Auricular acupuncture for adult tonsillectomy

Shah, Anil N.; Moore, Chad; Brigger, Matthew T.

doi:10.1002/lary.28338

Cited by 13 publications

(22 citation statements)

References 18 publications

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“…One meta-analysis [43] and seven studies involving 522 patients were included [44][45][46][47][48][49][50]. The majority reported a benefit with a reduction in pain and analgesic requirements if acupuncture was used.…”

Section: Acupuncturementioning

confidence: 99%

PROSPECT guideline for tonsillectomy: systematic review and procedure‐specific postoperative pain management recommendations

et al. 2020

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Tonsillectomy is one of the most frequently performed surgical procedures; however, pain management remains challenging. Procedure-specific efficacy as well as specific risks of treatment options should guide selection of pain management protocols based on evidence and should optimise analgesia without harm. The aims of this systematic review were to evaluate the available literature and develop recommendations for optimal pain management after tonsillectomy. A systematic review utilising preferred reporting items for systematic reviews and meta-analysis guidelines with procedure-specific postoperative pain management (PROSPECT) methodology was undertaken. Randomised controlled trials published in the English language up to November 2019 assessing postoperative pain using analgesic, anaesthetic or surgical interventions were identified. Out of the 719 potentially eligible studies identified, 226 randomised controlled trials met the inclusion criteria, excluding the studies examining surgical techniques. Pre-operative and intra-operative interventions that improved postoperative pain were paracetamol; non-steroidal anti-inflammatory drugs; intravenous dexamethasone; ketamine (only assessed in children); gabapentinoids; dexmedetomidine; honey; and acupuncture. Inconsistent evidence was found for local anaesthetic infiltration; antibiotics; and magnesium sulphate. Limited evidence was found for clonidine. The analgesic regimen for tonsillectomy should include paracetamol; non-steroidal anti-inflammatory drugs; and intravenous dexamethasone, with opioids as rescue analgesics. Analgesic adjuncts such as intra-operative and postoperative acupuncture as well as postoperative honey are also recommended. Ketamine (only for children); dexmedetomidine; or gabapentinoids may be considered when some of the first-line analgesics are contra-indicated. Further randomised controlled trials are required to define risk and combination of drugs most effective for postoperative pain relief after tonsillectomy.

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Section: Acupuncturementioning

confidence: 99%

PROSPECT guideline for tonsillectomy: systematic review and procedure‐specific postoperative pain management recommendations

et al. 2020

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“…Others have studied the therapeutic effect of acupuncture following tonsillectomy, vascular surgery, childbirth, irritable bowel disease and colonoscopy. 18 –20,25 –28 In this study, the most common region of pain was the back (21%). Of note, Federman et al 11 observed a higher rate of chronic musculoskeletal back conditions (40%).…”

Section: Discussionmentioning

confidence: 66%

Battlefield acupuncture appears to be an effective therapy for pain management

2021

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Introduction: The Department of Defense has been training primary care providers in battlefield acupuncture (BFA), a subtype of auricular acupuncture, as an adjunct therapy for pain management. Methods: The objective of this study was to evaluate the effectiveness and safety of BFA for pain management in an outpatient Internal Medicine clinic staffed by resident physicians. The target population for this single-center prospective cohort study were military beneficiaries at a medical treatment facility located at the Wright-Patterson Air Force Base. Participants who met inclusion criteria were treated with BFA in addition to routine standard care for pain (n = 69). The control group was composed of participants who received routine standard care only without BFA (n = 27). Pain was assessed by a self-reported pain scale (0–10) at the time of encounter, immediately after BFA (for the intervention group), then at 24 and 48 h afterwards. Results: Mean pain for the intervention group decreased from 5.45 before BFA to 3.29 immediately following BFA to 2.21 at 24 h and to 2.10 at 48 h (p < 0.001). Thus, at all three post-treatment time points, mean decrease in pain surpassed a two-point reduction, deemed to be a clinically important difference. The BFA group had a greater reduction in pain compared to the no intervention group at 24 h (3.14 vs 0.59, p < 0.001) and at 48 h (3.26 vs 0.96, p < 0.001). Four intervention group participants (6%) reported an adverse reaction (three with pain at the insertion site) or complication (one with superficial infection). Conclusion: BFA provided by Internal Medicine residents appears to be a safe and effective adjunct therapy for pain management in an outpatient setting, but requires further validation by randomized controlled trials.

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“…This finding was somewhat unexpected given the number of positive results from prior meta‐analyses, 5,6 and recent BFA RCTs on postoperative pain 23–25 . There are potential explanations for the absence of a significant analgesic effect.…”

Section: Discussionmentioning

confidence: 94%

Battlefield acupuncture added no benefit as an adjunct analgesic in emergency department for abdominal, low back or limb trauma pain

Jan

Aldridge

Visser

et al. 2020

Emerg Medicine Australasia

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Objectives To ascertain whether ear acupuncture (modified Battlefield technique) as an adjunct (Adj‐BFA) to standard analgesia care (SAC) significantly reduces pain scores compared with sham acupuncture (Adj‐Sham) or SAC alone, when delivered by medical and nursing practitioners in an ED. Methods A randomised controlled trial using a convenience sample of 90 patients attending an ED with acute abdominal, limb trauma or low back pain were allocated to three treatment arms: Adj‐BFA, Adj‐Sham and SAC. The primary outcome of change in pain scores out‐of‐10 (NPRS‐10) from triage were assessed immediately after intervention and at 1 and 2 h post‐intervention. Secondary outcomes were the percentage of patients reporting ‘adequate analgesia’ or ≥30% reduction in pain score, analgesic medication use (in morphine equivalent dose [milligrammes]), analgesics and needle costs (Australian dollars), adverse effects and patient satisfaction (Likert scale). Results There was no significant difference in pain scores (P = 0.582) or secondary outcomes measures between Adj‐BFA, Adj‐Sham and SAC. Conclusion The present study on 90 patients did not show a significant difference in analgesia outcomes in the first 2 h using Adj‐BFA for acute pain in the ED, and there were no significant differences for secondary outcomes between treatment arms. Given the mixed results of recent BFA trials, further research using the original BFA technique on different painful conditions, as either stand‐alone or as‐adjunct to non‐opioid analgesia are needed before BFA can be recommended as a technique for acute pain management in the ED.

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Auricular acupuncture for adult tonsillectomy

Cited by 13 publications

References 18 publications

PROSPECT guideline for tonsillectomy: systematic review and procedure‐specific postoperative pain management recommendations

PROSPECT guideline for tonsillectomy: systematic review and procedure‐specific postoperative pain management recommendations

Battlefield acupuncture appears to be an effective therapy for pain management

Battlefield acupuncture added no benefit as an adjunct analgesic in emergency department for abdominal, low back or limb trauma pain

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