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Meta-Analysis
. 2019 Jul 30;19(1):192.
doi: 10.1186/s12906-019-2583-8.

Distal acupoint stimulation versus peri-incisional stimulation for postoperative pain in open abdominal surgery: a systematic review and implications for clinical practice

Juan Zhu  1 , Qian Xu  1 , Rong Zou  1 , Wenzhong Wu  2 , Xiaoqiu Wang  2 , Yanyi Wang  3 , Fangbing Ji  1 , Zhen Zheng  4 , Man Zheng  5
Affiliations
Meta-Analysis

Distal acupoint stimulation versus peri-incisional stimulation for postoperative pain in open abdominal surgery: a systematic review and implications for clinical practice

Juan Zhu et al. BMC Complement Altern Med. .

Abstract

Background: Acute postoperative pain remains a major clinical problem that affects patient recovery. Distal acupoint and peri-incisional stimulation are both used for relieving acute postoperative pain in hospital. Our objective was to assess and compare the effects of distal and peri-incisional stimulation on postoperative pain in open abdominal surgery.

Methods: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Chinese databases CNKI and Wanfangdata were searched to identify eligible randomized controlled trials. Intensity of postoperative pain, opioid consumption and related data were extracted and analyzed using a random effects model. Risk of bias was assessed. Subgroup analyses were conducted when data were enough.

Results: Thirty-five trials were included, in which 17 trials studied distal stimulation, another 17 trials studied peri-incisional stimulation and one studied the combination of the two approaches. No studies that directly compared the two approaches were identified. Subgroup analysis showed that both distal and peri-incisional stimulation significantly alleviated postoperative resting and movement pain from 4 h to 48 h after surgery by 6 to 25 mm on a 100 mm visual analogue scale. Peri-incisional stimulation showed a better reduction in postoperative opioid consumption. No studies compared the effects of the combined peri-incisional and distal stimulation with either mode alone. Overall the quality of evidence was moderate due to a lack of blinding in some studies, and unclear risk of allocation concealment.

Conclusion: Both distal and peri-incisional modes of stimulation were effective in reducing postoperative pain. Whether a combined peri-incisional stimulation and distal acupuncture has superior results requires further studies.

Keywords: Distal acupoint stimulation; Open abdominal surgery; Peri-incisional stimulation; Postoperative pain.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the search process and study selection
Fig. 2
Fig. 2
Risk of bias graph: review authors’ judgements about each risk of bias item presented as percentages across included studies
Fig. 3
Fig. 3
Postoperative resting pain intensity at 24 h: Subgroup analysis of Peri-incisional stimulation vs distal stimulation
Fig. 4
Fig. 4
Postoperative pain intensity on movement at 24 h: Subgroup analysis of Peri-incisional stimulation vs distal stimulation
Fig. 5
Fig. 5
Postoperative opioid consumption at 24 h: Subgroup analysis of Peri-incisional stimulation vs distal stimulation
See this image and copyright information in PMC

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References

    1. Pfuntner A, Wier LM. Most Frequent Procedures Performed in U.S. Hospitals, 2011: Statistical brief #165[M]// healthcare cost and utilization project (HCUP) statistical briefs. PubMed, vol. 2013.
    1. Kehlet H. Surgical stress: the role of pain and analgesia. Br J Anaesth. 1989;63:189–195. doi: 10.1093/bja/63.2.189. - DOI - PubMed
    1. Ung JW, Lui JC. Postoperative pain management: Study of patients’ level of pain and satisfaction with health care providers’ responsiveness to their reports of pain. Nurs Health Sci. 2003;5:13–21. doi: 10.1046/j.1442-2018.2003.00130.x. - DOI - PubMed
    1. American Society of Anesthesiologists (ASA) Committee on Standards and Practise Parameters Practice guidelines for acute pain management in the perioperative setting. An updatereport by the American Society of Anesthesiologists task force on acute pain management. Anes. 2010;116:248–273. - PubMed
    1. Hines R, Barash PG, Watrous G, O’Connor T. Complications occurring in the postanesthesia care unit: a survey. Anesth Analg. 1992;74:503–509. doi: 10.1213/00000539-199204000-00006. - DOI - PubMed