Auricular Acupuncture for Pain Relief after Ambulatory Knee Arthroscopy—A Pilot Study

Usichenko, Taras; Hermsen, M.; Witstruck, T.; Hofer, André; Pavlović, Dragan; Lehmann, Christian; Feyerherd, F

doi:10.1093/ecam/neh097

Cited by 56 publications

(53 citation statements)

References 24 publications

(19 reference statements)

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“…8,12 Interestingly, in our pilot study 12 the ibuprofen requirement in both groups was higher than in the present investigation, probably because of a higher rate of painful arthroscopic procedures. A potentially painful lateral release procedure was performed in 7 (39%) of 18 patients in the pilot study 12 but only 22 (18%) of 120 in the present investigation. The withdrawal rate of 12% in the present study can be explained by the time of randomization, before general anesthesia.…”

Section: Discussioncontrasting

confidence: 53%

“…This rate is at the lower limit of the withdrawal rates for other acupuncture studies for postoperative pain relief (11% to 25%). 12,13,17 To avoid dropouts due to change in type of surgery, it would be expedient to perform randomization after the surgical procedure, in the recovery room. However, we chose not to perform acupuncture after surgery, because of experimental and clinical reports indicating that administration of anesthetic before acupuncture weakens or annuls the effects of acupuncture.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, after refining the methodology in a pilot study, 12 we performed a randomized controlled trial to compare the postoperative analgesic effect of auricular acupuncture with invasive needle control in patients after ambulatory knee surgery.…”

Section: 11mentioning

confidence: 99%

“…Total intravenous anesthesia was performed according to a previously described standardized protocol, 12 with monitoring of the depth of anesthesia (specifically, the bispectral index and core temperature). Incremental boluses of the weak opioid agonist piritramide (0.02 mg/kg) were administered in the anesthesia recovery room to keep the patients' reported pain intensity at less than 40 mm on a 100-mm visual analogue scale (VAS-100, where 0 = no pain and 100 = worst pain imaginable).…”

Section: 13mentioning

confidence: 99%

“…The sample size was estimated to detect a 30% difference in postoperative ibuprofen requirement, using data from the pilot study. 12 The sample size of 46 patients for each of the 2 groups was calculated to provide 90% power with α = 0.05. Anticipating a dropout rate of 15%, we adjusted the sample size to 60 patients per group.…”

Section: 13mentioning

confidence: 99%

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Auricular acupuncture for pain relief after ambulatory knee surgery: a randomized trial

Usichenko¹,

Kuchling²,

Witstruck³

et al. 2007

Canadian Medical Association Journal

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A lmost 70% of operative procedures in North America are currently performed in an ambulatory setting.1 Despite advances in surgical techniques and modern methods of analgesia, 45% of patients suffer pain at home after ambulatory surgery, 2 and moderate to severe pain intensity at home is reported by 30% of ambulatory patients.3 Inadequate relief of pain after ambulatory surgery increases morbidity and health care costs and reduces patients' quality of life.4,5 To improve postoperative pain relief, an integrative approach combining pharmacologic methods and various complementary nonpharmacologic analgesic techniques has been recommended.6 Auricular acupuncture holds promise, as it is an easily performed technique that might be effective for treatment of both preoperative anxiety and postoperative pain in patients undergoing ambulatory surgery.7,8 However, there are reasonable doubts in the scientific community concerning the specificity of acupuncture, 9 because the large randomized trials on auricular acupuncture for treatment of cocaine and alcohol dependence have found no difference between treatment and invasive needle control. 10,11Thus, after refining the methodology in a pilot study, 12 we performed a randomized controlled trial to compare the postoperative analgesic effect of auricular acupuncture with invasive needle control in patients after ambulatory knee surgery. MethodsThis prospective, patient-and evaluator-blinded, controlled study was performed between August 2003 and September 2004 at the Ambulatory Orthopedic Surgery Center of the Ernst Moritz Arndt University, Greifswald, Germany. The study was approved by the university's ethics committee. Consecutive patients scheduled for arthroscopic ambulatory knee surgery under general anesthesia (without premedication) were enrolled in the study. Exclusion criteria were age younger than 18 years or older than 70 years; American Society of Anesthesiologists physical status III (severe systemic disease with functional limitation); history of opioid, sedative or hypnotic medication or excess alcohol use; inability to understand the consent form or how to use a visual analogue scale for pain measurement; local auricular infection or significant auricular deformation; or presence of prosthetic cardiac valves. Patients were withdrawn from the study if it was necessary to change the perioperative analgesia scheme, if the arthroscopic procedure was turned into open knee surgery or if the patient was unexpectedly admitted to hospital after the procedure.On the day before surgery the patients were told that they would receive auricular acupuncture at specific points or Auricular acupuncture for pain relief after ambulatory knee surgery: a randomized trial Background: Auricular acupuncture is a promising method for postoperative pain relief. However, there is no evidence for its use after ambulatory surgery. Our aim was to test whether auricular acupuncture is better than invasive needle control for complementary analgesia after ambulatory knee surgery. Methods:O...

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Section: Discussioncontrasting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: 11mentioning

confidence: 99%

Section: 13mentioning

confidence: 99%

Section: 13mentioning

confidence: 99%

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Auricular acupuncture for pain relief after ambulatory knee surgery: a randomized trial

Usichenko¹,

Kuchling²,

Witstruck³

et al. 2007

Canadian Medical Association Journal

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Acupuncture for Chronic Radiation-Induced Xerostomia in Head and Neck Cancer

Cohen,

Danhauer,

Garcia

et al. 2024

JAMA Netw Open

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ImportancePatients with head and neck cancer who undergo radiotherapy can develop chronic radiation-induced xerostomia. Prior acupuncture studies were single center and rated as having high risk of bias, making it difficult to know the benefits of acupuncture for treating radiation-induced xerostomia.ObjectiveTo compare true acupuncture (TA), sham acupuncture (SA), and standard oral hygiene (SOH) for treating radiation-induced xerostomia.Design, Setting, and ParticipantsA randomized, blinded, 3-arm, placebo-controlled trial was conducted between July 29, 2013, and June 9, 2021. Data analysis was performed from March 9, 2022, through May 17, 2023. Patients reporting grade 2 or 3 radiation-induced xerostomia 12 months or more postradiotherapy for head and neck cancer were recruited from community-based cancer centers across the US that were part of the Wake Forest National Cancer Institute Community Oncology Research Program Research Base. Participants had received bilateral radiotherapy with no history of xerostomia.InterventionsParticipants received SOH and were randomized to TA, SA, or SOH only. Participants in the TA and SA cohorts were treated 2 times per week for 4 weeks. Those experiencing a minor response received another 4 weeks of treatment.Main Outcomes and MeasuresPatient-reported outcomes for xerostomia (Xerostomia Questionnaire, primary outcome) and quality of life (Functional Assessment of Cancer Therapy–General) were collected at baseline, 4 (primary time point), 8, 12, and 26 weeks. All analyses were intention to treat.ResultsA total of 258 patients (201 men [77.9%]; mean [SD] age, 65.0 [9.16] years), participated from 33 sites across 13 states. Overall, 86 patients were assigned to each study arm. Mean (SD) years from diagnosis was 4.21 (3.74) years, 67.1% (n = 173) had stage IV disease. At week 4, Xerostomia Questionnaire scores revealed significant between-group differences, with lower Xerostomia Questionnaire scores with TA vs SOH (TA: 50.6; SOH: 57.3; difference, −6.67; 95% CI, −11.08 to −2.27; P = .003), and differences between TA and SA (TA: 50.6; SA: 55.0; difference, −4.41; 95% CI, −8.62 to −0.19; P = .04) yet did not reach statistical significance after adjustment for multiple comparisons. There was no significant difference between SA and SOH. Group differences in Functional Assessment of Cancer Therapy–General scores revealed statistically significant group differences at week 4, with higher scores with TA vs SOH (TA: 101.6; SOH: 97.7; difference, 3.91; 95% CI, 1.43-6.38; P = .002) and at week 12, with higher scores with TA vs SA (TA: 102.1; SA: 98.4; difference, 3.64; 95% CI, 1.10-6.18; P = .005) and TA vs SOH (TA: 102.1; SOH: 97.4; difference, 4.61; 95% CI, 1.99-7.23; P = .001).Conclusions and RelevanceThe findings of this trial suggest that TA was more effective in treating chronic radiation-induced xerostomia 1 or more years after the end of radiotherapy than SA or SOH.Trial RegistrationClinicalTrials.gov Identifier: NCT02589938

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The thoracic spine

Longbottom¹

2010

Acupuncture in Manual Therapy

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Auricular Acupuncture for Pain Relief after Ambulatory Knee Arthroscopy—A Pilot Study

Cited by 56 publications

References 24 publications

Auricular acupuncture for pain relief after ambulatory knee surgery: a randomized trial

Auricular acupuncture for pain relief after ambulatory knee surgery: a randomized trial

Acupuncture for Chronic Radiation-Induced Xerostomia in Head and Neck Cancer

The thoracic spine

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