Acupuncture to improve tolerance of diagnostic esophagogastroduodenoscopy in patients without systemic sedation: results of a single-center, double-blinded, randomized controlled trial (DRKS00000164)

Abstract

BackgroundSedation prior to esophagogastroduodenoscopy is widespread and increases patient comfort. However, it demands additional trained personnel, accounts for up to 40 % of total endoscopy costs and impedes rapid hospital discharge. Most patients lose at least one day of work. 98 % of all serious adverse events occurring during esophagogastroduodenoscopy are ascribed to sedation. Acupuncture is reported to be effective as a supportive intervention for gastrointestinal endoscopy, similar to conventional premedication. We investigated whether acupuncture during elective diagnostic esophagogastroduodenoscopy could increase the comfort of patients refusing systemic sedation.MethodsWe performed a single-center, double-blinded, placebo-controlled superiority trial to compare the success rates of elective diagnostic esophagogastroduodenoscopies using real and placebo acupuncture. All patients aged 18 years or older scheduled for elective, diagnostic esophagogastroduodenoscopy who refused systemic sedation were eligible; 354 patients were randomized. The primary endpoint measure was the rate of successful esophagogastroduodenoscopies. The intervention was real or placebo acupuncture before and during esophagogastroduodenoscopy. Successful esophagogastroduodenoscopy was based on a composite score of patient satisfaction with the procedure on a Likert scale as well as quality of examination, as assessed by the examiner.ResultsFrom February 2010 to July 2012, 678 patients were screened; 354 were included in the study. Baseline characteristics of the two groups showed a similar distribution in all but one parameter: more current smokers were allocated to the placebo group. The intention-to-treat analysis included 177 randomized patients in each group. Endoscopy could successfully be performed in 130 patients (73.5 %) in the real acupuncture group and 129 patients (72.9 %) in the placebo group. Willingness to repeat the procedure under the same conditions was 86.9 % in the real acupuncture group and 87.6 % in the placebo acupuncture group.ConclusionsEsophagogastroduodenoscopy without sedation is safe and can successfully be performed in two-thirds of patients. Patients planned for elective esophagogastroduodenoscopy without sedation do not benefit from acupuncture of the Sinarteria respondens (Rs) 24 Chengjiang middle line, Pericard (Pc) 6 Neiguan bilateral, or Dickdarm (IC) 4 Hegu bilateral, according to traditional Chinese medicine meridian theory.Trial registrationDRKS00000164. Registered on 10 December 2009.

The cerebral mechanism of acupuncture for chronic insomnia with gastrointestinal disorder: protocol for a randomized controlled trial

“…However, there have been few reports on the mechanism of acupuncture in treating insomnia and GI comorbidities. Previous studies have found that acupuncture has a good effect on inflammation of GI diseases [16][17][18], which also provides strong support for the treatment of CID patients with GI diseases with acupuncture. In our protocol, multimodal MRI will be used to explore the pathological mechanism of CID with GI disorder and the main response characteristics of acupuncture therapy for this type of insomnia.…”

“…Multiple studies have shown that acupuncture effectively improves sleep quality [14,15]. Other studies have found that acupuncture can improve inflammation in gastrointestinal diseases and promote the recovery of gastrointestinal function [16][17][18]. Moreover, acupuncture is more effective than drug therapy in treating insomnia with GI disorder [19,20].…”

Acupuncture to Improve Patient Discomfort During Upper Gastrointestinal Endoscopy: Systematic Review and Meta-Analysis

“…The 23 RCTs included were conducted in Germany (one study) (21), Turkey (one study) (15), France (one study) (16), and China (20 studies), (22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41). A total of 3,349 patients (1,717 male and 1,393 female) who underwent UGE were included, with ages ranging from 16 to 86 years.…”

“…Four studies reported the incidence and types of adverse events related to acupuncture treatment. Some studies (15,16,21) also reported other outcomes, such as number of intubation attempts and eructation, the rate of successfully performed procedures, anxiety scores, etc. The details of the included studies were summarized in Tables 1, 2.…”

The Cerebral Mechanism of Acupuncture for Chronic Insomnia with Gastrointestinal Disorder: Protocol for a Randomized Controlled Trial

“…Multiple studies have shown that acupuncture effectively improves sleep quality [14][15] and regulates GI function. [16][17] Moreover, acupuncture is more effective than drug therapy in treating insomnia with GI disorder. [18][19] However, the mechanism underlying the effect of acupuncture on CID with GI symptoms remains to be elucidated.…”