Description The patients from the AA group received needles at 3 acupuncture points ipsilateral to the surgery site (Fig. 1): MA-AH4 (Hip), MA-TF1 (Shenmen), and MA-IC1 (Lung).
Experimental Description
One hundred and twenty patients scheduled for THA were enrolled in this patient-anesthesiologist-blinded study. The patients were randomly assigned to receive needling of specific AA points or a sham procedure (needling of 3 nonacupoints on the ear helix) ipsilateral to the surgery site.
Sample Count
120
Control
Sham
Sham acupuncture(n=60)
Experiment
auricular acupuncture(AA)(n=60)
Indicator
Fentanyl amount given during surgeryDuration of anesthesiaIncidence of intraoperative bradycardiaFrequency of hypotensive episodesIntraoperative infusion volumePostoperative piritramide time and requirementPostoperative Nausea and Vomiting(PONV)The length of recovery room stay
Auxiliary Medication
Thirty minutes before surgery, the patients were premedicated with oral midazolam (0.05 mg/kg). Anesthesia was induced intravenously with thiopental (4 to 5 mg/kg) and fentanyl (1 to 2mg/kg). Cisatracurium (0.1 mg/kg) was used to facilitate the trachea intubation. Anesthesia was maintained with volatile anesthetic desflurane (3.5 to 5.5 volume % endtidal concentration) in a 40% oxygen-air mixture to keep the values of Bispectral Index (BIS) between 40 and 55. The fentanyl was titrated to prevent spontaneous movements, mydriasis, and sweating because of painful stimuli during the surgery, and to keep the heart rate and mean arterial pressure within 20% of baseline values. The anesthesiologists were instructed to titrate fentanyl, if possible, in increment doses of 50mg. None of the patients received continuous fentanyl infusion.
Stimulation Method
MS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
-
-
-
-
-
-
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
0.22×1.5 mm
Seirin, Japan
-
Description The patients from the AA group received needles at 3 acupuncture points ipsilateral to the surgery site (Fig. 1): MA-AH4 (Hip), MA-TF1 (Shenmen), and MA-IC1 (Lung). The nonacupuncture points of the helix ipsilateral to the site of surgery were used for the sham procedure in patients from the control group. The principles for the choice and identification of AA and control points are described elsewhere in detail.5 Disposable indwelling-fixed “Pyonex” AA needles from Seirin, Japan, with a diameter of 0.22 mm and the length of 1.5 mm were used for both AA and sham procedure. The needles were fixed with skin-like colored adhesive tape and withdrawn on the day after surgery.
Anesthesia Method
AAA
Clinical Trial Type
random
Adverse Effects
There had been neither other anesthesia nor acupuncture-related side effects.
Contraindications
Local or systemic infection
Effector
The data of fentanyl requirement of 116 patients were available for the final analysis. Patients from AA group required 15% less fentanyl during surgery than the controls (4.6±1.1 μg/kg vs. 5.2±1.3 μg/kg; mean±SD;?P=0.008). Demographic data and secondary outcome measures were comparable in both groups. Regarding the modest clinical effect, AA should be further investigated for its clinical usefulness for complementary analgesia during the surgery.
The effect of auricular acupuncture on fentanyl requirement during hip arthroplasty: a randomized controlled trial.
Abstract
OBJECTIVES: Although auricular acupuncture (AA) is suggested to be effective in treatment of pain, it has not yet been used for intraoperative analgesia. Therefore, we studied whether the AA reduces intraoperative analgesic requirement during total hip arthroplasty (THA). METHODS: One hundred and twenty patients scheduled for THA were enrolled in this patient-anesthesiologist-blinded study. The patients were randomly assigned to receive needling of specific AA points or a sham procedure (needling of 3 nonacupoints on the ear helix) ipsilateral to the surgery site. Fixed indwelling AA needles were placed in the evening before THA and withdrawn on the day after surgery. The patients received general anesthesia with desflurane, which end-tidal concentration was kept within 3.5 volume % to 5.5 volume % to maintain the Bispectral Index within 40% to 55%. The anesthesiologists were asked to titrate fentanyl to keep the heart rate and blood pressure within 20% of baseline values. The primary outcome was fentanyl amount given during surgery. The secondary outcome measures were incidence of nausea and vomiting and time to first request of analgesics in the recovery room. The success of patients' and anesthesiologist blinding was also documented. RESULTS: The data of fentanyl requirement of 116 patients were available for the final analysis. Patients from AA group required 15% less fentanyl during surgery than the controls (4.6+/-1.1 mug/kg vs. 5.2+/-1.3 mug/kg; mean+/-SD; P=0.008). Demographic data and secondary outcome measures were comparable in both groups. DISCUSSION: Regarding the modest clinical effect, AA should be further investigated for its clinical usefulness for complementary analgesia during the surgery."
