Adverse Events Following Acupuncture: A Systematic Review of the Chinese Literature for the Years 1956–2010

He, Wenju; Zhao, Xue; Li, Yanqi; Xi, Qiang; Guo, Yi

doi:10.1089/acm.2011.0825

Cited by 73 publications

(61 citation statements)

References 16 publications

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“…4 Again PTX, 30% of the reported cases, was the most common traumatic adverse event. Over the last decade, Western literature has also reported numerous adverse events.…”

mentioning

confidence: 99%

Acupuncture-Related Pneumothorax

Hampton

Kaneko

Simeon

et al. 2014

Medical Acupuncture

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Background: Acupuncture-related pneumothorax (PTX) is a poorly reported complication of thoracic needling. Recent Chinese literature reviews cited PTXs as the most common adverse outcome. Because of delayed presentation, this complication is thought to be underrecognized by acupuncturists and is largely addressed by hospital and emergency room personnel. The goal of this case study was to demonstrate common risk factors for a PTX, the mechanisms for its development, and protocols to use if one is suspected. Case: A 43-year-old, athletic female with chronic neck pain that was poorly managed with oral medications sought an alternative intervention for pain control. Her treatment plan consisted of weekly acupuncture sessions in the prone and supine positions targeting points along the Bladder, Gall Bladder, and Small Intestine meridians, as well as the right scapular Ah Shi point. She also received infrared lamp therapy. The aim of this approach was to help the patient achieve subjective pain reduction and increased range of motion. Results: One hour after her third treatment session, this patient experienced pleuritic chest pain and dyspnea. She was transported to a local Level-1 trauma center by emergency medical services and was diagnosed with a right-sided PTX. Conclusions: The acupoints addressed, a practitioner's knowledge of variations in anatomy, and a patient's body habitus and medical history are risk factors for PTX development. A patient's initial presentation does not predict future outcome. A benign presentation can evolve into a potentially life-threatening cardiovascular collapse. When PTX is suspected, discussing it with the patient and facilitating appropriate evaluation and intervention by a tertiary-care facility is warranted.

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“…4 Again PTX, 30% of the reported cases, was the most common traumatic adverse event. Over the last decade, Western literature has also reported numerous adverse events.…”

mentioning

confidence: 99%

Acupuncture-Related Pneumothorax

Hampton

Kaneko

Simeon

et al. 2014

Medical Acupuncture

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“…1,5,12 In the case of AAVR, onset of prodromal symptoms is most commonly reported while needles are being inserted or during needle retention, however, published literature shows cases of AAVR onset occurring up to 12 hours post-treatment. 4,6,13 Due to the complexity of the neurocardiovascular reflexes involved, a patient can experience a wide range of signs and symptoms. These could include bradycardia, fatigue, lightheadedness, tunnel vision, blurred vision, nausea, vomiting, a feeling of warmth, cold perspiration, yawning, shaking, or general weakness.…”

Section: Biomedical Mechanism Of Aavrmentioning

confidence: 99%

“…2,3 With intervention, the effects of AAVR typically pass quickly, and in most cases, the patient recovers with no lasting effects. 4,6,13 In association with acupuncture treatment, it is possible that a patient can experience VVS suddenly and without the typical clinical triggers or prodromes of an AAVR. 5,12 While it is possible these individuals could be experiencing benign episodes of syncope, these patients should be examined further and referred as necessary to rule out any complicating and potentially life-threatening causes, such as cardiac or neurologic conditions, dysautonomic disturbances, or treatmentinduced adverse events or injuries.…”

Section: Biomedical Mechanism Of Aavrmentioning

confidence: 99%

“…12 Risk of AAVR is increased in cases when patients are nervous or fearful, poorly rested, fatigued, dehydrated, hungry or have not eaten recently, have a weak constitution, or are receiving acupuncture for the first time. 4,13 Additionally, strong stimulation from vigorous needling techniques, electrostimulation, or a large needle count, especially with acupuncture-naive patients, can confer additional risks. 1,4,13 Patient position during treatment also plays a role.…”

Section: Biomedical Mechanism Of Aavrmentioning

confidence: 99%

“…4,13 Additionally, strong stimulation from vigorous needling techniques, electrostimulation, or a large needle count, especially with acupuncture-naive patients, can confer additional risks. 1,4,13 Patient position during treatment also plays a role. Because acupuncture treatment causes vasodilation and subsequently reduced blood pressure, treating patients in a supine or prone position can help prevent AAVR.…”

Section: Biomedical Mechanism Of Aavrmentioning

confidence: 99%

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Acupuncture-Associated Vasovagal Response: Revised Terminology and Hospital Experience

Christensen

Gosse

Hildebrand

et al. 2017

Medical Acupuncture

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Background: Vasovagal responses associated with acupuncture therapy are relatively uncommon adverse events, occurring in *0.02%-7% of treatments. The complex neurocardiovascular reflexes involved in vasovagal responses can induce a range of symptoms such as dizziness, nausea, sweating, bradycardia, hypotension, and, in some cases, syncope or convulsions. Although patients typically recover quickly with proper support, these events may be of concern and anxiety-producing for both patient and provider. Providers need to be well-versed in methods for prevention and treatment of acupuncture-associated vasovagal responses to promote safe practice environments, patient satisfaction and comfort, and cost-effectiveness. Objectives: To examine the biomedical and Traditional Chinese Medicine mechanisms of vasovagal responses, propose updated terminology, and outline steps for prevention and treatment. Methods: During an 18-month period, 281 community-style acupuncture treatments were performed on family members of admitted patients and hospital staff members at the University of Minnesota Masonic Children's Hospital. Five (1.8%) treatments resulted in documented acupuncture-associated vasovagal response (AAVR) symptoms. Results: All 5 patients recovered from their AAVR symptoms after treatment interventions. After recovery, 3 patients reported reductions in their main complaint symptoms; main complaint symptom outcomes were not recorded for the other 2 patients. Conclusions: As integrative practices become more prevalent in academic institutions and primary care environments, clear communication about, as well as prevention treatment, documentation and reporting of acupuncture-associated adverse events will become increasingly valuable. The authors recommend that clinicians in integrative practice clinical environments consider developing formal AAVR response plans as well as training students, supervising and attending providers, and ancillary staff members to ensure rapid, prepared handling and documentation of AAVR incidents.

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