Acupuncture in ambulatory anesthesia: a review

Acupuncture for postoperative pain a literature review,

Finally, acupressure is an acupuncture-related treatment modality that is easy to implement in a clinical ambulatory setting. Quality of acupuncture, acupressure, and point selection in the papers Acupuncture treatment and the theory behind it vary across published research studies. Figure 1 displays a flow diagram of the paper-selection process. Only four out of the 16 articles reported adequate allocation concealment. Among the included studies, nine studies were presented as being performed in an ambulatory setting. While acupressure more or less exclusively is used for PONV in ambulatory anesthesia, acupuncture is in addition used for other morbidities, such as pain, emergence agitation, sore throat, and hypothermia Tables 1 and 2. It is also common, and indeed relevant for an acupuncturist, to present a rationale for the selection of acupoints.

Contents

Our review process has also revealed that a lack of knowledge and clinical experience of acupuncture might bias a review or meta-perspective of the topic. Sixteen studies were included; eight studies reported on acupuncture and eight on acupressure. One study using intravenous anesthesia found acupuncture effective, 59 and one found it was not effective.

[Acupuncture for postoperative pain, a literature review].

Overall, the studies were of fairly good quality. Filters were English language, human, and clinical trial. Further, one more study seemed to be relevant. Our findings support the use of acupuncture for postoperative pain a literature review as adjuvant therapy in treating postoperative pain.

The cumulative use of opioid analgesics was defined as the cumulative amount sum within 24 hours after surgery mg In addition, planned subgroup analysis of thesis of education management effectiveness was performed according to difference interventions ie, acupuncture eletroacupuncture, transcutaneous electric acupoint stimulation TEASand control.

It has also been held that acustimulation is ineffective when performed while under anesthesia. Studies were also excluded if the outcomes of interest were not presented quantitatively. Multimodal analgesic treatment is thus recommended for POP. For the purpose of our review, these studies were regarded as virtually having been conducted in an ambulatory anesthesia setting.

Consequently, we might have missed some eligible RCTs published elsewhere. Journal of Clinical Epidemiology, May Thirteen studies were included for qualitative and quantitative analyses [ 12 — 24 ]. Well aware of this potential for bias, we developed a tool to explore the acupuncture relevance of related techniques.

It is also common, and indeed relevant for an acupuncturist, to present a rationale for the selection of acupoints. These involved therapeutic modalities including acupuncture injection, 3839 electroacupuncture, 4041 transcutaneous electro acupoint stimulation, 4243 auricular acupuncture, 4445 Korean hand acupressure, 4647 and capsicum plaster used on acupuncture points.

Results Literature Search Of the articles identified in the initial search, were excluded for not being relevant Fig 1. Data extraction and quality assessment The following information was extracted from studies that met the inclusion criteria: Another publication bias, also referred to as the bias against the null hypothesis, is the tendency for published studies to report statistically significant results, as authors tend to refrain from submitting articles with negative results, and peer reviewers tend to reject reviewing, editors tend not to publish, the dissertation a guide for architecture students pdf readers tend to ignore the results of such studies.

All analyses were performed using Comprehensive Meta-Analysis statistical software, version 2. According to TCM, energy free flows within the body and also along paths referred to as meridians. Hence, we have addressed some of the issues related to this diversity in acupuncture research.

A study by White et al 86 showed that acupuncture has little preemptive effect; the optimal timing of stimulation seemed pew homework gap be postoperatively.

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Selection of papers The search performed in Medline, PubMed, latex writing service Embase provided a total of, and references, respectively. Meta-analyses and reviews of acupuncture and related techniques for postoperative nausea and vomiting POVN and postoperative vomiting POV show promising results while many clinicians remain skeptical of the value of acupuncture.

In this figure, the acupuncture relevance of acupuncture-related techniques is compared with skin-penetrating acupuncture needles and acupressure stimulation. Given the interest in finding safe non-pharmacological approaches toward postoperative care, this body of knowledge needs to be considered.

Anesthesia as risk factor for PONV Propofol has antiemetic properties, and it advantages of doing research proposal now well established that maintenance of anesthesia with propofol is superior to that with volatile agents, including isoflurane theme essay rubric sevoflurane with or without nitrous oxide, in terms of reducing PONV in adults and children.

The lines from the hub O represent the modality continuum of optimal acupuncture—suboptimal acupuncture, illustrated as spokes in a wheel. A review by Wang et al 85 indicated that acupuncture is effective when performed pre- and postoperatively.

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Any difference between the control and sham groups could be related to placebo responses, including potential nonspecific and specific effects of sham treatment. Introduction Postoperative pain results from surgical trauma and is a significant challenge for healthcare providers [ 1 ]. Placebo controls commonly used include sham acupuncture acupuncture on non-acupuncture pointssuperficial acupuncture penetrating needling of the skinand placebo acupuncture needles needles not penetrating the skin.

The reports of adverse events in this study showed that this sham procedure was far from a tactile stimulation. Statistical analysis The primary outcome was the pain score on the first day Day 1 following surgery.

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  3. Acupressure can be performed by patients, parents, and care providers.

In a clinical setting, skin-penetrating body acupuncture might be regarded as optimal acupuncture stimulation, compared with other acupuncture-related techniques, even though these techniques are considered as acupuncture. While acupressure more or less exclusively is used for PONV in ambulatory anesthesia, acupuncture is in addition used for other morbidities, such as pain, emergence agitation, sore throat, acupuncture for postoperative pain a literature review hypothermia Tables 1 and 2.

Acupressure can be performed by patients, parents, and care providers. In addition, antiemetic drugs can cause unpleasant adverse events, such as agitation and restlessness, sedation and delayed awakening, extrapyramidal reactions, headache, blurred vision, dry mouth, and tachycardia. In addition, no publication bias was detected.

This raises an interesting question as to whether or not there are point-specific effects of acupressure; however, this discussion is beyond the scope of this review.

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Nine studies out of 16 found acupuncture or btm-8109 planning dissertation research in business effective on primary endpoints including PONV, POP, sore throat, and emergence agitation.

Conventional precautions such as unbiased selection, power calculation, homogeneity, and clearly defined outcomes must be fulfilled to ensure validity and reliability.

Opioid Alternative: Try Acupuncture Instead of Addictive Prescription Pain Killers

The literature search identified 15 peer-reviewed RCTs that met the inclusion criteria. This may have resulted in selection bias. Sensitivity analysis using the leave-one-out approach indicated the findings are reliable and are not dependent on any one study. The review advantages of doing research proposal selection of studies, study data extraction, and quality assessment were hand-searched by two independent reviewers, and if necessary a third reviewer was consulted to resolve any uncertainties regarding the inclusion.

The other, which was performed inevaluated the use of acupuncture more broadly following surgery [ 1 ]. Recommendations for future research Research on complex therapies, such as acupuncture, should be conducted with an approach toward the whole treatment package, including placebo responses, using a pragmatic design.

The so-called sham was placed on the dorsum of theme essay rubric arm, probably off an acupuncture apply texas essay c ideas. The following search terms were used: Some studies also indicate that the effect of acupuncture and acupressure was similar to that of antiemetic drugs.

One study was open. Four studies reported the need for rescue medication 5261626466 and five reported adverse events.

[Full text] Acupuncture in ambulatory anesthesia: a review | AA Only papers published in English or Chinese were included.

Other acupuncture-related techniques advantages of doing research proposal be regarded to be in the same category of alternative therapeutic approaches. Materials and methods Search strategy Articles were identified through computerized literature searches.

[Acupuncture for postoperative pain, a literature review].

For the purpose of this review, we focused on homogeneity in the selection process. Editor who approved publication: Acupuncture is often used to treat pain, and numerous studies have found it is safe compared to routine care [ 6 — 9 ]. In addition to the 15 published studies, we included one relevant article in press, 37 meaning the review encompassed, in total, 16 RCTs.

The use of placebo controls is controversial due to their large nonspecific effects, which may imply difficulties in detecting the effects of the intervention and in interpreting results.

Among the included studies, nine studies were presented as being performed in an ambulatory setting. Figure 1 displays a flow diagram of the paper-selection process. Four studies found acupuncture had a similar effect to antiemetic medication. Restricting the review according to our selection criteria could have introduced risk of publication bias, as unpublished articles were excluded, and articles not subjected to peer review were likely not identified.

The secondary outcome was the cumulative use of opioid analgesics in the acupuncture and control treatment groups. For how long should the needles be retained?

Associated Data

Sensitivity analysis was carried out for primary outcome using the leave-one-out approach. The literature search also identified numerous other studies on acupuncture-related techniques other than needling acupuncture and acupressure. Post-anesthetic morbidities remain challenging in our daily practice of anesthesia.

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Other methodology issues Eight out of the 16 articles employed a power calculation, 3757 — 6266 but one study was completed before the sample size was attained, 61 and in one study the description of the calculation was unclear. We decided to include articles published after the yeardue to the fact that anesthesiology and surgical techniques, and methodology in acupuncture research, have been developed further in recent decades.

Research methodology should be rigorous and have acupuncture for postoperative pain a literature review specific focus toward blinding, placebo, and allocation concealment. Hence, the study was excluded. A number of clinical studies have evaluated the efficacy of acupuncture and related methods as adjuvant treatment for postoperative analgesia [ 1 ].