Efectividad de la acupuntura en el tratamiento del dolor agudo postquirúrgico en adultos, en comparación con tratamientos activos o con acupuntura simulada

Cargill, Francisca Fuentealba; Alarcón, Leandro Biagini

doi:10.4067/s0034-98872016000300007

Cited by 8 publications

(3 citation statements)

References 11 publications

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“…3 Lao and colleagues 4 observed that the pain-free duration in patients with third molar extractions under acupuncture analgesia was significantly longer than that in the same surgery patients experiencing placebo acupuncture; and the pain intensity after oral surgery was significantly lower in the former surgery patients. Moreover, Fuentealba and Biagini 5 reported that in the postoperative period of tonsillectomy, acupuncture interventions reduced pain by 36% and 22% at 20 min and 2 h, respectively. In patients undergoing knee replacement, acupuncture intervention reduced pain by 2% and analgesic consumption by 42%.…”

Section: Introductionmentioning

confidence: 99%

<p>GABAergic Inhibition of Spinal Cord Dorsal Horns Contributes to Analgesic Effect of Electroacupuncture in Incisional Neck Pain Rats</p>

Wang¹,

Bai²,

Gao³

et al. 2020

JPR

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Background: Acupuncture has shown to be effective in relieving post-surgical pain. Nonetheless, its underlying mechanisms remain largely unknown. In the present study, we investigated the effect of electroacupuncture (EA) on the expression of GABA, GABA-A receptor (R) and GABA-BR in the spinal cord dorsal horns (DHs), and the involved neural cells in rats with incisional neck pain. Materials and Methods: Male SD rats were randomly divided into control, model, Futu (LI18), Hegu-Neiguan (LI4-PC6), and Zusanli-Yanglingquan (ST36-GB34) groups. The incisional neck pain model was established by making a longitudinal incision and repeated mechanical separation along the thyroid gland region. EA (2Hz/100Hz, 1mA) was applied to LI18, LI4-PC6, ST36-GB34 separately for 30min, once at 4, 24 and 48h after incision. The local thermal pain threshold (TPT) of the focus was measured and the expression of GABA, and GABAR proteins and mRNAs detected by immunofluorescence stain and quantitative RT-PCR, respectively. Results: The analgesic effect of LI18 and LI4-PC6 was superior to that of ST36-GB34 in incisional neck pain rats. Moreover, the EA stimulation of LI18 or LI4-PC6 increased the expression of GABA and GABA-Aα2 and GABA-Aβ3, GABA-B1, and GABA-B2 mRNAs in spinal DHs 4h after surgery, while GABA-A and GABA-B antagonists inhibited the analgesic effect of LI18. Immunofluorescence double staining showed that GABA was expressed on astrocytes and neurons, and GABA-B expressed only on neurons. Conclusion: EA of both LI18 and LI4-PC6 has a good analgesic effect in incisional neck pain rats, which is closely related to their effects in upregulating the expression of GABA and its receptors in spinal DHs. The effects of LI18 and LI4-PC6 EA are obviously better that those of ST36-GB34 EA, and GABA is expressed on neurons and astrocytes.

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Section: Introductionmentioning

confidence: 99%

<p>GABAergic Inhibition of Spinal Cord Dorsal Horns Contributes to Analgesic Effect of Electroacupuncture in Incisional Neck Pain Rats</p>

Wang¹,

Bai²,

Gao³

et al. 2020

JPR

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“…It was reported that percutaneous peripheral nerve stimulation can be used to treat acute postoperative pain of various types of surgeries [ 32 ]. Acupuncture intervention and transcutaneous electrical nerve stimulation (TENS), being similar to percutaneous peripheral nerve stimulation, have been proved to be effective for relieving postoperative pain of neck surgery [ 9 , 10 , 33 ], tonsillectomy [ 7 , 11 , 34 ], back surgery [ 5 ], dental procedures [ 7 , 35 ], and knee replacement [ 7 ]. Our previous clinical study [ 33 ] also showed that EA of LI18 and LI4-PC6 had a good effect in inducing analgesia and controlling the mean arterial pressure (MAP) and heart rate (HR), and reduced the anesthetic dose required by patients undergoing thyroid surgery.…”

Section: Discussionmentioning

confidence: 99%

Electroacupuncture Alleviates Hyperalgesia by Regulating CB1 Receptor of Spinal Cord in Incisional Neck Pain Rats

Wang

Zhang

Gao

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Acupuncture therapy is effective in relieving postoperative pain of neck surgery, but its underlying mechanisms remain largely unknown. This study, in the incisional neck pain rat model, was designed to explore whether the endocannabinoid receptor 1 (CB1) in the cervical spinal cord is involved in the analgesic effect of electroacupuncture (EA) or not.The incisional neck pain model was established by making a longitudinal incision and applied EA treatment of Futu (LI18), Hegu-Neiguan (LI4-PC6), or Zusanli-Yanglingquan (ST36-GB34) for pain relief. The results showed that EA LI18 and EA LI4-PC6 effectively relieve allodynia caused by neck incision, which was obviously better than EA ST34-GB34 ( P < 0.05). After EA, the expression levels of CB1 mRNA at 4h in the EALI18 group, and 24 and 48h in both EALI18 and EALI4-PC6 groups, and those of CB1 protein at 4, 24, and 48h in the EALI18 group, and the immunoactivity of CB1 in both EALI18 and EALI4-PC6 groups at 4h were significantly upregulated in contrast to those of the model group ( P < 0.05). EA of either acupoint group had no effect on the expression of CB2 protein ( P > 0.05). Moreover, the antinociceptive effect of EA was reversed by AM251 (CB1 antagonist). Immunofluorescence dual staining showed that CB1 expressed in astrocytes in the superficial layer (laminae I and II) of dorsal horns of the cervical spinal cord. Therefore, the findings of this study revealed that upregulation of CB1 expression in the cervical spinal cord contributes to the analgesic effect of EA in incisional neck pain rats. The CB1 receptor expresses on astrocytes.

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“…Low numbers of studies of heterogenous design and quality limit the reliability of data, however, and more studies are needed to reach aconsensus. [60][61][62][63] Evidence for cold therapy exists so far only in randomized controlled trials for a variety of surgical procedures, including hernia repair, A-V fistula creation, and dental surgery. 59,[64][65][66][67][68][69][70][71][72] Other methods also need further study even though they are endorsed by various institutions.…”

Section: Recommendations and Summary Of Evidencementioning

confidence: 99%

Consensus Statement for the Prescription of Pain Medication at Discharge after Elective Adult Surgery

Clarke

Manoo

Pearsall

et al. 2020

Canadian Journal of Pain

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This Consensus Statement provides recommendations on the prescription of pain medication at discharge from hospital for opioid-naïve adult patients who undergo elective surgery. It encourages health care providers (surgeons, anesthesiologists, nurses/nurse practitioners, pain teams, pharmacists, allied health professionals, and trainees) to (1) use nonopioid therapies and reduce the prescription of opioids so that fewer opioid pills are available for diversion and (2) educate patients and their families/caregivers about pain management options after surgery to optimize quality of care for postoperative pain. These recommendations apply to opioid-naïve adult patients who undergo elective surgery. This consensus statement is intended for use by health care providers involved in the management and care of surgical patients. A modified Delphi process was used to reach consensus on the recommendations. First, the authors conducted a scoping review of the literature to determine current best practices and existing guidelines. From the available literature and expertise of the authors, a draft list of recommendations was created. Second, the authors asked key stakeholders to review and provide feedback on several drafts of the document and attend an in-person consensus meeting. The modified Delphi stakeholder group included surgeons, anesthesiologists, residents, fellows, nurses, pharmacists, and patients. After multiple iterations, the document was deemed complete. The recommendations are not graded because they are mostly based on consensus rather than evidence. RÉSUMÉ Cette déclaration de consensus fait des recommandations pour la prescription d'analgésiques à la sortie de l'hôpital pour les patients adultes n'ayant jamais pris d'opiacés et qui subissent une intervention chirurgicale non urgente. Elle encourage les prestataires de soins de santé (chirurgiens, anesthésiologistes, infirmières et infirmiers, infirmières et infirmiers praticiens, équipes antidouleur, pharmaciens, professionnels de la santé et stagiaires) à (1) utiliser des traitements non opiacés et à réduire la prescription d'opiacés afin de réduire le nombre de pilules opiacées pouvant être détournées; et (2) à éduquer les patients, ainsi que leurs familles et soignants, sur les options de prise en charge de la douleur après l'opération afin d'optimiser la qualité des soins pour la douleur postopératoire. Ces recommandations s'appliquent aux patients adultes n'ayant jamais pris d'opioïdes et qui subissent une intervention chirurgicale non urgente. Cette déclaration de consensus est destinée à être utilisée par les prestataires de soins de santé impliqués dans la prise en charge des patients opérés et les soins qui leur sont apportés. Un processus Delphi modifié a été utilisé pour parvenir à un consensus sur les recommandations. Tout d'abord, les auteurs ont procédé à une de la portée de la littérature afin de déterminer les pratiques exemplaires actuelles et les lignes directrices existantes. À partir de la littérature disponible et de l'expertise des ...

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Efectividad de la acupuntura en el tratamiento del dolor agudo postquirúrgico en adultos, en comparación con tratamientos activos o con acupuntura simulada

Abstract: Artículos de InvestIgAcIón (Rev Med Chile 2016; 144: 325-332)

Cited by 8 publications

References 11 publications

<p>GABAergic Inhibition of Spinal Cord Dorsal Horns Contributes to Analgesic Effect of Electroacupuncture in Incisional Neck Pain Rats</p>

<p>GABAergic Inhibition of Spinal Cord Dorsal Horns Contributes to Analgesic Effect of Electroacupuncture in Incisional Neck Pain Rats</p>

Electroacupuncture Alleviates Hyperalgesia by Regulating CB1 Receptor of Spinal Cord in Incisional Neck Pain Rats

Consensus Statement for the Prescription of Pain Medication at Discharge after Elective Adult Surgery

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