Acupuncture in the Emergency Department: A Systematic Review of Randomised Controlled Trials

Chia, Kwan Leung; Lam, Rex Pui Kin; Lam, Chung Kwun; Tsui, Sik Hon

doi:10.1136/acupmed-2017-011547

Cited by 19 publications

(23 citation statements)

References 25 publications

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“…The hectic environment of the ED together with a requirement for rapid administration of analgesia by usual ED workers, may not be conducive to acupuncture treatments compared to the outpatient or perioperative setting 11 . Despite this, from the patients' perspective, we showed the majority (68%) of patients are willing to be treated with acupuncture in the ED 12 .…”

Section: Introductionmentioning

confidence: 70%

Battlefield acupuncture added no benefit as an adjunct analgesic in emergency department for abdominal, low back or limb trauma pain

Jan

Aldridge

Visser

et al. 2020

Emerg Medicine Australasia

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Objectives To ascertain whether ear acupuncture (modified Battlefield technique) as an adjunct (Adj‐BFA) to standard analgesia care (SAC) significantly reduces pain scores compared with sham acupuncture (Adj‐Sham) or SAC alone, when delivered by medical and nursing practitioners in an ED. Methods A randomised controlled trial using a convenience sample of 90 patients attending an ED with acute abdominal, limb trauma or low back pain were allocated to three treatment arms: Adj‐BFA, Adj‐Sham and SAC. The primary outcome of change in pain scores out‐of‐10 (NPRS‐10) from triage were assessed immediately after intervention and at 1 and 2 h post‐intervention. Secondary outcomes were the percentage of patients reporting ‘adequate analgesia’ or ≥30% reduction in pain score, analgesic medication use (in morphine equivalent dose [milligrammes]), analgesics and needle costs (Australian dollars), adverse effects and patient satisfaction (Likert scale). Results There was no significant difference in pain scores (P = 0.582) or secondary outcomes measures between Adj‐BFA, Adj‐Sham and SAC. Conclusion The present study on 90 patients did not show a significant difference in analgesia outcomes in the first 2 h using Adj‐BFA for acute pain in the ED, and there were no significant differences for secondary outcomes between treatment arms. Given the mixed results of recent BFA trials, further research using the original BFA technique on different painful conditions, as either stand‐alone or as‐adjunct to non‐opioid analgesia are needed before BFA can be recommended as a technique for acute pain management in the ED.

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Section: Introductionmentioning

confidence: 70%

Battlefield acupuncture added no benefit as an adjunct analgesic in emergency department for abdominal, low back or limb trauma pain

Jan

Aldridge

Visser

et al. 2020

Emerg Medicine Australasia

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“…So far, electricity, infrared rays, medicine, and microwaves have been added to acupuncture. Many scholars have continued to work hard in this regard [8,[32][33][34], although more peer input is required. This research institute is willing to cooperate with the industry with UFA in the future, and doing so may add some color to acupuncture innovation.…”

Section: Discussionmentioning

confidence: 99%

Development and Evaluation of Inexpensive Ultrasound Using A-Mode and M-Mode Signals to Identify Lung Depth and Avoid Risk of Pneumothorax in Acupuncture

et al. 2020

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Purpose To increase patient safety, ultrasound detection acupuncture (UDA) has been developed, which can detect a safe depth for acupuncturists to avoid causing pneumothorax. This study aims to develop and evaluate a single-transducer ultrasound for acupuncture (UFA) to promote UDA. Methods Special A-mode and M-mode signals were analyzed to identify the depth of the lung. Six subjects were recruited to test the reliability and validity of UFA on GB21, LV14 and BL43 acupuncture points. Results The result showed UFA’s coefficient of variation was less than 0.2 and no difference in age, gender, and BMI of the subjects statistically, demonstrating excellent reliability. However, the content validity index of 0.51 did not meet expectations. UFA has good reliability, but it cannot reach the level of medical ultrasound. UFA uses A-mode and the seashore sign of M-mode to make a good identification of the lung, and it would be useful in the promotion of UDA.

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“…15,21,22 A 2018 systematic review of various acute pain conditions found that acupuncture was more efficacious than intravenous (IV) morphine, comparable to conventional ED treatment and superior to standard ED care alone when used on an adjuvant basis. 23 Another systematic review found immediate pain relief from ear acupuncture extending to the first 48 h to be equivalent to analgesics with fewer side effects. 24 Acupuncture in the ED continues to be promising in randomized clinical trials (RCTs).…”

Section: Acupuncture In the Edmentioning

confidence: 99%

Acupuncture intervention for acute pain in the Emergency Department trial: a consensus process

Nielsen

Olson²,

Quesada

et al. 2022

Acupunct Med

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Purpose: This document describes the consensus process and intervention for a National Institutes of Health (NIH)-funded multi-site feasibility study utilizing acupuncture for ACUte paIn in The EmergencY Department (ACUITY). The acupuncture intervention is designed to be flexible and responsive to the most common Emergency Department (ED) scenarios, including trauma, acute pain of the low back, abdomen and/or musculoskeletal system, renal colic and headache. Background: Opioids remain a primary treatment for acute ED pain with attendant risk of adverse effects, addiction liability, diversion and death. Effective/safer options for acute pain are needed. Although acupuncture therapy has shown promise for acute pain in the ED alone or in conjunction with usual care, pragmatic trials are needed to obtain definitive and generalizable evidence. Methods: An Acupuncture Advisory Panel was convened that included nine acupuncture experts with 5–44 years of experience in practice and 2–16 years of experience in the acute pain care setting. A modified Delphi process was used with provision of a literature review, surveys of our panel members, three online discussions and email discussion as needed. The STandards for Reporting Interventions in Controlled Trials (STRICTA) checklist was used as a guide. Results: A responsive acupuncture intervention was agreed on for ACUITY. Session forms were fashioned in REDCap (Research Electronic Data Capture program to capture essential treatment data, assess fidelity and inform our design for a future pragmatic multi-site randomized controlled trial (RCT) of acupuncture in the ED, and for use by other future researchers. Conclusion: Development of a responsive manualization intervention provides the appropriate framework for conducting a future, pragmatic, multi-site, definitive RCT of acupuncture in the ED. Trial registration number: NCT04880733 (ClinicalTrials.gov).

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Acupuncture in the Emergency Department: A Systematic Review of Randomised Controlled Trials

Abstract: There is a lack of high-quality evidence to support the use of acupuncture in the ED. Multicentre RCTs with rigorous designs are warranted.

Cited by 19 publications

References 25 publications

Battlefield acupuncture added no benefit as an adjunct analgesic in emergency department for abdominal, low back or limb trauma pain

Battlefield acupuncture added no benefit as an adjunct analgesic in emergency department for abdominal, low back or limb trauma pain

Development and Evaluation of Inexpensive Ultrasound Using A-Mode and M-Mode Signals to Identify Lung Depth and Avoid Risk of Pneumothorax in Acupuncture

Acupuncture intervention for acute pain in the Emergency Department trial: a consensus process

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