Auricular Acupuncture for Pain Relief after Ambulatory Knee Arthroscopy-A Pilot Study

Abstract

Auricular acupuncture (AA) is effective in treating various pain conditions, but there have been no analyses of AA for the treatment of pain after ambulatory knee surgery. We assessed the range of analgesic requirements under AA after ambulatory knee arthroscopy. Twenty patients randomly received a true AA procedure (Lung, Shenmen and Knee points) or sham procedure (three non-acupuncture points on the auricular helix) before ambulatory knee arthroscopy. Permanent press AA needles were retained in situ for one day after surgery. Post-operative pain was treated with non-steroidal anti-inflammatory ibuprofen, and weak oral opioid tramadol was used for rescue analgesic medication. The quantity of post-operative analgesics and pain intensity were used to assess the effect of AA. The incidence of analgesia-related side effects, time to discharge from the anesthesia recovery room, heart rate and blood pressure were also recorded. Ibuprofen consumption after surgery in the AA group was lower than in the control group: median 500 versus 800 mg, P = 0.043. Pain intensity on a 100 mm visual analogue scale for pain measurement and other parameters were similar in both groups. Thus AA might be useful in reducing the post-operative analgesic requirement after ambulatory knee arthroscopy.

Figure 1

Flow diagram showing specific and sham auricular acupuncture points (non-acupuncture points of the helix) used in the study.

Figure 2

Post-operative ibuprofen requirement between surgery and the follow-up examination the next morning, as a box plot. The thick horizontal lines are median values. The outlier represents the patient from the control group who required only 400 mg ibuprofen. *P = 0.043.

Figure 3

Pain intensity on a visual analogue scale (VAS-100) measured before and after surgery, on discharge from the anesthesia recovery room and during the follow-up examination the next morning. Hatched bars: patients who received true auricular acupuncture; empty bars: control group with sham acupuncture as mean ± standard deviation. The differences are not significant.