Skip to main content
Top
Published in: BMC Anesthesiology 1/2020

Open Access 01-12-2020 | Acupuncture | Research article

Postoperative analgesic efficacy of ear acupuncture in patients undergoing abdominal hysterectomy: a randomized controlled trial

Authors: Hamdy A. Hendawy, Mohamed E. Abuelnaga

Published in: BMC Anesthesiology | Issue 1/2020

Login to get access

Abstract

Background

Numerous studies have revealed that acupuncture can increase the somatic pain threshold. Electro-acupuncture (EA) can help pain-relieving with minimal physiologic disturbance. Various painful disorders, as well as pain following various surgeries, like cesarean section, gastrostomy, and enterectomy were managed properly with acupuncture. Therefore we studied the postoperative analgesic effect of EA in patients undergoing abdominal hysterectomy.

Methods

A randomized, prospective clinical trial study was carried out on 56 women undergoing hysterectomy under spinal anesthesia. Patients were allocated randomly to receive either spinal anesthesia and electric ear acupuncture (EEA group) or spinal anesthesia alone (control group). EEA was done by fine needles to anatomically defined 4 points of the ear: Shen Men Point, thalamus Point 26, Analgesia Point 3, and Uterus Point 58, and connected to EA therapeutic apparatus. After finishing surgery, the fine needles were substituted by permanent press needles to be removed after 24 hours. The primary outcome was the postoperative 24 h morphine consumption by patient-controlled analgesia, while secondary outcomes included Post-operative pain scores and postoperative 1st request of analgesia.

Results

Total morphine consumption in the first 24 postoperative hours was obviously reduced in the EEA group versus the control group (mean ± SD:6.214± 2.1319 mg vs 15.714 ± 3.3428 mg, d = − 3.3886, 95% Confidence interval = − 4.2061,-2.5712, p-value =0.000). The postoperative pain scores were significantly reduced in the EEA group in comparison to the control group, with delayed 1st request of postoperative analgesia.

Conclusions

Electric ear acupuncture provides postoperative analgesia, reducing morphine requirement and consequently its side effects.

Trial registration

The trial was registered before enrolment of the first patient at the Pan African Clinical Trial Registry (www.​pactr.​org) database (PACTR20190377060​7799, Date of registration: 5th March 2019).
Literature
2.
go back to reference Taguchi R. Acupuncture anesthesia and analgesia for clinical acute pain in Japan. Evid Based Complement Alternat Med. 2008;5:153–8.CrossRefPubMed Taguchi R. Acupuncture anesthesia and analgesia for clinical acute pain in Japan. Evid Based Complement Alternat Med. 2008;5:153–8.CrossRefPubMed
3.
go back to reference Inoue M, Kitakoji H, Yano T, Ishizaki N, Itoi M, Katsumi Y. Acupuncture treatment for low back pain and lower limb symptoms the relation between acupuncture or electroacupuncture stimulation and sciatic nerve blood flow, Evid Based Complement Alternat Med. 2008;5:133–43. Inoue M, Kitakoji H, Yano T, Ishizaki N, Itoi M, Katsumi Y. Acupuncture treatment for low back pain and lower limb symptoms the relation between acupuncture or electroacupuncture stimulation and sciatic nerve blood flow, Evid Based Complement Alternat Med. 2008;5:133–43.
4.
go back to reference Chen CL. Traditional Chinese veterinary medicine. Chin Agric Encyclopedia. 1991:57–8. Chen CL. Traditional Chinese veterinary medicine. Chin Agric Encyclopedia. 1991:57–8.
5.
go back to reference Hyodo M, Nakamura N, Yukimati T, Sugasawa T, Oki J. The experience of acupuncture anesthesia. Jap J Anesthesiol. 1973;22:251–8. Hyodo M, Nakamura N, Yukimati T, Sugasawa T, Oki J. The experience of acupuncture anesthesia. Jap J Anesthesiol. 1973;22:251–8.
6.
go back to reference Kitade T, Hyodo M. The effects of stimulation of ear acupuncture points on the body's pain threshold. Am J Chin Med. 1979;7:241–52.CrossRefPubMed Kitade T, Hyodo M. The effects of stimulation of ear acupuncture points on the body's pain threshold. Am J Chin Med. 1979;7:241–52.CrossRefPubMed
7.
go back to reference Vadivelu N, Mitra S, Narayan D. Recent advances in postoperative pain management. Yale J Biol Med. 2010;83:11. Vadivelu N, Mitra S, Narayan D. Recent advances in postoperative pain management. Yale J Biol Med. 2010;83:11.
8.
go back to reference Rubach A. Principles of ear acupuncture—microsystem of the auricle, hippokrates; 2001. Rubach A. Principles of ear acupuncture—microsystem of the auricle, hippokrates; 2001.
9.
go back to reference Lin JG, Lo MW, Wen YR, Hsieh CL, Tsai SK, Sun WZ. The effect of high and low frequency electroacupuncture in pain after lower abdominal surgery. Pain. 2002;99:509–14.CrossRefPubMed Lin JG, Lo MW, Wen YR, Hsieh CL, Tsai SK, Sun WZ. The effect of high and low frequency electroacupuncture in pain after lower abdominal surgery. Pain. 2002;99:509–14.CrossRefPubMed
10.
go back to reference Kim KS, Nam YM. The analgesic effects of capsicum plaster at the Zusanli point after abdominal hysterectomy. Anesth Analg. 2006;103:709–13.CrossRefPubMed Kim KS, Nam YM. The analgesic effects of capsicum plaster at the Zusanli point after abdominal hysterectomy. Anesth Analg. 2006;103:709–13.CrossRefPubMed
11.
go back to reference Sim CK, Xu PC, Pua HL, Zhang G, Lee TL. Effects of electroacupuncture on intraoperative and postoperative analgesic requirement. Acupunct Med. 2002;20:56–65.CrossRefPubMed Sim CK, Xu PC, Pua HL, Zhang G, Lee TL. Effects of electroacupuncture on intraoperative and postoperative analgesic requirement. Acupunct Med. 2002;20:56–65.CrossRefPubMed
12.
go back to reference Chen L, Tang J, White PF. The effect of location of transcutaneous electrical nerve stimulation on postoperative opioid analgesic requirement: acupoint versus nonacupoint stimulation. Anesth Analg. 1998;87:1129–34.PubMed Chen L, Tang J, White PF. The effect of location of transcutaneous electrical nerve stimulation on postoperative opioid analgesic requirement: acupoint versus nonacupoint stimulation. Anesth Analg. 1998;87:1129–34.PubMed
13.
go back to reference Tsang HC, Lam CS, Chu PW, Yap J, Fung TY, Cheing GL. A randomized controlled trial of auricular transcutaneous electrical nerve stimulation for managing posthysterectomy pain. Evid Based Complement Alternat Med. 2011:1–9. Tsang HC, Lam CS, Chu PW, Yap J, Fung TY, Cheing GL. A randomized controlled trial of auricular transcutaneous electrical nerve stimulation for managing posthysterectomy pain. Evid Based Complement Alternat Med. 2011:1–9.
14.
go back to reference Wilson DB. Practical meta-analysis effect size calculator 2016. URL: http://www.Campbellcollaboration org/escalc/HTML/EffectSizeCalculator-SMD1 PHP [accessed 2020-04-25] [WebCite Cache ID 6MqcuP70x]. Wilson DB. Practical meta-analysis effect size calculator 2016. URL: http://​www.​Campbellcollabor​ation org/escalc/HTML/EffectSizeCalculator-SMD1 PHP [accessed 2020-04-25] [WebCite Cache ID 6MqcuP70x].
15.
go back to reference Wu H, Liu YC, Ou KL, Chang YH, Hsieh CL, HCT A, et al. Effects of acupuncture on post-cesarean section pain. Chin Med J. 2009;122:1743–8.PubMed Wu H, Liu YC, Ou KL, Chang YH, Hsieh CL, HCT A, et al. Effects of acupuncture on post-cesarean section pain. Chin Med J. 2009;122:1743–8.PubMed
16.
go back to reference Ishimaru K, Shinohara S, Kitade T, Morioka T, Kudou D, Umeki N. Effect on pain threshold of low frequency electrical acupuncture and silver spike point electrical stimulation. Meiji Shinkyu Igaku. 1990;6:61–7. Ishimaru K, Shinohara S, Kitade T, Morioka T, Kudou D, Umeki N. Effect on pain threshold of low frequency electrical acupuncture and silver spike point electrical stimulation. Meiji Shinkyu Igaku. 1990;6:61–7.
17.
go back to reference Ishimaru K, Shinohara S, Iwa M, Kawakita K, Higuchi J, Watanabe S. Effects of electrical acupuncture on deep pain threshold in human subjects. Meiji Shinkyu Igaku. 1991;8:27–33. Ishimaru K, Shinohara S, Iwa M, Kawakita K, Higuchi J, Watanabe S. Effects of electrical acupuncture on deep pain threshold in human subjects. Meiji Shinkyu Igaku. 1991;8:27–33.
18.
go back to reference Ishimaru K, Kawakita K, Sakita M. Analgesic effects induced by TENS and electroacupuncture with different types of stimulating electrodes on deep tissues in human subjects. Pain. 1995;63:181–7.CrossRefPubMed Ishimaru K, Kawakita K, Sakita M. Analgesic effects induced by TENS and electroacupuncture with different types of stimulating electrodes on deep tissues in human subjects. Pain. 1995;63:181–7.CrossRefPubMed
19.
go back to reference Kitade T, Minamikawa M, Hyodo M, Nakao K, Oki S, Imura H. β-Endorphin and ACTH concentrations in plasma and cerebrospinal fluid during acupuncture analgesia in human subjects. Orient Med Pain Clinic. 1980;10:116–20. Kitade T, Minamikawa M, Hyodo M, Nakao K, Oki S, Imura H. β-Endorphin and ACTH concentrations in plasma and cerebrospinal fluid during acupuncture analgesia in human subjects. Orient Med Pain Clinic. 1980;10:116–20.
20.
go back to reference Ishimaru K, Sekido R, Sakita M. Association between endogenous analgesia and meridians in LI4 (Hegu, Gokoku) point electro-acupuncture. J Jap Soc Acupunct Moxibust. 2003;53:184–9. Ishimaru K, Sekido R, Sakita M. Association between endogenous analgesia and meridians in LI4 (Hegu, Gokoku) point electro-acupuncture. J Jap Soc Acupunct Moxibust. 2003;53:184–9.
21.
go back to reference Ishimaru K. Effects of acupuncture analgesia on postoperative pain after abdominal surgery and the relationship of endogenous analgesic substances. Meiji Shinkyu Igaku. 2000;26:11–22. Ishimaru K. Effects of acupuncture analgesia on postoperative pain after abdominal surgery and the relationship of endogenous analgesic substances. Meiji Shinkyu Igaku. 2000;26:11–22.
22.
go back to reference Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012;172:1444–53.CrossRefPubMedPubMedCentral Vickers AJ, Cronin AM, Maschino AC, Lewith G, MacPherson H, Foster NE. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012;172:1444–53.CrossRefPubMedPubMedCentral
23.
go back to reference De Freitas ATG, Lemonica L, De Faveri J, Pereira S, Henao MDB. Preemptive analgesia with acupuncture monitored by c-Fos expression in rats. J Acupunct Meridian Stud. 2016;9(1):16–21.CrossRef De Freitas ATG, Lemonica L, De Faveri J, Pereira S, Henao MDB. Preemptive analgesia with acupuncture monitored by c-Fos expression in rats. J Acupunct Meridian Stud. 2016;9(1):16–21.CrossRef
24.
go back to reference Iacobone M, Citton M, Zanella S, Scarpa M, Pagura G, Tropea S, et al. The effects of acupuncture after thyroid surgery: a randomized controlled trial. Surgery. 2014;156:1605–13.CrossRefPubMed Iacobone M, Citton M, Zanella S, Scarpa M, Pagura G, Tropea S, et al. The effects of acupuncture after thyroid surgery: a randomized controlled trial. Surgery. 2014;156:1605–13.CrossRefPubMed
25.
go back to reference Chen CC, Yang CC, Hu CC, Shih HN, Chang YH, Hsieh PH. Acupuncture for pain relief after total knee arthroplasty: a randomized controlled trial. Reg Anesth Pain Med. 2015;40:31–6.CrossRefPubMed Chen CC, Yang CC, Hu CC, Shih HN, Chang YH, Hsieh PH. Acupuncture for pain relief after total knee arthroplasty: a randomized controlled trial. Reg Anesth Pain Med. 2015;40:31–6.CrossRefPubMed
26.
go back to reference Dingemann J, Plewig B, Baumann I, Plinkert PK, Sertel S. Acupuncture in post-tonsillectomy pain. Hno. 2017;65:73–9.CrossRefPubMed Dingemann J, Plewig B, Baumann I, Plinkert PK, Sertel S. Acupuncture in post-tonsillectomy pain. Hno. 2017;65:73–9.CrossRefPubMed
27.
go back to reference Usichenko T, Dinse M, Hermsen M, Witstruck T, Pavlovic D, Lehmann C. Auricular acupuncture for pain relief after total hip arthroplasty–a randomized controlled study. Pain. 2005;114:320–7.CrossRefPubMed Usichenko T, Dinse M, Hermsen M, Witstruck T, Pavlovic D, Lehmann C. Auricular acupuncture for pain relief after total hip arthroplasty–a randomized controlled study. Pain. 2005;114:320–7.CrossRefPubMed
28.
go back to reference Chang L, Hsu CH, Jong GP, Ho S, Tsay SL, Lin KC. Auricular acupressure for managing postoperative pain and knee motion in patients with total knee replacement:a randomized sham control study. Evid Based Complement Alternat Med. 2012;2012:1–7. Chang L, Hsu CH, Jong GP, Ho S, Tsay SL, Lin KC. Auricular acupressure for managing postoperative pain and knee motion in patients with total knee replacement:a randomized sham control study. Evid Based Complement Alternat Med. 2012;2012:1–7.
Metadata
Title
Postoperative analgesic efficacy of ear acupuncture in patients undergoing abdominal hysterectomy: a randomized controlled trial
Authors
Hamdy A. Hendawy
Mohamed E. Abuelnaga
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2020
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-020-01187-4

Other articles of this Issue 1/2020

BMC Anesthesiology 1/2020 Go to the issue