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Auricular Acupressure Adjunct Treatment for Opioid Tapering: A Randomized Pilot Feasibility Study
Heather J Jackson1, Micaela Arseneau2, Michelle Terrell2
1Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN.
Insights
Acupressure is a safe and feasible method to manage opioid withdrawal in infants. This study found it reduced weaning time and was well-accepted by parents and healthcare providers.
Area of Science:
- Pediatric Critical Care Medicine
- Integrative Medicine
- Neonatal Abstinence Syndrome Management
Background:
- Opioid medications are essential for critically ill infants but can cause withdrawal.
- Iatrogenic withdrawal syndrome (IWS) is a significant concern in neonatal intensive care units.
- Non-pharmacological interventions are needed to manage IWS.
Purpose of the Study:
- To assess the feasibility of an acupressure protocol for IWS in a pediatric cardiac intensive care unit.
- To evaluate the impact of acupressure on withdrawal symptom duration.
- To determine the acceptance of acupressure by parents and healthcare providers.
Main Methods:
- A randomized pilot feasibility trial was conducted.
- Acupressure stickers were applied to the ear every 1-3 days until symptoms improved.
- Parent and healthcare provider satisfaction and acceptance were measured.
Main Results:
- No serious adverse events occurred; only one case of skin irritation was reported.
- Weaning phases were significantly shorter in the acupressure group (6.0 vs 22.0 days).
- Parents reported high satisfaction (96.2%), and 71.9% of healthcare providers found acupressure acceptable.
Conclusions:
- Acupressure is a safe, feasible, and accepted adjunct treatment for iatrogenic withdrawal in pediatric cardiac ICUs.
- Findings support larger trials to optimize clinical management of infants dependent on sedative medications.
Purpose:
Opioid medications are necessary in the treatment of critically ill infants; however. prolonged use may lead to withdrawal syndrome. The purpose of this study was to assess feasibility of delivering an acupressure protocol for the treatment of iatrogenic withdrawal in a pediatric cardiac intensive care unit as well as impact and acceptance of acupressure as an adjunct treatment.
Design:
Randomized pilot feasibility trial.
Methods:
Acupressure stickers were applied and rotated to one ear every 1-3 days until withdrawal symptoms improved.
Results:
There were no serious adverse events, with only one reported incident of skin irritation. Recruiting benchmarks were exceeded. Weaning phases were significantly shorter in the acupressure group (medians 6.0 vs 22.0 respectively, p = .025, d = 0.90) and the control group used skin-to-skin contact as a comfort measure significantly more than the acupressure group (42.9% vs 6.3%, p = .18). Acupressure was accepted by parents, with an overall 96.2% rating their experience as positive, as measured by the Parent Client Satisfaction Questionnaire. The majority of health care providers (n = 19) were supportive, with 71.9% agreeing or completely agreeing acupressure is an acceptable adjunct for the treatment of withdrawal symptoms; 26.8% were neutral, as measured by the Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure.
Conclusions:
Acupressure was found to be safe, feasible, and accepted by health care providers in a pediatric cardiac intensive care setting.
Clinical Implications:
These findings support future research with larger sample sizes to improve clinical treatment of infants physically dependent on sedative medications.
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