Introduction: Acupuncture is one of the most popular forms of complementary medicine. Previous studies have proven that traditional manual acupuncture is safe when it is performed by well-trained professionals. However, the safety of electro-acupuncture ( EA) has not been well-evaluated. Objectives: This literature review was undertaken to assess the safety of EA. Methods: In October 2010, searches were conducted-using six electronic databases, three Chinese databases (CBM, CNKI, and VIP), and three English databases (PubMed, EMBASE and Cochrane Library)-to identify articles published between 1979 and 2010 regarding EA. Case reports, case series, surveys, and observational studies were considered to be eligible for inclusion in this review if they reported factual data on adverse events (AEs) related to EA. Review articles, translations, and clinical trials were excluded. Information on acupuncture points and AEs was extracted from the primary articles and entered onto a preformulated spreadsheet. Results: Fifteen articles met the inclusion criteria. In total, 44 cases of AEs after EA were reported. These AEs were classified into two categories: general AEs (n = 7) and specific AEs (n = 37). General AEs included 4 traumatic events, 2 cases of fainting, and 1 case of hyperventilation syndrome. Specific AEs associated with electrical current were spastic injury (e.g., fracture of the femur head and dislocation of the wrist joint), electrical injury, atrioventricular block, aggravated bulbar palsy, and "others.'' Conclusions: Apart from general AEs, there are also types of specific AEs that could be caused by connecting an electrical current to the acupuncture needles. Although the incidence of the AEs is unknown, based merely on information acquired during this review, the specific risks associated with EA should be of concern for acupuncturists in clinical practice.
