Prehospital Analgesia with Acupressure in Victims of Minor Trauma: A Prospective, Randomized, Double-Blinded Trial

Kober, Alexander; Scheck, Thomas; Greher, Manfred; Lieba, Frank; Fleischhackl, Roman; Fleischhackl, Sabine; Randunsky, Frederick; Hoerauf, Klaus

doi:10.1097/00000539-200209000-00035

Cited by 39 publications

(38 citation statements)

References 15 publications

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“…Although some studies had methodological flaws, studies consistently show that acupressure is more effective than control for reducing pain, namely dysmenorrhoea (acupressure at SP6) [9,28-30], lower back pain [31-33] and labour pain [34,35]. The evidence for minor trauma [36,37] and injection pain [38,39] is less conclusive and the evidence for headache is insufficient [40]. Each pain condition is discussed below.…”

Section: Resultsmentioning

confidence: 99%

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The evidence for Shiatsu: a systematic review of Shiatsu and acupressure

Robinson

Lorenc

Liao

2011

BMC Complement Altern Med

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BackgroundShiatsu, similar to acupressure, uses finger pressure, manipulations and stretches, along Traditional Chinese Medicine meridians. Shiatsu is popular in Europe, but lacks reviews on its evidence-base. MethodsAcupressure and Shiatsu clinical trials were identified using the MeSH term 'acupressure' in: EBM reviews; AMED; BNI; CINAHL; EMBASE; MEDLINE; PsycARTICLES; Science Direct; Blackwell Synergy; Ingenta Select; Wiley Interscience; Index to Theses and ZETOC. References of articles were checked. Inclusion criteria were Shiatsu or acupressure administered manually/bodily, published after January 1990. Two reviewers performed independent study selection and evaluation of study design and reporting, using standardised checklists (CONSORT, TREND, CASP and STRICTA).ResultsSearches identified 1714 publications. Final inclusions were 9 Shiatsu and 71 acupressure studies. A quarter were graded A (highest quality). Shiatsu studies comprised 1 RCT, three controlled non-randomised, one within-subjects, one observational and 3 uncontrolled studies investigating mental and physical health issues. Evidence was of insufficient quantity and quality. Acupressure studies included 2 meta-analyses, 6 systematic reviews and 39 RCTs. Strongest evidence was for pain (particularly dysmenorrhoea, lower back and labour), post-operative nausea and vomiting. Additionally quality evidence found improvements in sleep in institutionalised elderly. Variable/poor quality evidence existed for renal disease symptoms, dementia, stress, anxiety and respiratory conditions. Appraisal tools may be inappropriate for some study designs. Potential biases included focus on UK/USA databases, limited grey literature, and exclusion of qualitative and pre-1989 studies. ConclusionsEvidence is improving in quantity, quality and reporting, but more research is needed, particularly for Shiatsu, where evidence is poor. Acupressure may be beneficial for pain, nausea and vomiting and sleep.

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Section: Resultsmentioning

confidence: 99%

“…Two double-blind RCTs evaluated acupressure for minor trauma pain during ambulance transport [36,37]. Both used sham acupressure as a control, with Kober et al [36] additionally comparing to no treatment.…”

Section: Resultsmentioning

confidence: 99%

The evidence for Shiatsu: a systematic review of Shiatsu and acupressure

Robinson

Lorenc

Liao

2011

BMC Complement Altern Med

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“…The combination of multiple acupressure points was shown to be beneficial for ventilator-induced anxiety and dyspnoea [22], for prehospital analgesia in patients with radial fractures [25] and for prehospital analgesia in patients with minor trauma [26]. …”

Section: Discussionmentioning

confidence: 99%

Randomized trial of acupressure to improve patient satisfaction and quality of recovery in hospitalized patients: study protocol for a randomized controlled trial

Noll

Shodhan

Madariaga

et al. 2017

Trials

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BackgroundAcupressure therapy may be potentially beneficial in improving postoperative symptoms like postoperative nausea and vomiting (PONV), pain and sleep disorder and improving postoperative quality of recovery. The primary aim of this study is to investigate the efficacy of acupressure therapy on postoperative patient satisfaction and quality of recovery in hospitalized patients after surgical treatment.Methods/designThis three-group, parallel, superiority, blinded, randomized controlled trial will test the hypothesis that a combination of PC6, LI4 and HT7 acupressure is superior to sham or no intervention for improving postoperative quality of recovery in hospitalized patients. A minimum of 150 patients will be randomly allocated to one of the three experimental groups: control (no visit), light touch (sham acupressure) or active acupressure therapy in a 1:1:1 ratio. Interventions will be performed three times a day for 2 days. Patient satisfaction, quality of recovery, PONV and pain will be measured during the 3 days following randomization. The study protocol was approved by the Stony Brook University Institutional Review Board on 21 March 2016. Written informed consent will be recorded from every consented patient.DiscussionThis study has the potential to improve the recovery of hospitalized patients by adding knowledge on the efficacy of acupressure therapy in this setting. A multipoint acupressure protocol will be compared to both a no intervention group and a light touch group, providing insight into different aspects of the placebo effect.Trial registrationClinicalTrial.gov, NCT02762435. Registered on 14 April 2016.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-017-1839-1) contains supplementary material, which is available to authorized users.

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“…21 In one study, the SDs were approximated from similar studies by the same authors under similar trial circumstances. 16,22,23 Secondary outcomes. Medication usage included opioids and nonopioids, the frequency of usage both during and post ED stay, and the rate of discharge analgesic dispensing and prescriptions.…”

Section: Data Synthesismentioning

confidence: 99%

Does Ear Acupuncture Have a Role for Pain Relief in the Emergency Setting? A Systematic Review and Meta-Analysis

Jan

Aldridge

Rogers

et al. 2017

Medical Acupuncture

111

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Objective: Ear acupuncture might be the form of acupuncture best suited to improving acute pain management in the emergency department (ED). The primary aim of this review was to assess the analgesic efficacy of ear acupuncture in the ED. Secondary outcomes included measures of patient satisfaction, adverse effects, cost, administration techniques, and reduction of medication usage. Methods: Seven databases and Google Scholar were searched up to April 27, 2017, using MeSH descriptors for three overarching themes (ear acupuncture, pain management, and emergency medicine). Meta-analyses were performed in 3 comparator groups: (1) ear acupuncture versus sham; (2) ear acupuncture-as-adjunct to standard care; and (3) ear acupuncture (both as sole therapy and adjuvant) versus control to calculate the standardized mean difference (SMD) and weighted mean difference (WMD) for pain scores out of 10. Results: Six randomized controlled trials and 2 observational studies, totaling 458 patients, were retrieved after exclusions. The meta-analysis used data from 4 randomized studies representing 286 patients. The above 3 comparator groups resulted in SMDs of 1.69, 1.68, and 1.66, and WMDs of 2.47, 2.84, and 2.61 respectively, all favoring acupuncture. Battlefield (ear) acupuncture was the most commonly used technique. There were no significant adverse effects and patient satisfaction improved. Results regarding if acupuncture reduced medication use were equivocal. Significant study bias and heterogeneity were found. Conclusions: While study numbers are limited, ear acupuncture, either as stand-alone or as-an-adjunct technique, significantly reduced pain scores and has potential benefits for use in the ED. Further studies will define acupuncture's role and if it reduces use of analgesic medications.

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Prehospital Analgesia with Acupressure in Victims of Minor Trauma: A Prospective, Randomized, Double-Blinded Trial

Abstract: We tested, in a double-blinded manner, the hypothesis that acupressure could be an effective pain therapy in minor-trauma patients. Our results show that acupressure is an effective and simple-to-learn treatment of pain in emergency medical care and can improve the quality of care.

Cited by 39 publications

References 15 publications

The evidence for Shiatsu: a systematic review of Shiatsu and acupressure

The evidence for Shiatsu: a systematic review of Shiatsu and acupressure

Randomized trial of acupressure to improve patient satisfaction and quality of recovery in hospitalized patients: study protocol for a randomized controlled trial

Does Ear Acupuncture Have a Role for Pain Relief in the Emergency Setting? A Systematic Review and Meta-Analysis

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