Analgesic Effect of Electroacupuncture in Postthoracotomy Pain: A Prospective Randomized Trial

doi:10.1016/j.athoracsur.2005.12.064

The Annals of Thoracic Surgery

Volume 81, Issue 6, June 2006, Pages 2031-2036

https://doi.org/10.1016/j.athoracsur.2005.12.064 Get rights and content

Background

The role of electroacupuncture in postthoracotomy pain control is uncertain. We conducted a pilot study to evaluate the role of electroacupuncture in the management of early postthoracotomy wound pain.

Methods

A total of 27 patients with operable non–small cell lung carcinoma who received thoracotomy were recruited and randomized to receive either electroacupuncture or sham acupuncture in addition to routine oral analgesics and patient-controlled intravenous analgesia for postoperative pain control. All patients received acupuncture twice daily with visual analog pain score recorded for the first 7 postoperative days. Specific chest acupoints (LI 4, GB 34, GB 36, and TE 8) were targeted. Patient-controlled analgesia was used for the first 3 postoperative days in all patients, and the cumulative dosage used was recorded.

Results

Two patients were excluded after randomization because of complications unrelated to acupuncture. Interventions and data collection were completed for the remaining 25 patients (13 in the electroacupuncture group; 12 in the sham acupuncture group). There was a trend for lower visual analog scale pain scores in the electro-acupuncture group between postoperative days 2 and 6, although this did not reach statistical significance. The cumulative dose of patient-controlled analgesia morphine used on postoperative day 2 was significantly lower in the electroacupuncture group (7.5 ± 5 mg versus 15.6 ± 12 mg; p < 0.05). Such delay of onset of pain control may be related to the frequency of electroacupuncture used.

Conclusions

Electroacupuncture may reduce narcotic analgesic usage in the early postoperative period. A prospective randomized controlled trial using different electroacupuncture frequency is warranted to verify this benefit.

Section snippets

Patient Selection and Surgical Protocol

The study design was a randomized, double-blind, placebo-controlled trial conducted at the Cardiothoracic Surgical Unit of a tertiary referral university-teaching hospital in Hong Kong. Patients diagnosed to have operable non–small cell lung carcinoma, and whose primary tumor was equal or larger than 4 cm in diameter precluding a video-assisted thoracic surgery approach, were eligible for study. From January 2002 to August 2004, 32 consecutive patients referred to our unit for operable lung

Results

Subjects were recruited from January 2002 to August 2004. A total of 153 patients were screened, and 27 (17.6%) were enrolled. Two patients were subsequently excluded from the study because of postoperative complications unrelated to acupuncture: one patient experienced respiratory failure requiring ventilatory support and the other had gastrointestinal bleeding necessitating endoscopic intervention. Of the 25 remaining patients, 13 were in the EA group and 12 in the SA group. The flowchart of

Comment

There have been an increasing number of randomized controlled trials studying the role of acupuncture in chronic pain management in recent years. The possible mechanisms of action include activation of various endogenous opioid-related pain-inhibiting pathways by means of stimulation of peripheral nerve fibers, activation of the dorsolateral prefrontal cortex, profound alteration of local hemodynamics in the state of De-Qi, and activation of the diffuse noxious inhibitory controls system in

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Original articleGeneral thoracicAnalgesic Effect of Electroacupuncture in Postthoracotomy Pain: A Prospective Randomized Trial

Background

Methods

Results

Conclusions

Section snippets

Patient Selection and Surgical Protocol

Results

Comment

J Craniomaxillofac Surg

Pain

Pain

Pain

Med Hypotheses

Neuroscience

Neuroimage

Neuroscience

Original article
General thoracic
Analgesic Effect of Electroacupuncture in Postthoracotomy Pain: A Prospective Randomized Trial