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Intraoperative acupuncture for posttonsillectomy pain: a randomized, double-blind, placebo-controlled trial
Gabriel J Tsao1, Anna H Messner1, Jeannie Seybold1
1Department of Otolaryngology-Head and Neck Surgery, and the Department of Anesthesia, Stanford University School of Medicine, Stanford, California, U.S.A.
Insights
Intraoperative acupuncture significantly improved pain control and oral intake in children after tonsillectomy. This safe and well-tolerated treatment offers a promising option for pediatric post-tonsillectomy pain management.
Area of Science:
- Pain Management
- Pediatric Surgery
- Integrative Medicine
Background:
- Posttonsillectomy pain is a significant concern in pediatric patients.
- Effective pain management strategies are crucial for recovery and well-being.
- Current treatments may have limitations or side effects.
Purpose of the Study:
- To evaluate the efficacy of intraoperative acupuncture in reducing posttonsillectomy pain.
- To assess the impact of acupuncture on opioid consumption and recovery time.
- To determine the safety and tolerability of intraoperative acupuncture in children.
Main Methods:
- Prospective, double-blind, randomized, placebo-controlled trial.
- Recruitment of pediatric patients (3-12 years) undergoing tonsillectomy.
- Comparison of intraoperative acupuncture versus sham acupuncture during anesthesia.
Main Results:
- No significant differences in opioid use or postanesthesia care unit time.
- Patients receiving acupuncture reported significantly improved postoperative pain control.
- Earlier improvement in oral intake was observed in the acupuncture group.
- No adverse effects were reported with acupuncture treatment.
Conclusions:
- Intraoperative acupuncture is a feasible and well-tolerated intervention.
- Acupuncture demonstrates significant benefits in pediatric posttonsillectomy pain management.
- This approach may enhance recovery and improve patient experience.
Objectives/Hypothesis:
To evaluate the effect of intraoperative acupuncture on posttonsillectomy pain in the pediatric population.
Study Design:
Prospective, double-blind, randomized, placebo-controlled trial.
Methods:
Patients aged 3 to 12 years undergoing tonsillectomy were recruited at a tertiary children's hospital between February 2011 and May 2012. Participants were block-randomized to receive acupuncture or sham acupuncture during anesthesia for tonsillectomy. Surgeons, staff, and parents were blinded from treatment. Tonsillectomy was performed by one of two surgeons using a standard technique (monopolar cautery), and a single anesthetic protocol was followed. Study endpoints included time spent in the postanesthesia care unit, the amount of opioids administered in the perioperative period, and pain measures and presence of nausea/vomiting from postoperative home surveys.
Results:
Fifty-nine children aged 3 to 12 years were randomized to receive acupuncture (n = 30) or sham acupuncture (n = 29). No significant demographic differences were noted between the two cohorts. Perioperative data were recorded for all patients; 73% of patients later returned home surveys. There were no significant differences in the amount of opioid medications administered or total postanesthesia care unit time between the two cohorts. Home surveys of patients but not of parents revealed significant improvements in pain control in the acupuncture treatment-group postoperatively (P = 0.0065 and 0.051, respectively), and oral intake improved significantly earlier in the acupuncture treatment group (P = 0.01). No adverse effects of acupuncture were reported.
Conclusions:
This study demonstrates that intraoperative acupuncture is feasible, well tolerated, and results in improved pain and earlier return of diet postoperatively.
Level Of Evidence:
1b.
