Auricular acupuncture for pain relief after ambulatory knee surgery

[Guest guest]

Hi All,

 

See the abstract, below, and Dr Taras Usichenko's reply after it on their

definition of " an invasive needle control procedure " .

 

Taras, many thanks for taking the time to reply!

 

Usichenko TI, Kuchling S, Witstruck T, Pavlovic D, Zach M, Hofer A, Merk

H, Lehmann C, Wendt M. Auricular acupuncture for pain relief after

ambulatory knee surgery: a randomized trial. CMAJ. 2007 Jan

16;176(2):179-83. Comment in: CMAJ. 2007 Jan 16;176(2):193-4.

Department of Anesthesiology and Intensive Care Medicine, Ernst Moritz

Arndt University, Greifswald, Germany. taras

BACKGROUND: Auricular acupuncture is a promising method for

postoperative pain relief. However, there is no evidence for its use after

ambulatory surgery. Our aim was to test whether auricular acupuncture is

better than invasive needle control for complementary analgesia after

ambulatory knee surgery. METHODS: 120 patients undergoing ambulatory

arthroscopic knee surgery under standardized general anesthesia were

randomly assigned to receive auricular acupuncture or a control procedure.

Fixed indwelling acupuncture needles were inserted before surgery and

retained in situ until the following morning. Postoperative rescue analgesia

was directed to achieve pain intensity less than 40 mm on a 100-mm visual

analogue scale. The primary outcome measure was the postoperative

requirement for ibuprofen between surgery and examination the following

morning. RESULTS: Intention-to-treat analysis showed that patients from

the control group (n = 59) required more ibuprofen than patients from the

auricular acupuncture group (n = 61): median (interquartile range) 600 (200-

800) v. 200 (0-600) mg (p = 0.012). Pain intensity on a visual analogue

scale was similar in both groups at all time points registered. The majority of

patients in both groups believed that they had received true acupuncture

and wanted to repeat it in future. INTERPRETATION: Auricular acupuncture

reduced the requirement for ibuprofen after ambulatory knee surgery

relative to an invasive needle control procedure. PMID: 17224599 [PubMed

- indexed for MEDLINE]

 

I wrote to the corresponding author <taras: " Dear

Colleague, What do you mean by " an invasive needle control procedure " in

the abstract? Can you please give more detail of the control procedure?

Best regards, "

 

Dr Taras Usichenko replied:

> Dear Phil, Invasive control procedure (co-called sham acupuncture) here

> means intradermal insertion of the needles in non-acupuncture points on

> the external auricle. We used this control procedure because any

> intradermal needling elicites physiological response (including weak

> analgesia). Please see also discussion of our paper and our previous

> paper in Pain 2005. Thank you for your interest to the results of our

> research, please, write me if you have any questions more With best

> regards from Baltic Sea Taras.

 

Best regards,

 

 

 

 

[Guest guest]

Hi All,

 

See the abstract, below, and Dr Taras Usichenko's reply after it on their

definition of " an invasive needle control procedure " .

 

Taras, many thanks for taking the time to reply!

 

Usichenko TI, Kuchling S, Witstruck T, Pavlovic D, Zach M, Hofer A, Merk

H, Lehmann C, Wendt M. Auricular acupuncture for pain relief after

ambulatory knee surgery: a randomized trial. CMAJ. 2007 Jan

16;176(2):179-83. Comment in: CMAJ. 2007 Jan 16;176(2):193-4.

Department of Anesthesiology and Intensive Care Medicine, Ernst Moritz

Arndt University, Greifswald, Germany. taras

BACKGROUND: Auricular acupuncture is a promising method for

postoperative pain relief. However, there is no evidence for its use after

ambulatory surgery. Our aim was to test whether auricular acupuncture is

better than invasive needle control for complementary analgesia after

ambulatory knee surgery. METHODS: 120 patients undergoing ambulatory

arthroscopic knee surgery under standardized general anesthesia were

randomly assigned to receive auricular acupuncture or a control procedure.

Fixed indwelling acupuncture needles were inserted before surgery and

retained in situ until the following morning. Postoperative rescue analgesia

was directed to achieve pain intensity less than 40 mm on a 100-mm visual

analogue scale. The primary outcome measure was the postoperative

requirement for ibuprofen between surgery and examination the following

morning. RESULTS: Intention-to-treat analysis showed that patients from

the control group (n = 59) required more ibuprofen than patients from the

auricular acupuncture group (n = 61): median (interquartile range) 600 (200-

800) v. 200 (0-600) mg (p = 0.012). Pain intensity on a visual analogue

scale was similar in both groups at all time points registered. The majority of

patients in both groups believed that they had received true acupuncture

and wanted to repeat it in future. INTERPRETATION: Auricular acupuncture

reduced the requirement for ibuprofen after ambulatory knee surgery

relative to an invasive needle control procedure. PMID: 17224599 [PubMed

- indexed for MEDLINE]

 

I wrote to the corresponding author <taras: " Dear

Colleague, What do you mean by " an invasive needle control procedure " in

the abstract? Can you please give more detail of the control procedure?

Best regards, "

 

Dr Taras Usichenko replied:

> Dear Phil, Invasive control procedure (co-called sham acupuncture) here

> means intradermal insertion of the needles in non-acupuncture points on

> the external auricle. We used this control procedure because any

> intradermal needling elicites physiological response (including weak

> analgesia). Please see also discussion of our paper and our previous

> paper in Pain 2005. Thank you for your interest to the results of our

> research, please, write me if you have any questions more With best

> regards from Baltic Sea Taras.

 

Best regards,

 

 

 

 

[Guest guest]

Phil and All,

 

Why use a sham needle in the first place? It's riddled with problems.

Why not just test auricular acupuncture against the next best

treatment, i.e. use paracetamol pain killers in the control group for

knee pain.

 

Attilio

www.chinesemedicinetimes.com

 

, " "

< wrote:

>

> Hi All,

>

> See the abstract, below, and Dr Taras Usichenko's reply after it on

their

> definition of " an invasive needle control procedure " .

>

> Taras, many thanks for taking the time to reply!

>

> Usichenko TI, Kuchling S, Witstruck T, Pavlovic D, Zach M, Hofer A,

Merk

> H, Lehmann C, Wendt M. Auricular acupuncture for pain relief after

> ambulatory knee surgery: a randomized trial. CMAJ. 2007 Jan

> 16;176(2):179-83. Comment in: CMAJ. 2007 Jan 16;176(2):193-4.

> Department of Anesthesiology and Intensive Care Medicine, Ernst

Moritz

> Arndt University, Greifswald, Germany. taras

> BACKGROUND: Auricular acupuncture is a promising method for

> postoperative pain relief. However, there is no evidence for its

use after

> ambulatory surgery. Our aim was to test whether auricular

acupuncture is

> better than invasive needle control for complementary analgesia

after

> ambulatory knee surgery. METHODS: 120 patients undergoing

ambulatory

> arthroscopic knee surgery under standardized general anesthesia

were

> randomly assigned to receive auricular acupuncture or a control

procedure.

> Fixed indwelling acupuncture needles were inserted before surgery

and

> retained in situ until the following morning. Postoperative rescue

analgesia

> was directed to achieve pain intensity less than 40 mm on a 100-mm

visual

> analogue scale. The primary outcome measure was the postoperative

> requirement for ibuprofen between surgery and examination the

following

> morning. RESULTS: Intention-to-treat analysis showed that patients

from

> the control group (n = 59) required more ibuprofen than patients

from the

> auricular acupuncture group (n = 61): median (interquartile range)

600 (200-

> 800) v. 200 (0-600) mg (p = 0.012). Pain intensity on a visual

analogue

> scale was similar in both groups at all time points registered. The

majority of

> patients in both groups believed that they had received true

acupuncture

> and wanted to repeat it in future. INTERPRETATION: Auricular

acupuncture

> reduced the requirement for ibuprofen after ambulatory knee surgery

> relative to an invasive needle control procedure. PMID: 17224599

[PubMed

> - indexed for MEDLINE]

>

> I wrote to the corresponding author <taras: " Dear

> Colleague, What do you mean by " an invasive needle control

procedure " in

> the abstract? Can you please give more detail of the control

procedure?

> Best regards, "

>

> Dr Taras Usichenko replied:

> > Dear Phil, Invasive control procedure (co-called sham

acupuncture) here

> > means intradermal insertion of the needles in non-acupuncture

points on

> > the external auricle. We used this control procedure because any

> > intradermal needling elicites physiological response (including

weak

> > analgesia). Please see also discussion of our paper and our

previous

> > paper in Pain 2005. Thank you for your interest to the results of

our

> > research, please, write me if you have any questions more With

best

> > regards from Baltic Sea Taras.

>

> Best regards,

>

>

>

>