The Efficacy of Acupuncture in Post-Operative Pain Management: A Systematic Review and Meta-Analysis

被引:188
作者
Wu, Ming-Shun [1 ,2 ]
Chen, Kee-Hsin [3 ,4 ,5 ]
Chen, I-Fan [6 ]
Huang, Shihping Kevin [6 ]
Tzeng, Pei-Chuan [7 ]
Yeh, Mei-Ling [8 ]
Lee, Fei-Peng [9 ,10 ]
Lin, Jaung-Geng [11 ]
Chen, Chiehfeng [4 ,5 ,7 ,9 ,12 ]
机构
[1] Taipei Med Univ, Wan Fang Hosp, Dept Internal Med, Div Gastroenterol, Taipei, Taiwan
[2] Taipei Med Univ, Sch Med, Div Gastroenterol & Hepatol, Dept Internal Med,Coll Med, Taipei, Taiwan
[3] Taipei Med Univ, Wan Fang Hosp, Dept Nursing, Taipei, Taiwan
[4] Taipei Med Univ, Sch Nursing, Coll Nursing, Taipei, Taiwan
[5] Taipei Med Univ, Cochrane Taiwan, Taipei, Taiwan
[6] Natl Chiao Tung Univ, Inst Management Technol, Hsinchu, Taiwan
[7] Taipei Med Univ, Wan Fang Hosp, Evidence Based Med Ctr, Taipei, Taiwan
[8] Natl Taipei Univ Nursing & Hlth Sci, Grad Inst Integrat Tradit Chinese Med Western Nur, Taipei, Taiwan
[9] Taipei Med Univ, Grad Inst Clin Med, Coll Med, Taipei, Taiwan
[10] Taipei Med Univ, Shuang Ho Hosp, Dept Otolaryngol, New Taipei, Taiwan
[11] China Med Univ, Sch Chinese Med Acupuncture Sci, Taichung, Taiwan
[12] Taipei Med Univ, Sch Med, Dept Publ Hlth, Coll Med, Taipei, Taiwan
关键词
ELECTRICAL NERVE-STIMULATION; ANALGESIC REQUIREMENT; ELECTROACUPUNCTURE; ACUPOINT; SURGERY; COMPLICATIONS; RELIEF;
D O I
10.1371/journal.pone.0150367
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Postoperative pain resulting from surgical trauma is a significant challenge for healthcare providers. Opioid analgesics are commonly used to treat postoperative pain; however, these drugs are associated with a number of undesirable side effects. Objective This systematic review and meta-analysis evaluated the effectiveness of acupuncture and acupuncture-related techniques in treating postoperative pain. Data Source MEDLINE, Cochrane Library, and EMBASE databases were searched until Sep 30, 2014. Study Eligibility Criteria Randomized controlled trials of adult subjects (>= 18 years) who had undergone surgery and who had received acupuncture, electroacupuncture, or acupoint electrical stimulation for managing acute post-operative pain were included. Results We found that patients treated with acupuncture or related techniques had less pain and used less opioid analgesics on Day 1 after surgery compared with those treated with control (P < 0.001). Sensitivity analysis using the leave-one-out approach indicated the findings are reliable and are not dependent on any one study. In addition, no publication bias was detected. Subgroup analysis indicated that conventional acupuncture and transcutaneous electric acupoint stimulation (TEAS) were associated with less postoperative pain one day following surgery than control treatment, while electroacupuncture was similar to control (P = 0.116). TEAS was associated with significantly greater reduction in opioid analgesic use on Day 1 post surgery than control (P < 0.001); however conventional acupuncture and electroacupuncture showed no benefit in reducing opioid analgesic use compared with control (P >= 0.142). Conclusion Our findings indicate that certain modes of acupuncture improved postoperative pain on the first day after surgery and reduced opioid use. Our findings support the use of acupuncture as adjuvant therapy in treating postoperative pain.
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页数:12
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