Acupuncture as a complement to the pharmacological management of pain, nausea and vomiting after cesarean section: A randomized clinical trial

Gamermann, Patrícia Wajnberg; Martins, Ana Lucia Costa; Rosa, Letícia; Ribeiro, Hugo Daniel Welter; Borba, Daniela L.; Antoniazzi, Vinicius; Corte, Roberta Rigo Dalla

doi:10.1016/j.arthe.2014.12.002

Cited by 7 publications

(4 citation statements)

References 16 publications

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“…The mean pain intensity on movement of 4.7 points in patients who received acupuncture was comparable to that in patients from the pilot study and the RCT of Wu et al; however, both of these previous studies did not record the mobilization parameters of patients. One RCT that involved 56 patients who were scheduled for cesarean delivery under spinal anesthesia and were randomized either to a single session of acupuncture or a sham procedure did not report any benefits of acupuncture over the sham intervention . However, a single session of 20-minute needling of 2 acupoints without stimulation suggests that the acupuncture dose was likely insufficient.…”

Section: Discussionmentioning

confidence: 99%

“…Effectiveness of Acupuncture for Pain Control After Cesarean Delivery session of acupuncture or a sham procedure did not report any benefits of acupuncture over the sham intervention. 32 However, a single session of 20-minute needling of 2 acupoints without stimulation suggests that the acupuncture dose was likely insufficient. The application of indwelling intradermal needles in this RCT may have provided an adequate ongoing acupuncture dose through the continuous stimulation of Aβ, Aδ, and/or C afferent fibers from skin and transmission via the spinal ventrolateral funiculus to the brain nuclei, which is considered a leading analgesic mechanism of acupuncture.…”

Section: Jama Network Open | Anesthesiologymentioning

confidence: 99%

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Effectiveness of Acupuncture for Pain Control After Cesarean Delivery

et al. 2022

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IMPORTANCE A pharmacological approach to pain control after cesarean delivery is often insufficient on its own. Acupuncture is a promising method for mitigating postoperative pain and reducing postoperative opioid requirements. OBJECTIVE To evaluate the efficacy and effectiveness of acupuncture as an adjunctive therapy for pain control after cesarean delivery, compared with a placebo intervention and standard care alone. DESIGN, SETTING, AND PARTICIPANTSThis single-center, placebo-controlled, patient-and assessor-blinded randomized clinical trial was conducted from January 13, 2015, to June 27, 2018, at a tertiary university hospital in Greifswald, Germany. Participants were women who were scheduled for elective cesarean delivery under spinal anesthesia and were randomized to either the acupuncture group (n = 60) or placebo group (n = 60). Another 60 consecutive patients who met the eligibility criteria and received the standard postoperative analgesia were selected to form a nonrandomized standard care group. The intention-to-treat analysis was performed from August 19, 2019, to September 13, 2019. INTERVENTIONSIn addition to standard pain treatment, each patient in the acupuncture group received auricular and body acupuncture with indwelling intradermal needles, whereas patients in the placebo group were treated with nonpenetrating placebo needles. MAIN OUTCOMES AND MEASURESThe primary outcome was pain intensity on movement, which was measured using an 11-item verbal rating scale. Secondary outcomes were analgesia-related adverse effects, analgesics consumption, time to mobilization and Foley catheter removal, quality of patient blinding to randomization, and patient satisfaction with treatment of pain. RESULTSA total of 180 female patients (mean [SD] age, 31 [5] years) were included in the intentionto-treat analysis. The mean pain intensity on movement in the acupuncture group on the first postoperative day was lower than in the placebo group (4.7 [1.8] vs 6.0 [2.0] points; Cohen d, 0.73; 95% CI, 0.31-1.01; P = .001) and the standard care group (6.3 [1.3] points; Cohen d, 1.01; 95% CI, 0.63-1.40; P < .001). On the first postoperative day, 59 patients (98%) in the acupuncture group were fully mobilized vs 49 patients (83%) in the placebo group (relative risk [RR], 1.18; 95% CI, 1.06-1.33; P = .01) and 35 patients (58%) in the standard care group (RR, 1.69; 95% CI, 1.36-2.09; P < .001). The Foley catheter was removed in a total of 57 patients (93%) from the acupuncture group vs 43 patients (72%) from the placebo group (RR, 1.33; 95% CI, 1.12-1.57; P = .003) and 42 patients (70%) from the standard care group (RR, 1.37; 95% CI, 1.14-1.62; P = .002). Other parameters were comparable across the 3 study groups.

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Section: Discussionmentioning

confidence: 99%

Section: Jama Network Open | Anesthesiologymentioning

confidence: 99%

Effectiveness of Acupuncture for Pain Control After Cesarean Delivery

et al. 2022

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“…Die Anwendung etablierter klinischer Parameter als Endpunkt der Studie sowie der Versuch, die Wirkmechanismen der Ma- 36-Stimulation mit minimalinvasiver instrumenteller Diagnostik (EKG und EMG) zu verifizieren, gehören eindeutig zu den Vorteilen dieser Untersuchung. Auch die adäquate Dosierung der Stimulationsdauer und die Wiederholung der TEAS-Sitzungen (1 Stunde Stimulation unmittelbar postoperativ sowie 2×täglich jeweils 1 Stunde Stimulation für 3 Tage nach dem Eingriff) zeichnen diese Untersuchung positiv aus im Vergleich zu bereits vorhandenen Studien, bei denen Dauer und Stärke der Stimulation eindeutig unzureichend waren 4 .…”

Section: Kommentarunclassified

“…Bisher wurde die Anwendung der Akupunktur bei Patientinnen nach einem Kaiserschnitt hauptsächlich auf die Linderung des postoperativen Schmerzes limitiert 4 5 6 ; somit scheint die vorliegende Studie eine 1. Untersuchung zur Wirksamkeit der Ma- 36-Stimulation zur Linderung postoperativer gastrointestinaler Beschwerden bei Patientinnen nach einem Kaiserschnitt zu sein.…”

Section: Kommentarunclassified