Description left and right of the T9–L3 spinal vertebrae (BL18–BL24);intervertebral space (T10–L1)
Experimental Description
Preoperative insertion of intradermal needles at acupoints 2.5 cm from the spinal vertebrae (bladder meridian). Before anesthesia, patients undergoing each type of surgery were randomly assigned to one of two groups: acupuncture (n = 50 and n = 39 for upper and lower abdominal surgery, respectively) or control (n = 48 and n = 38 for upper and lower abdominal surgery, respectively).
upper abdominal surgery by acupuncture (n=50); lower abdominal surgery by acupuncture(n=39)
Indicator
Consumption of intravenous morphineIncisional pain at rest and during coughingDeep visceral painVerbal rating scale(VRS)Cortisol(Cor)Catecholamines
Auxiliary Medication
Subarachnoid placement was excluded by injection of 3 ml of 2% lidocaine, and correct catheter position was tested by injection of 7-10 ml of 1% lidocaine. We next determined the area of analgesia by administering an additional 7 ml of 1% lidocaine. Patients were premedicated with 0.01–0.02 mg/kg oral diazepam and 75 mg oral roxatidine (an H2 blocker) 90 min before induction of anesthesia. Anesthesia was induced with 1-2 ug/kg fentanyl, 5 mg/kg thiopental, and 0.08 mg/kg vecuronium. We maintained anesthesia with 0.15 mg/kg droperidol, 10-20 ug/kg fentanyl, and vecuronium. Epidural anesthesia was not used intraoperatively. Lactated Ringer’s solution (8-10 ml · kg-1 · h-1) was administered per the judgment of the attending anes- thesiologist.
Stimulation Method
MS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
-
-
-
-
-
4
postoperative days
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
0.16×5 mm
Asahi Industry, Inc., Kawaguchi, Japan
-
Description 5-mm-long intradermal needles (Asahi Industry, Inc., Kawaguchi, Japan). The diameter of these needles was 0.16 mm
Anesthesia Method
AAA
Clinical Trial Type
random
Effector
Starting from the recovery room, intradermal acupuncture increased the fraction of patients with good pain relief as compared with the control (P < 0.05). Consumption of supplemental intravenous morphine was reduced 50%, and the incidence of postoperative nausea was reduced 20-30% in the acupuncture patients who had undergone either upper or lower abdominal surgery (P < 0.01). Plasma cortisol and epinephrine concentrations were reduced 30-50% in the acupuncture group during recovery and on the first postoperative day (P < 0.01). Preoperative insertion of intradermal needles reduces postoperative pain, the analgesic requirement, and opioid-related side effects after both upper and lower abdominal surgery. Acupuncture analgesia also reduces the activation of the sympathoadrenal system that normally accompanies surgery.
"Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses."
Abstract
BACKGROUND: In a controlled and double-blind study, the authors tested the hypothesis that preoperative insertion of intradermal needles at acupoints 2.5 cm from the spinal vertebrae (bladder meridian) provide satisfactory postoperative analgesia. METHODS: The authors enrolled patients scheduled for elective upper and lower abdominal surgery. Before anesthesia, patients undergoing each type of surgery were randomly assigned to one of two groups: acupuncture (n = 50 and n = 39 for upper and lower abdominal surgery, respectively) or control (n = 48 and n = 38 for upper and lower abdominal surgery, respectively). In the acupuncture group, intradermal needles were inserted to the left and right of bladder meridian 18-24 and 20-26 in upper and lower abdominal surgery before induction of anesthesia, respectively. Postoperative analgesia was maintained with epidural morphine and bolus doses of intravenous morphine. Consumption of intravenous morphine was recorded. Incisional pain at rest and during coughing and deep visceral pain were recorded during recovery and for 4 days thereafter on a four-point verbal rating scale. We also evaluated time-dependent changes in plasma concentrations of cortisol and catecholamines. RESULTS: Starting from the recovery room, intradermal acupuncture increased the fraction of patients with good pain relief as compared with the control (P < 0.05). Consumption of supplemental intravenous morphine was reduced 50%, and the incidence of postoperative nausea was reduced 20-30% in the acupuncture patients who had undergone either upper or lower abdominal surgery (P < 0.01). Plasma cortisol and epinephrine concentrations were reduced 30-50% in the acupuncture group during recovery and on the first postoperative day (P < 0.01). CONCLUSION: Preoperative insertion of intradermal needles reduces postoperative pain, the analgesic requirement, and opioid-related side effects after both upper and lower abdominal surgery. Acupuncture analgesia also reduces the activation of the sympathoadrenal system that normally accompanies surgery."
