Therapeutic effects of auricular point acupressure on the recovery of patients after pterygium surgery: A pilot study

The analgesic effectiveness of auriculotherapy for acute postoperative pain: A systematic review and meta-analysis

BACKGROUND

Postoperative pain is a significant yet inadequately managed complication following surgery, and auriculotherapy to alleviate acute postoperative pain (APP) and reduce the use of opioids remains controversial.

METHODS

We searched the MEDLINE, Web of Science, Embase, Cochrane Library, CINAHL Complete, and ClinicalTrials.gov from inception to January 23, 2024 for all randomized controlled trials (RCTs) of auriculotherapy in the treatment of APP. The extracted data underwent risk of bias assessment, meta-analysis, subgroup analyses, sensitivity analysis, meta-regression analysis, and evidence rating.

RESULTS

A total of 24 studies involving 2131 patients were included in the meta-analysis. Low-quality evidence indicated that auriculotherapy was effective in reducing pain intensity at 24 [MD(95 %CI)=-0.64(-1.09, -0.19), I2=77 %, P＜0.01], 48 [MD(95 %CI)=-0.49(-0.97, 0.00), I2=71 %, P=0.05], and 72 [MD(95 %CI)=-0.80(-1.32, -0.28), I2=52 %, P＜0.01] hours after surgery, while moderate-quality evidence showed a decrease in total opioid consumption [MD(95 %CI)=-24.41 OME (-38.28, -10.54), I2=95 %, P＜0.01]. However, no significant effects were observed in reducing postoperative nausea or vomiting [RR(95 %CI)=0.61(0.32, 1.16), I2=71 %, P=0.13; RR(95 %CI)=0.32(0.09, 1.18), I2=71 %, P=0.09; RR (95 %CI)=0.34(0.11, 1.06), I2=28 %, P=0.06; for postoperative nausea and vomiting (PONV), postoperative nausea or postoperative vomiting respectively], with evidence ranging from moderate to very low. Additionally, two RCTs found that auriculotherapy could delay the time to the first request for analgesia.

CONCLUSIONS

The summary estimates indicate that auriculotherapy may be beneficial in reducing APP and opioid consumption in specific surgeries based on low-to-moderate quality evidence. However, high-quality RCTs are still further studied in different surgical populations.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO database, CRD42024506989.

Efficacy of thumbtack needle acupuncture combined with PCIA on patients after laparoscopic myomectomy: a randomized controlled trial

Background

Pain and gastrointestinal dysfunction after laparoscopic myomectomy (LM) are significant issues that prevent this procedure from being classified as a "Day Surgery." This study aims to assess the effectiveness and safety of thumbtack needle acupuncture (TNA) combined with patient-controlled intravenous analgesia (PCIA) for promoting enhanced recovery after LM.

Methods

A total of 52 patients were enrolled in the study, divided into a treatment group receiving TNA and a control group. Both groups were administered PCIA without background sufentanil. For rescue analgesia or antiemetic needs, a bolus infusion of flurbiprofen axetil (50 mg) or intravenous metoclopramide (10 mg) was provided. The primary outcomes measured were the Visual Analog Scale (VAS) scores at awakening, as well as at 36 h, 48 h, and 60 h after LM. Secondary outcomes included VAS scores at 6 h, 12 h, 24 h, and 72 h after LM, total sufentanil consumption, the number of PCIA analgesic requests (attempts), the number of doses of rescue flurbiprofen axel analgesia required, preoperative anxiety scores, gastrointestinal function recovery assessment, first ambulation time, length of hospital stay, and patient satisfaction. Adverse events were also recorded.

Results

Compared to the control group, the treatment group showed significantly lower VAS scores, fewer analgesia attempts, reduced total sufentanil consumption, and a smaller number of rescue analgesia doses after LM, along with lower preoperative anxiety scores and higher satisfaction with pain management (p < 0.05). Gastrointestinal function recovery was enhanced in the treatment group, as indicated by earlier flatus and defecation, a lower incidence of postoperative nausea and vomiting (PONV), and a smaller number of metoclopramide doses required (p < 0.05). Additionally, ambulation occurred earlier, and the length of hospital stay was shorter in the treatment group (p < 0.05). No adverse events were observed in patients receiving TNA.

Conclusion

TNA is a safe intervention that effectively alleviates postoperative pain, decreases the total consumption of sufentanil, reduces preoperative anxiety, enhances the recovery of gastrointestinal function, and shortens the duration of hospitalization, making it an ideal adjunct treatment for postoperative recovery after LM. Further research is required to understand the mechanisms underlying this intervention.

Clinical trial registration

www.chictr.org.cn, ChiCTR2300069015.

The Efficacy and Safety of Chinese Eye Exercise of Acupoints in Dry Eye Patients: A Randomized Controlled Trial

INTRODUCTION

Dry eye disorder (DED) is a growing global issue linked to excessive digital screen time. Chinese eye exercise of acupoint (CEA), a set of self-massages on shared Chinese acupuncture (CA), has been used to reduce visual-related ocular symptoms and possibly as an alternative treatment for DED. This study aimed to assess the efficacy and safety of CEA.

METHODS

A single-blind randomized controlled trial was conducted at Thammasat University Hospital in Thailand, recruiting 56 participants aged 20-60 years, equally divided into two groups: the treatment group with CEA and the control group with standard lid hygiene treatment (STD). The intervention program lasted 12 weeks.

MAIN OUTCOME MEASURES

Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), Schirmer-I test (SIT), corneal surface staining (CSS), and self-recorded forms for safety and adverse effects were measured at baseline, week 4, and week 12. An independent sample t test, paired t test, and repeated measures (ANOVA) were used to compare results between both groups, study visits, and primary and secondary outcome measurements, respectively. The p values <0.05 were considered statistically significant.

RESULTS

The characteristics were not statistically different between both groups at the baseline. The mean OSDI scores were significantly reduced in both groups at week 4 and week 12 compared to baseline (p value <0.05). Additionally, both CEA and STD showed significant improvement in TBUT and SIT (p value <0.05). CSS was significantly improved only in the CEA groups (p value <0.05). No significant differences were observed between the study groups, except for SIT at week 12 (p value <0.05). For the safety, there were no adverse side effects in either group.

CONCLUSION

CEA seemed to be as effective as STD in improving the OSDI, TBUT, and SIT of DED without causing any side effects.

Einleitung

Das Trockene Auge (Dry eye disorder, DED) ist weltweit ein zunehmendes Problem, das mit übermässiger Bildschirmarbeit zusammenhängt. Die chinesische Augenübung der Akupunkturpunkte (Chinese eye exercise of acupoint, CEA), eine Reihe von Selbstmassagen an gemeinsamen CA-Akupunkturpunkten, wird zur Linderung visusbezogener Augensymptome und als mögliche alternative Behandlung für DED eingesetzt. Mit dieser Studie sollte die Wirksamkeit und Sicherheit von CEA bewertet werden.

Methoden

Am Thammasat-Universitätsklinikum in Thailand wurde eine einfach verblindete, randomisierte, kontrollierte Studie mit 56 Teilnehmern im Alter von 20 bis 60 Jahren durchgeführt, die zu gleichen Teilen zwei Gruppen zugewiesen wurden: die Behandlungsgruppe mit CEA und die Kontrollgruppe, die die Standard-Lidhygienebehandlung erhielt (STD). Das Interventionsprogramm dauerte 12 Wochen. Die Haupt-Zielkriterien, der Ocular Surface Disease Index (OSDI), die Tränenfilmaufreisszeit (tear break-up time, TBUT), der Schirmer-I-Test (SIT), das Corneal Surface Staining (CSS) und Selbstauskunftsformulare zur Sicherheit und zu unerwünschten Wirkungen wurden zu Beginn der Behandlung, in Woche 4 und in Woche 12 ermittelt. Für den Vergleich der Ergebnisse zwischen den beiden Gruppen, den Studienvisiten bzw. den primären und sekundären Zielkriterien wurden ein t Test für unabhängige Stichproben, ein t Test für paarige Stichproben und eine ANOVA mit Messwiederholungen verwendet. p-Werte <0,05 galten als statistisch signifikant.

Ergebnisse

Hinsichtlich der Merkmale bestand zwischen den beiden Gruppen kein statistischer Unterschied bei Studienbeginn. In beiden Gruppen fielen die mittleren OSDI-Scores in Woche 4 und Woche 12 im Vergleich zum Ausgangswert signifikant geringer aus (p-Wert <0,05). Darüber hinaus zeigten sowohl die CEA- als auch die STD-Gruppe eine signifikante Verbesserung der TBUT- und SIT-Werte (p-Wert <0,05). Das CSS verbesserte sich nur in der CEA-Gruppe signifikant (p-Wert <0,05). Zwischen den Studiengruppen waren keine signifikanten Unterschiede zu beobachten, ausser beim SIT in Woche 12 (p-Wert <0,05). Was die Sicherheit betrifft, so traten in beiden Gruppen keine unerwünschten Nebenwirkungen auf.

Schlussfolgerung

Die CEA schien die OSDI-, TBUT- und SIT-Werte bei DED ebenso wirksam zu verbessern wie die Standardbehandlung, ohne Nebenwirkungen zu verursachen.

Results of Fibrin Glue Applied Over the Corneal Surface Immediately After Pterygium Surgery: A Novel Pain Relief Technique

PURPOSE

The aim of this study was to compare the use of fibrin glue on the corneal epitheliectomy site at the end of pterygium surgery versus conventional eye patch regarding pain levels, need for oral analgesic medications, number of days feeling pain, and awakening due to pain after surgery.

METHODS

Forty-eight eyes of 24 patients with bilateral primary pterygium were included in this prospective, randomized, double-masked controlled trial. Each eye of the same patient was randomized to the intervention or control group. The intervention group received 2 drops of fibrin glue in the epitheliectomy site at the end of surgery and an eye patch, whereas the control group was only received an eye patch. Patients returned on the first and seventh days after surgery. Pain intensity (measured using the visual pain analog scale), need for oral analgesics, the number of days the pain lasted, and quality of sleep were assessed during follow-up visits and compared between groups. Comparison analysis accounted for sex, age, pterygium grading, and comorbidities.

RESULTS

Visual analog pain scale after surgery was significantly lower in eyes receiving fibrin glue (-1.58; 95% confidence interval: -2.84 to -0.32; P = 0.014). In addition, the intervention group presented a 73% lower chance of using oral analgesics (OR: 0.27; 95% confidence interval: 0.07-0.95; P = 0.041). No difference in the awakenings at night was noted ( P = 0.240) nor the mean days of ocular pain in the first week after surgery ( P = 0.474).

CONCLUSIONS

Fibrin glue at the end of pterygium surgery effectively reduces pain and the need for oral analgesics compared with conventional eye patching. This study is the first to describe the results of this strategy.

Efficacy of auricular plaster therapy for sleep disorders in preschool children with autism spectrum disorders: Study protocol for a randomized controlled trial

Background

Children with autism spectrum disorders (ASDs) suffer from sleep disorders to a considerable degree; however, there is no safe and effective treatment available in clinical practice. The objective of the trial is to assess the clinical effectiveness of auricular plaster therapy (APT) in treating sleep disorders in children with ASD.

Method

This is a single-center, patient-assessor blind, randomized controlled trial. A total of 44 preschool children with sleep disorders with ASD will be included in this study. Eligible participants will be randomly assigned to either the auricular plaster group or the sham auricular plaster group in a 1:1 ratio. Participants in the different groups will receive APT or sham APT, respectively, for a total of 30 sessions over 30 days. The primary outcome includes the Children's Sleep Habits Questionnaire (CSHQ), while secondary outcomes include the Autism Behavior Checklist (ABC) and polysomnography (PSG) for total sleep time, sleep latency, awakening duration, and sleep structures. The CSHQ and ABC will be assessed at baseline, 10, 20, 30, 60, 90, and 120 days after randomization, whereas PSG will be assessed at baseline and 30 days after randomization. The follow-up period will be scheduled to be 60, 90, and 120 days after randomization.

Discussion

The results of this study may provide evidence of the efficacy of APT, as well as offer new alternatives for the treatment of sleep disorders in children with ASD.

Trial registration

CHiCTR.org.cn (ChiCTR2100048257). Registered on July 5, 2021.