Adverse events related to electroacupuncture: a systematic review of single case studies and case series

Abstract

Objective Electroacupuncture (EA) is used in the treatment of various diseases through the use of electrical stimulation. Reports of adverse events (AEs) associated with acupuncture are relatively consistent, but the safety of EA has been less well reported. In this systematic review, we provide a summary of the types of AEs related to EA in clinical practice. Methods Twelve electronic databases, including those in English (PubMed, Ovid-EMBASE, CENTRAL), Korean (KMbase, KISS, NDSL, KISTI, OASIS), Chinese (CNKI, Wanfang, Weipu) and Japanese (J-STAGE), were systematically searched for single case studies and case series through April 2018. There were no language restrictions. We included clinical studies in which EA was used as a key intervention and in which AEs that may have been causally related to EA were reported. Results Thirty-seven studies, including 27 single case studies and 10 case series, were evaluated. The most frequently reported AEs were pallor (eight cases), skin pigmentation (eight cases), vertigo (seven cases), chest tightness (six cases), vomiting (six cases) and unconsciousness (five cases). Thirty-one cases (62%) achieved full recovery and three cases (6%) achieved partial recovery. There were also three cases of death (6%). Conclusion AEs related to EA included acupuncture-related AEs and serious AEs induced by electrical stimulation. Currently, specific stimulation conditions associated with EA-specific AEs are not identifiable due to inappropriate reporting. However, skin pigmentation, syncope or spasm, implantable cardioverter-defibrillator shock, cardiac emergencies, electrical burns, and potential internal organ injury are potential EA-specific AEs regarding which physicians should be cautious in clinical practice.

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“…The types of AEs commonly observed after electroacupuncture include nervous system disorders such as vertigo and unconsciousness, general disorders and administration site conditions such as pallor, skin and subcutaneous tissue disorders such as skin pigmentation, gastrointestinal disorders such as nausea and vomiting, and cardiac/vascular disorders such as cyanosis and palpitations. 41 If such AEs were judged to have a causal relationship with the electroacupuncture treatment based on the time interval between the treatment and the appearance of the AE, it was judged as AE related to the electroacupuncture. The severity and causal relationships between AEs and the intervention were also recorded in the CRF.…”

Rapid Progression to Complete Paraplegia After Electroacupuncture in a Patient With Spinal Dural Arteriovenous Fistula: A Case Report

“…As in the previous cases, the deeper puncture may have affected the thecal sac and the spinal cord. There have been reports of peripheral nerve damage or dysfunction of implantable cardioverter-defibrillators due to electrical stimulation of electroacupuncture (23). The deeper position of the electroacupuncture needle may have inflicted direct damage to the thecal sac or nerve.…”

Electroacupuncture for treating cancer-related insomnia: a multicenter, assessor-blinded, randomized controlled, pilot clinical trial

“…For the safety assessment, the researchers used data from medical examinations and laboratory tests to investigate all adverse events (AEs) during the trial period, irrespective of their relationship with the intervention. The AEs including nervous system disorders, gastrointestinal disorders, and cardiac and vascular disorders can occur after EA [ 40 ]. If the Korean medicine doctor judged such AEs to have a causal relationship with the EA treatment by the Korean medicine doctor in terms of the onset and disappearance time of symptoms, participant’s usual condition, and past history, it was judged as an AE related to the EA.…”