Efficacy of Acupuncture Combined with Patient-Controlled Analgesia in the Treatment of Acute Pain after Back Surgery: A Meta-Analysis

Objectives. Acupuncture is used worldwide to relieve both acute and chronic pain. Patient-controlled analgesia (PCA) is also frequently used for postoperative pain relief. However, there are few meta-analyses of the efficacy of acupuncture with PCA in reducing acute postoperative pain. This meta-ana...

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Main Authors: Daling Deng, Feng Xu, Yafeng Wang, Lulin Ma, Tianhao Zhang, Wenjing Zhao, Xiangdong Chen
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Pain Research and Management
Online Access:http://dx.doi.org/10.1155/2022/2551591
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author Daling Deng
Feng Xu
Yafeng Wang
Lulin Ma
Tianhao Zhang
Wenjing Zhao
Xiangdong Chen
author_facet Daling Deng
Feng Xu
Yafeng Wang
Lulin Ma
Tianhao Zhang
Wenjing Zhao
Xiangdong Chen
author_sort Daling Deng
collection DOAJ
description Objectives. Acupuncture is used worldwide to relieve both acute and chronic pain. Patient-controlled analgesia (PCA) is also frequently used for postoperative pain relief. However, there are few meta-analyses of the efficacy of acupuncture with PCA in reducing acute postoperative pain. This meta-analysis aimed to assess the effectiveness of acupuncture with PCA in relieving acute pain after back surgery. Methods. We searched seven databases (Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure (CNKI), Wanfang database, Chongqing VIP (VIP), and Chinese BioMedical Literature Database (CBM)-from 1949 until now) without language restrictions for randomized controlled trials, including patients undergoing back surgery and receiving PCA alone or treated with acupuncture/sham acupuncture + PCA for pain relief. This meta-analysis assessed pain intensity, with visual analogue scale (VAS) score and postoperative opioid dosage as primary outcomes. Results. A total of 12 randomized controlled trials (n = 904) met the inclusion criteria. Compared with the control group (standard mean difference (SMD) = ‒0.42, 95% CI = ‒0.60 to ‒0.25, P<0.01) or sham acupuncture + PCA (SMD = ‒0.7, 95% CI = ‒0.94 to ‒0.46, P<0.01), acupuncture + PCA treatment reduced the VAS score in patients after back surgery. Acupuncture + PCA decreased the use of opioids after surgery compared to sham acupuncture + PCA (SMD = −0.35, 95% CI = ‒0.63 to ‒0.07, P=0.01) or control group (SMD = ‒0.82, 95% CI = ‒1.03 to ‒0.61, P<0.01). Furthermore, the use of acupuncture with PCA reduced the incidence of postoperative PCA-related total complications (odds ratio = 0.44, 95% CI = 0.23 to 0.85, P=0.01), but may not reduce the incidence of postoperative nausea and vomiting (odds ratio =0.82 , 95% CI =0.49 to 1.36, P=0.44). Conclusion. This systematic review found that acupuncture with PCA relieved acute pain after back surgery more effectively than PCA alone and could reduce opioid use and the incidence of postoperative PCA-related total complications
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spelling doaj-art-c73484a292ef44438c1e7253f6231d592025-02-03T05:57:30ZengWileyPain Research and Management1918-15232022-01-01202210.1155/2022/2551591Efficacy of Acupuncture Combined with Patient-Controlled Analgesia in the Treatment of Acute Pain after Back Surgery: A Meta-AnalysisDaling Deng0Feng Xu1Yafeng Wang2Lulin Ma3Tianhao Zhang4Wenjing Zhao5Xiangdong Chen6Department of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyDepartment of AnesthesiologyObjectives. Acupuncture is used worldwide to relieve both acute and chronic pain. Patient-controlled analgesia (PCA) is also frequently used for postoperative pain relief. However, there are few meta-analyses of the efficacy of acupuncture with PCA in reducing acute postoperative pain. This meta-analysis aimed to assess the effectiveness of acupuncture with PCA in relieving acute pain after back surgery. Methods. We searched seven databases (Cochrane Library, Web of Science, PubMed, China National Knowledge Infrastructure (CNKI), Wanfang database, Chongqing VIP (VIP), and Chinese BioMedical Literature Database (CBM)-from 1949 until now) without language restrictions for randomized controlled trials, including patients undergoing back surgery and receiving PCA alone or treated with acupuncture/sham acupuncture + PCA for pain relief. This meta-analysis assessed pain intensity, with visual analogue scale (VAS) score and postoperative opioid dosage as primary outcomes. Results. A total of 12 randomized controlled trials (n = 904) met the inclusion criteria. Compared with the control group (standard mean difference (SMD) = ‒0.42, 95% CI = ‒0.60 to ‒0.25, P<0.01) or sham acupuncture + PCA (SMD = ‒0.7, 95% CI = ‒0.94 to ‒0.46, P<0.01), acupuncture + PCA treatment reduced the VAS score in patients after back surgery. Acupuncture + PCA decreased the use of opioids after surgery compared to sham acupuncture + PCA (SMD = −0.35, 95% CI = ‒0.63 to ‒0.07, P=0.01) or control group (SMD = ‒0.82, 95% CI = ‒1.03 to ‒0.61, P<0.01). Furthermore, the use of acupuncture with PCA reduced the incidence of postoperative PCA-related total complications (odds ratio = 0.44, 95% CI = 0.23 to 0.85, P=0.01), but may not reduce the incidence of postoperative nausea and vomiting (odds ratio =0.82 , 95% CI =0.49 to 1.36, P=0.44). Conclusion. This systematic review found that acupuncture with PCA relieved acute pain after back surgery more effectively than PCA alone and could reduce opioid use and the incidence of postoperative PCA-related total complicationshttp://dx.doi.org/10.1155/2022/2551591
spellingShingle Daling Deng
Feng Xu
Yafeng Wang
Lulin Ma
Tianhao Zhang
Wenjing Zhao
Xiangdong Chen
Efficacy of Acupuncture Combined with Patient-Controlled Analgesia in the Treatment of Acute Pain after Back Surgery: A Meta-Analysis
Pain Research and Management
title Efficacy of Acupuncture Combined with Patient-Controlled Analgesia in the Treatment of Acute Pain after Back Surgery: A Meta-Analysis
title_full Efficacy of Acupuncture Combined with Patient-Controlled Analgesia in the Treatment of Acute Pain after Back Surgery: A Meta-Analysis
title_fullStr Efficacy of Acupuncture Combined with Patient-Controlled Analgesia in the Treatment of Acute Pain after Back Surgery: A Meta-Analysis
title_full_unstemmed Efficacy of Acupuncture Combined with Patient-Controlled Analgesia in the Treatment of Acute Pain after Back Surgery: A Meta-Analysis
title_short Efficacy of Acupuncture Combined with Patient-Controlled Analgesia in the Treatment of Acute Pain after Back Surgery: A Meta-Analysis
title_sort efficacy of acupuncture combined with patient controlled analgesia in the treatment of acute pain after back surgery a meta analysis
url http://dx.doi.org/10.1155/2022/2551591
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