Effectiveness of Acupuncture for Pain Control After Cesarean Delivery

Abstract

IMPORTANCE A pharmacological approach to pain control after cesarean delivery is often insufficient on its own. Acupuncture is a promising method for mitigating postoperative pain and reducing postoperative opioid requirements. OBJECTIVE To evaluate the efficacy and effectiveness of acupuncture as an adjunctive therapy for pain control after cesarean delivery, compared with a placebo intervention and standard care alone. DESIGN, SETTING, AND PARTICIPANTSThis single-center, placebo-controlled, patient-and assessor-blinded randomized clinical trial was conducted from January 13, 2015, to June 27, 2018, at a tertiary university hospital in Greifswald, Germany. Participants were women who were scheduled for elective cesarean delivery under spinal anesthesia and were randomized to either the acupuncture group (n = 60) or placebo group (n = 60). Another 60 consecutive patients who met the eligibility criteria and received the standard postoperative analgesia were selected to form a nonrandomized standard care group. The intention-to-treat analysis was performed from August 19, 2019, to September 13, 2019. INTERVENTIONSIn addition to standard pain treatment, each patient in the acupuncture group received auricular and body acupuncture with indwelling intradermal needles, whereas patients in the placebo group were treated with nonpenetrating placebo needles. MAIN OUTCOMES AND MEASURESThe primary outcome was pain intensity on movement, which was measured using an 11-item verbal rating scale. Secondary outcomes were analgesia-related adverse effects, analgesics consumption, time to mobilization and Foley catheter removal, quality of patient blinding to randomization, and patient satisfaction with treatment of pain. RESULTSA total of 180 female patients (mean [SD] age, 31 [5] years) were included in the intentionto-treat analysis. The mean pain intensity on movement in the acupuncture group on the first postoperative day was lower than in the placebo group (4.7 [1.8] vs 6.0 [2.0] points; Cohen d, 0.73; 95% CI, 0.31-1.01; P = .001) and the standard care group (6.3 [1.3] points; Cohen d, 1.01; 95% CI, 0.63-1.40; P < .001). On the first postoperative day, 59 patients (98%) in the acupuncture group were fully mobilized vs 49 patients (83%) in the placebo group (relative risk [RR], 1.18; 95% CI, 1.06-1.33; P = .01) and 35 patients (58%) in the standard care group (RR, 1.69; 95% CI, 1.36-2.09; P < .001). The Foley catheter was removed in a total of 57 patients (93%) from the acupuncture group vs 43 patients (72%) from the placebo group (RR, 1.33; 95% CI, 1.12-1.57; P = .003) and 42 patients (70%) from the standard care group (RR, 1.37; 95% CI, 1.14-1.62; P = .002). Other parameters were comparable across the 3 study groups.

Behandlung einer Plantarfasziitis mit Akupunktur

“…Die Anwendung von Dauernadeln wird in letzter Zeit für die Behandlung von situativer Angst und akuter postoperativer Schmerzen favorisiert 8 9 . Das Konzept der Dauerstimulation peripherer sensorischer und vegetativer Afferenzen durch intradermale Dauernadeln (bei der Körperakupunktur) und kranialer Nerven inkl.…”

The Application of Acupuncture Therapy for Postoperative Pain Over the Past 20 Years: A Bibliometric Analysis

“…22 Another RCT also found that acupuncture therapy was safe and effective in the management of post-cesarean pain. 23 Bibliometric analysis is a method for evaluating and quantifying literature information using mathematical and statistical methods, 24 which can help to recognize the research advances in a specific field of science comprehensively. 25 This analytical method has been applied to many areas with a large body of research accumulated, including pain management.…”

“… 22 Another RCT also found that acupuncture therapy was safe and effective in the management of post-cesarean pain. 23 …”

Effectiveness of acupuncture for pain control after Cesarean section is associated with the length of experience of the acupuncturist: observational data from a randomized clinical trial

“…In a recent randomized controlled investigation, acupuncture with indwelling intradermal needles reduced pain and accelerated mobilization in patients undergoing elective Cesarean section (CS). 1 In this investigation, acupuncture administered bilaterally at four traditional auricular acupuncture (AA) point locations and six traditional acupuncture point locations of the body (n = 60) was compared with placebo acupuncture (n = 60) at the same sites using non-penetrating placebo devices. 2 Both study interventions (acupuncture and the placebo procedure) were provided by three physicians— C.K.…”