Wrist-Ankle Acupuncture for Pain After Transcatheter Arterial Chemoembolization in Patients with Liver Cancer: A Randomized Controlled Trial

Abstract

This study was designed to evaluate the analgesic effect of wrist-ankle acupuncture (WAA) for patients with primary liver cancer (PLC) after transcatheter arterial chemoembolization (TACE). Sixty PLC patients with post-TACE visual analog pain intensity scores greater than 3 were divided equally into two groups receiving either WAA or oral morphine sulphate (MOR) for post-TACE pain. Pain intensity scores were reassessed at 1, 2, 4, and 6 h after analgesic intervention. Patients were also monitored for adverse reactions to analgesic treatment. Pain scores recorded when the patients first felt pain after TACE showed no statistical difference between the two groups (p > 0.05). WAA and MOR had indistinguishable degrees of pain relief 1, 2, and 4 h after analgesic intervention (p > 0.05). At 6 h after intervention, the WAA group experienced significantly greater pain relief than the MOR group (p < 0.05). Incidence of abdominal distension was lower in the WAA group than in the MOR group (p < 0.05). The results suggest that WAA not only had an analgesic effect equal to or greater than MOR in PLC patients with moderate to severe post-TACE pain, but also reduced the incidence of post-operative abdominal distention.

Management of Postembolization Syndrome Following Hepatic Transarterial Chemoembolization for Primary or Metastatic Liver Cancer

“…The analgesics used were IV morphine 8,15,17 and PO oxycodone 8,24 (PO morphine sulfate was used as a control). 23 Studies using PO oxycodone 8,24 after TACE reported an adequate analgesic effect, as defined within these studies. The only available placebo-controlled randomized controlled trial (RCT) 24 reported superior pain control in groups receiving PO controlledrelease oxycodone (CRO).…”

“…The duration of pain relief for the control group was 4 hours after TACE beyond which the intervention group reported superior analgesic effect. 23 In the 2 DEB-TACEYrelated studies, 15,17 IV morphine was administered 30 minutes before procedure and 6 hours after the procedure. Grades 2 and 3 RUQP was reported in both studies, and Narayanan et al 17 report modification of the pain protocol to include IV hydromorphone at increments throughout the procedure.…”

“…These findings show the analgesic benefit of WAA for post-TACE RUQP, but further research is required because the present study was limited by small sample size and the lack of an effective (sham acupuncture) control. 23 …”

Wrist-Ankle Acupuncture for Precompetition Nervous Syndrome: A Randomized Controlled Trial

“…The treatment scheme originates from the principles of WAA and has been practiced in previous clinical trials for several decades [11][12][13][14][15][16][17]. According to the theory of WAA, each side of the body and each limb are longitudinally divided into six zones, and one needling point is defined in each zone at the wrist or ankle.…”

“…No other needling sensation was found. A single registered acupuncturist, with at least 1 year of previous WAA experience, administered the care to all subjects [11,15].…”