Acupuncture as an adjunct for sedation during lithotripsy.
ABSTRACT To determine whether a combination of auricular and body acupuncture is effective as an adjunct for the preprocedural anxiety and pain management in patients undergoing lithotripsy procedures.
Randomized controlled study. SETTING AND LOCATION: Lithotripsy suite located at the Yale New Haven Hospital, New Haven CT.
Adult patients who were scheduled to receive elective lithotripsy procedures.
Acupuncture group: Preprocedural auricular acupuncture intervention combined with intraprocedural electroacupuncture stimulation (n = 29); Sham control group: Preprocedural sham auricular acupuncture intervention combined with intraprocedural sham electroacupuncture stimulation (n = 27). OUTCOMES MEASUREMENT: Preprocedural anxiety, intraprocedural alfentanil consumption, visual analogue scale for pain.
Patients in the acupuncture group were less anxious preprocedure than those in the Sham Control Group 32 (29-34) versus 40 (35-45) (p = 0.029). Similarly, patients in the Acupuncture Group used a lesser amount of alfentanil than those in the sham control group (p = 0.040). The adjustable alfentanil consumption as expressed by median rate of alfentanil consumption of 1 (0.6-1.6) microg kg(-1) minute(-1) in the acupuncture group was lower than that of 1.5 (0.9-2.3) microg kg(-1) minute(-1) in the sham control group. Patients in the Acupuncture group also reported lower pain scores on admission to the recovery room (p = 0.014).
A combination of auricular and body acupuncture can be used as an adjunct treatment to decrease preprocedural anxiety and intraprocedural analgesia in patients undergoing lithotripsy.
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ABSTRACT: Background. Acupuncture has been shown to reduce preoperative anxiety in several previous randomized controlled trials (RCTs). In order to assess the preoperative anxiolytic efficacy of acupuncture therapy, this study conducted a meta-analysis of an array of appropriate studies. Methods. Four electronic databases (MEDLINE, EMBASE, CENTRAL, and CINAHL) were searched up to February 2014. In the meta-analysis data were included from RCT studies in which groups receiving preoperative acupuncture treatment were compared with control groups receiving a placebo for anxiety. Results. Fourteen publications (N = 1,034) were included. Six publications, using the State-Trait Anxiety Inventory-State (STAI-S), reported that acupuncture interventions led to greater reductions in preoperative anxiety relative to sham acupuncture (mean difference = 5.63, P < .00001, 95% CI [4.14, 7.11]). Further eight publications, employing visual analogue scales (VAS), also indicated significant differences in preoperative anxiety amelioration between acupuncture and sham acupuncture (mean difference = 19.23, P < .00001, 95% CI [16.34, 22.12]). Conclusions. Acupuncture therapy aiming at reducing preoperative anxiety has a statistically significant effect relative to placebo or nontreatment conditions. Well-designed and rigorous studies that employ large sample sizes are necessary to corroborate this finding.Evidence-based Complementary and Alternative Medicine 01/2014; 2014:850367. · 2.18 Impact Factor
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ABSTRACT: Abstract Integrative oncology uses non-pharmacological adjuncts to mainstream care to manage physical, emotional, and psychological symptoms experienced by cancer survivors. Depression, anxiety, fatigue and pain are among the common, often burdensome symptoms that can occur in clusters, deplete patient morale, interfere with treatment plans, and hamper recovery. Patients already seek various modalities on their own to address a broad range of problems. Legitimate complementary therapies offered at major cancer institutions improve quality of life, speed recovery, and optimize patient support. They also augment the benefits of psychiatric interventions, due to their ability to increase self-awareness and improve physical and psychological conditioning. Further, these integrated therapies provide lifelong tools and develop skills that patients use well after treatment to develop self-care regimens. The active referral of patients to integrative therapies achieves three important objectives: complementary care is received from therapists experienced in working with cancer patients, visits become part of the medical record, allowing treatment teams to guide individuals in maximizing benefit, and patients are diverted from useless or harmful 'alternatives.' We review the reciprocal physical and psychiatric benefits of exercise, mind-body practices, massage, acupuncture, and music therapy for cancer survivors, and suggest how their use can augment mainstream psychiatric interventions.International Review of Psychiatry 02/2014; 26(1):114-27. · 1.80 Impact Factor
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ABSTRACT: Shock wave lithotripsy (SWL) is an established treatment for renal stones. Although non-invasive, it can cause significant pain and anxiety during the procedure. Our purpose was to review the literature to look at the effect of complimentary therapy in patients undergoing SWL and whether it led to a reduction in the requirement of analgesics and anxiolytics. A systematic review was performed on the use of acupuncture, auricular acupressure, transcutaneous electrical nerve stimulation (TENS) and music during SWL. Only prospective randomized controlled trials were selected. Two reviewers independently extracted the data from each study. Outcomes relating to analgesia requirement, anxiety and stone-free rates (SFR) were compared. Seven papers were identified reporting on 591 patients (acupuncture-3, TENS-1 and music-3). Pain control/analgesia requirement was significantly better in four studies (music-2, acupuncture-1, TENS-1). Significantly lower anxiety was noted in one study with music and two using acupuncture. No difference in SFR was noted with the use of complementary therapy. No major or minor side effects were noted. Complementary therapy for SWL can help lower analgesia requirement and the anxiety associated with it. However, it does not have any effect on the SFR.Urolithiasis. 03/2014; 42(3).