Laser acupuncture reduces pain in pediatric kidney biopsies: a randomized controlled trial

Abstract

Evaluate laser acupuncture as an adjuvant therapy in pain management during percutaneous kidney biopsy procedure in children and adolescents. This prospective, double-blinded, randomized controlled trial enrolled patients aged 7-26 years admitted to a children’s hospital for percutaneous kidney biopsy. Patients received laser acupuncture to treatment points (acupuncture group) or sham points (control group) prior to the procedure. Laser delivered a dose of 42 J/cm2 over 10 acupoints. Patients and parents rated the pain during and after the biopsy, and change in pain scores were calculated for each patient. Anxiety, vital signs, sedation medication, and patient’s biopsy experience were secondary outcomes. Sixty-nine treatments (33 acupuncture group, 36 control group) were eligible for analysis. Patients in the acupuncture group reported a significantly improved change in pain score after the biopsy compared to the controls (0.8 vs −0.5, ρ=0.044). Patients in the acupuncture group had a statistically significant decrease in procedure vital signs including heart rate (−1.8 vs 5.6, ρ=0.043) and respiratory rate (−2.4 vs 0.4, ρ=0.045) when compared to controls. Parents also perceived a correspondingly greater improvement in their child’s pain for those in the acupuncture group compared to the controls (2.3 vs 0.3, ρ=0.04). Adjunctive laser acupuncture significantly improved pain after pediatric percutaneous kidney biopsies.

Acupuncture for pediatric pain: The trend of evidence-based research

“… 17 Oates et al., 2017 7–26 year old 69 Procedure pain in kidney biopsy Two-arm RCT Adjunctive laser acupuncture significantly improved pain after pediatric percutaneous kidney biopsies. 14 Pour et al., 2017 6–12 year old 120 Venipuncture pain Three-arm RCT Acupressure at the Extra −1 (Yintang) and the PC8 (Laogong) was as effective as topical anesthesia cream in alleviating children's venipuncture pain. 15 …”

“…This report evaluates research in pediatric acupuncture and pain management, in which approximately 55% of the selected articles were related to procedural pediatric pain management. The pediatric procedures included infant heel lancing, 3 , 4 , 7 , 8 , 9 ,nsillectomy 10 , 11 and dental-related, 12 myringotomy tube surgery, 13 kidney biopsy, 14 ventipuncture, 15 and endoscopic pre-procedural anxiety. 16 Collectively, these studies researched how acupuncture could lead to the reduction of post-operative pain, emergence irritation, procedural time, and infantile crying.…”

“… 13 Post-procedural pain in ages 7–26 years old has shown to be reduced in percutaneous kidney biopsies with acupuncture of GB25, BL52, BL21, BL22, and BL 23 bilaterally performed pre-operatively. 14 Acupressure of EX-HN3 and P8 (Laogong) in ages 6–12 years old has been shown to effectively lower pain comparable to topical anesthesia cream. 15 …”

Unilateral Acupuncture Reduces Postoperative Pain Scores in Children Undergoing Adenotonsillectomy: A Randomized Controlled Trial

“…Similar to our results, Oates et al found improvement of self-reported pain scores as well as the associated hemodynamic changes. 29 …”

Invasive and non-invasive acupuncture techniques for pain management in neonates: a systematic review

“…Acupuncture is a gentle treatment tool, yet it is a relatively new research field in children and neonates. 31,32 Acupuncture treatment for pain in the paediatric population has been investigated in several studies, including headache, abdominal pain, fibromyalgia, juvenile arthritis, complex regional pain syndrome, cancer pain and perioperative pain. 33 In most cases, acupuncture has demonstrated a pain relieving effect and good acceptance by patients and parents, so it has been suggested as a safe and cost-effective treatment modality for paediatric pain.…”