Meta-Analysis of Electroacupuncture in Cardiac Anesthesia and Intensive Care

Asmussen, Sven; Przkora, René; Maybauer, Dirk M.; Sanfilippo, Filippo; Jennings, Kristofer; Adamzik, Michael; Maybauer, Marc O.

doi:10.1177/0885066617708558

Cited by 23 publications

(13 citation statements)

References 32 publications

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“…Evidence exists that an integrated health approach to perioperative care has the potential to improve a patient’s entire recovery process 25. In addition to opioids, CM therapies may help minimize the use of other perioperative pharmacologic agents (eg, benzodiazepines, propofol infusions, inhalational agents) 26–28. By reducing the doses of these agents, the associated side effects and the resources expended to treat these side effects may also be reduced.…”

Section: Discussionmentioning

confidence: 99%

“…By reducing the doses of these agents, the associated side effects and the resources expended to treat these side effects may also be reduced. For example, studies of perioperative acupuncture have reported a reduced incidence of postoperative nausea and delirium, decreased frequency of postoperative antiemetic use, and shorter times to extubation and discharge from the recovery room 11–17 27–29. Furthermore, studies suggest that CM therapies may also mitigate the body’s overall response to the stress of surgery 26.…”

Section: Discussionmentioning

confidence: 99%

“…For example, two meta-analyses of perioperative acupuncture reported an associated decrease in stress biomarkers such as lower troponin levels after open cardiac procedures and lower S100β levels after craniotomies 27 28. Perioperative acupuncture has also been associated with decreased vasopressor requirement, improved glucose control, and shorter intensive care unit (ICU) stays, which could be surrogate evidence of reduced stress and better recovery from the operative procedure 26 27. While these claims need more rigorous investigation, the potential benefits seem reason enough to include CM in the perioperative setting.…”

Section: Discussionmentioning

confidence: 99%

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Integrating complementary medicine in the perioperative period: a simple, opioid-sparing addition to your multimodal analgesia strategy?

Kelleher

Kirksey

et al. 2020

Reg Anesth Pain Med

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The current US opioid health-related crisis underscores the importance for perioperative physicians to optimize various approaches to pain management. Multimodal techniques and enhanced recovery after surgery (ERAS) protocols are frequently cited as the most effective strategies for improving the experience of pain and reducing opioid exposure. Complementary medicine (CM) techniques, while frequently shown to be effective at reducing opioid and other pharmacologic agent use, are rarely discussed as part of these multimodal strategies. In general, CM therapies are low-cost with minimal associated risk, making them an ideal choice for incorporation into ERAS and other opioid-sparing protocols. In this Daring Discourse, we discuss the benefits and challenges of incorporating CM therapy into anesthetic practice. We hope that anesthesiologists can become more familiar with the current evidence regarding perioperative CM therapy, and begin incorporating these therapies as part of their comprehensive multimodal approach to perioperative pain management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Integrating complementary medicine in the perioperative period: a simple, opioid-sparing addition to your multimodal analgesia strategy?

Kelleher

Kirksey

et al. 2020

Reg Anesth Pain Med

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“…A meta-analysis performed by Asmussen and colleagues reported that the complementary use of acupuncture could reduce the amounts of volatile anesthetics used during craniotomy and cardiac surgery, leading to faster extubation and postoperative recovery times. They also reported a lower incidence of postoperative nausea and vomiting (PONV) in patients receiving acupuncture [84,85]. Many of the POCD studies included in Table 1 also reported these beneficial effects of acupuncture.…”

Section: Reducing the Use Of Anesthetic Agents Promoting Patientmentioning

confidence: 97%

Application of Acupuncture to Attenuate Immune Responses and Oxidative Stress in Postoperative Cognitive Dysfunction: What Do We Know So Far?

Zhao

Yeung

et al. 2020

Oxidative Medicine and Cellular Longevity

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Postoperative cognitive dysfunction (POCD) is a common sequela following surgery and hospitalization. The prevention and management of POCD are important during clinical practice. POCD more commonly affects elderly patients who have undergone major surgery and can result in major decline in quality of life for both patients and their families. Acupuncture has been suggested as an effective intervention for many neurological disorders. In recent years, there are increasing interest in the use of acupuncture to prevent and treat POCD. In this review, we summarized the clinical and preclinical evidence of acupuncture on POCD using a narrative approach and discussed the potential mechanisms involved. The experimental details and findings of studies were summarized in tables and analyzed. Most of the clinical studies suggested that acupuncture before surgery could reduce the incidence of POCD and reduce the levels of systematic inflammatory markers. However, their reliability is limited by methodological flaws. Animal studies showed that acupuncture reduced cognitive impairment and the associated pathology after various types of surgery. It is possible that acupuncture modulates inflammation, oxidative stress, synaptic changes, and other cellular events to mitigate POCD. In conclusion, acupuncture is a potential intervention for POCD. More clinical studies with good research design are required to confirm its effectiveness. At the same time, findings from animal studies will help reveal the protective mechanisms, in which systematic inflammation is likely to play a major role.

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“…Acupuncture is a typical traditional Chinese medicine treatment for migraines, widely applied in clinical setting, [ 10 ] and it is recommended as a supplementary or alternative treatment for various diseases. [ 11 – 14 ] EA is a form of acupuncture, consisting of electrical impulses passing through needles to stimulate acupoints. [ 4 ] Although numerous studies have demonstrated the curative effect of EA on post-stroke incontinence, they were mired with questionable quality and inconsistencies in safety [ 15 ] and efficacy.…”

Section: Introductionmentioning

confidence: 99%

The efficacy and safety of electroacupuncture against urinary incontinence after stroke

et al. 2020

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Background: Urinary incontinence (UI) is still a persistent challenge in many stroke survivors, affecting the quality of life and emotional being of these individuals. Numerous studies have demonstrated the curative effect of electroacupuncture on post-stroke incontinence, however they were mired with questionable quality and inconsistencies in safety and efficacy. Therefore, the main objective of this meta-analysis is to provide a comprehensive evaluation of the efficacy and safety of electroacupuncture against urinary incontinence after stroke, with a view of providing more reliable evidence-based solutions for UI. Methods: A systematic literature search will be conducted using PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, and 4 Chinese databases from inception to June 2020 to identify randomized control trials that report on electroacupuncture against urinary incontinence after stroke. Two reviewers will independently identify eligible studies and extract data. The risk of bias of the included randomized control trials will be evaluated according to the Cochrane tool. Risk ratio and 95% confidence intervals will be used to estimate the efficacy of treatment,. and the grading of recommendations, assessment, development, and evaluation approach to rate the certainty of evidence. The statistical heterogeneity will be evaluated by Cochran's Q and the I 2 . Data will be analyzed using Stata software (Version 13.0, Stata Corp, College Station, TX, USA). Results: This study will provide a comprehensive evaluation of the efficacy and safety of electroacupuncture against UI after stroke, with a view of providing more reliable evidence-based solutions for UI. Ethics and dissemination: This work synthesises evidence from previously published studies and does not require ethics review or approval. A manuscript describing the findings will be submitted for publication in a peer-reviewed scientific journal. INPLASY registration number: INPLASY202050073

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Meta-Analysis of Electroacupuncture in Cardiac Anesthesia and Intensive Care

Abstract: The complementary use of EA for open-heart surgery reduces the duration of MV and ICU stay, blunts the inflammatory response, and might have protective effects on the heart. Our findings stimulate future RCT to provide definitive recommendations.

Cited by 23 publications

References 32 publications

Integrating complementary medicine in the perioperative period: a simple, opioid-sparing addition to your multimodal analgesia strategy?

Integrating complementary medicine in the perioperative period: a simple, opioid-sparing addition to your multimodal analgesia strategy?

Application of Acupuncture to Attenuate Immune Responses and Oxidative Stress in Postoperative Cognitive Dysfunction: What Do We Know So Far?

The efficacy and safety of electroacupuncture against urinary incontinence after stroke

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