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The safety of pediatric acupuncture: a systematic review
Denise Adams1, Florence Cheng, Hsing Jou
1Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Insights
Pediatric acupuncture is generally safe, with most adverse events (AEs) being mild, such as pain or bruising. Serious AEs were rare and often linked to improper practice, underscoring the need for trained practitioners.
Area of Science:
- Integrative Medicine
- Pediatric Health
- Patient Safety
Background:
- Pediatric acupuncture use is rising, but systematic safety data is limited.
- Assessing adverse events (AEs) is crucial for understanding pediatric acupuncture safety.
Purpose of the Study:
- To systematically review and identify adverse events associated with needle acupuncture in pediatric populations.
Main Methods:
- Comprehensive database search (inception-September 2010) for original research on pediatric acupuncture and AEs.
- Inclusion criteria: peer-reviewed studies, children (0-17 years), needle acupuncture, AE assessment.
- Safety data extraction from 37 included reports.
Main Results:
- 279 AEs identified: 25 serious, 1 moderate, 253 mild.
- Mild AEs included pain, bruising, bleeding; serious AEs involved infections, deformities, and rare severe complications.
- Mild AE incidence was 11.8% (168/1422 patients).
Conclusions:
- The majority of AEs from pediatric needle acupuncture are mild.
- Serious AEs may stem from substandard practice, highlighting practitioner training importance.
- Acupuncture is safe in children when performed by qualified professionals, consistent with adult data.
Context:
Acupuncture is increasingly used in children; however, the safety of pediatric acupuncture has yet to be reported from systematic review.
Objective:
To identify adverse events (AEs) associated with needle acupuncture in children.
Methods:
Eighteen databases were searched, from inception to September 2010, irrespective of language. Inclusion criteria were that the study (1) was original peer-reviewed research, (2) included children from birth to 17 years, inclusively, (3) involved needle acupuncture, and (4) included assessment of AEs in a child. Safety data were extracted from all included studies.
Results:
Of 9537 references identified, 450 were assessed for inclusion. Twenty-eight reports were included, and searches of reference lists identified 9 additional reports (total: 37). A total of 279 AEs were identified, 146 from randomized controlled trials, 95 from cohort studies, and 38 from case reports/series. Of the AEs, 25 were serious (12 cases of thumb deformity, 5 infections, and 1 case each of cardiac rupture, pneumothorax, nerve impairment, subarachnoid hemorrhage, intestinal obstruction, hemoptysis, reversible coma, and overnight hospitalization), 1 was moderate (infection), and 253 were mild. The mild AEs included pain, bruising, bleeding, and worsening of symptoms. We calculated a mild AE incidence per patient of 168 in 1422 patients (11.8% [95% confidence interval: 10.1-13.5]).
Conclusions:
Of the AEs associated with pediatric needle acupuncture, a majority of them were mild in severity. Many of the serious AEs might have been caused by substandard practice. Our results support those from adult studies, which have found that acupuncture is safe when performed by appropriately trained practitioners.
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