Electroacupuncture for post-thoracotomy pain: A systematic review and meta-analysis

Abstract

Background Thoracotomy is an invasive surgical procedure that produces intense postoperative pain. Electroacupuncture has been used to induce analgesia in various situations, including after surgery. The aim of the following systematic review and meta-analysis was to evaluate the effect of electroacupuncture on post-thoracotomy pain. Methods The studies for the systematic review were searched using the following 9 databases: PubMed, Cochrane Library, EMBASE, MEDLINE Complete, Google Scholar, China National Knowledge Infrastructure (CNKI), Korean Medical Database (KMBASE), Koreanstudies Information Service System (KISS), and OASIS, without language restriction. Randomized controlled trials (RCTs) that met the inclusion criteria were selected. The quality assessment was performed using the Cochrane risk-of-bias tool, and RevMan 5.3 was used for meta-analysis. The review protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO) as CRD42019142157. Results Eleven randomized controlled trials were included in the systematic review. The meta-analysis was performed for two outcome measures: pain score 24 hours after surgery and total dose of opioid analgesics. A subgroup analysis was performed according to the control group: sham acupuncture and conventional analgesia group. Pain score 24 hours after surgery of electroacupuncture group showed a standard mean difference of -0.98 (95% CI: -1.62 to -0.35) compared to sham acupuncture. The standard mean difference was -0.94 (95% CI: -1.33 to -0.55) compared to conventional analgesia. The total dose of opioid analgesics of electroacupuncture group showed a standard mean difference values of -0.95 (95% CI: -1.42 to -0.47) compared to sham acupuncture. The standard mean difference was -1.96 (95% CI: -2.82 to -1.10) compared to conventional analgesia. Conclusion Current evidence suggests that electroacupuncture might provide useful pain relieving effect on post-thoracotomy patients. However, due to low quality and high heterogeneity of existing data, further rigorously designed studies should be performed to confirm the safety and efficacy.

The Use of Evidence-Based Acupuncture: Current Evidence

“…A total of 1286 articles related to eight conditions were searched (Table 1). After reviewing the abstract and full text of the article, 17 systematic reviews and meta-analyses of the six conditions that met the inclusion criteria were finally included [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29], and articles related to allergic rhinitis and chemotherapy-induced nausea and vomiting (CINV) did not meet the criteria for inclusion (Table 1).…”

“…They found that auricular acupressure plus acupuncture, acupuncture, other acupuncture techniques, and auricular acupressure were significantly superior over usual care, and auricular acupressure plus acupuncture ranked the most effective when analyzed for pain intensity, but the findings were limited by the quality of the evidence. Park et al [29] assessed the quality of evidence in RCTs comparing pain scores between the EA and the sham groups, finding low cumulative evidence certainty across all studies. A low rating was given because there was inconsistency and a high risk of bias across all studies.…”

“…A low rating was given because there was inconsistency and a high risk of bias across all studies. However, according to data synthesized from previous studies, EA demonstrated the possibility of reducing pain for patients after thoracotomy with lower amounts of opioid analgesics [29].…”

Efficacy and Safety of Electroacupuncture for Pain Control in Herpes Zoster: A Systematic Review and Meta-Analysis

“…[ 9 , 10 ] Different acupuncture methods include manual acupuncture, electroacupuncture (EA), warm needling, auricular therapy, fire needling, etc., Currently, EA is one of the most common methods for treating pain in traditional Chinese medicine hospitals and has an excellent therapeutic effect on acute and chronic pain. [ 11 – 13 ] Recent studies have shown that EA can relieve pain by activating numerous bioactive chemicals through peripheral and central mechanisms and forestall the adverse impacts of often-debilitating pharmaceuticals. [ 14 ] Over recent years, some studies have confirmed that EA effectively relieves postherpetic neuralgia.…”

Electroacupuncture for postoperative pain in mixed hemorrhoids: A meta-analysis

“…[12,13] Electroacupuncture has shown good effects in many postoperative analgesic fields, such as pain after thoracotomy, abdominal pain after intestinal obstruction, pain after total hip replacement, pain after joint replacement, et cetera. [14][15][16][17][18] This meta-analysis will investigate the efficacy of electroacupuncture for postoperative pain in mixed hemorrhoids.…”