medical treatments. The range of adverse events reported is wide and some events, specifically trauma and some episodes of infection, are likely to be avoidable.

High Prevalence of Sternal Foramen: Quantitative, Anatomical Analysis and its Clinical Implications in Acupuncture Practice

“…By all means, the particular major risks that acupuncture carries are the risk of traumatic injury to an internal organ, especially the pleura, by needle penetration (Bodner et al, 1983;Gray et al, 1991;Rampes & James, 1995;Cantan et al, 2003), and the risk of causing bacterial infections in deep structures, though the latter seems to be negligible, probably because the needle tip is too small to carry sufficient inoculum of infected material from the skin (Hoffman, 2001;White, 2006). In this way, several authors have collated list of complications caused by or associated with acupuncture (Norheim & Fonnebo, 1995;Ernst;Ernst & White, 1997;Rampes & James;Peuker et al;White, 2004).…”

Pneumotórax pós-acupuntura: apresentação clínica e tratamento

“…A ocorrência de pneumotórax pós-acupuntura é rara, tendo sido observado, em revisão sistemática, um evento a cada 125 mil sessões 11 , e, em estudo observacional prospectivo, dois casos em 97.733 pacientes submetidos a acupuntura 12 . Ainda assim, em uma revisão recente de artigos reportando eventos adversos relacionados a acupuntura (incluindo relatos de caso, séries de casos e outras formas de publicação), foram contabilizados 715 casos, destes, 191 foram pneumotórax, 17 resultando em morte 3 . Infelizmente, neste estudo, não foram apresentados detalhes quanto as características dos pacientes ou evolução clínica.…”

“…Várias publicações relatam sérias lesões associadas à acupuntura, inclusive com desfecho fatal, como casos de tamponamento cardíaco e pneumotórax bilateral [2][3][4] . Dentre as diversas complicações, o pneumotórax é o descrito com maior freqüência.…”

Report of Adverse Event with Electroacupuncture

“…2 Adverse events (or potentially adverse events) related to the use of EA have been reported, 3 and these have mostly related to cardiac effects (angina, cardiac arrest, interference with a demand pacemaker). Up to 2004, White found fi ve primary reports (written by clinicians involved in the relevant case) and four secondary reports (written by other authors) of deaths related to needle trauma during EA.…”