Out-of-hospital Auricular Acupressure in Elder Patients with Hip Fracture: A Randomized Double-blinded Trial. Acad Emer Med

Department of Anesthesiology and Intensive Care, University of Vienna, Vienna, Austria.
Academic Emergency Medicine (Impact Factor: 2.01). 02/2006; 13(1):19-23. DOI: 10.1197/j.aem.2005.07.014
Source: PubMed


Auricular acupressure is known to decrease the level of anxiety in patients during ambulance transport. The purpose of this randomized, double-blind, sham control study was to determine whether auricular acupressure can decrease not only the level of anxiety but also the level of pain in a group of elder patients with acute hip fracture.
With the assistance of the Vienna Red Cross, 38 patients with acute hip fracture were enrolled into this study. Patients were randomized into two study groups: the true intervention group and the sham control group. Subjects in the true intervention group (n = 18) received bilateral auricular acupressure at three auricular acupressure points for hip pain. Patients in the sham group (n = 20) received bilateral auricular acupressure at sham points. Baseline demographic information, anxiety level, pain level, blood pressure, and heart rate were obtained before the administration of the appropriate acupressure intervention. The level of anxiety, level of pain, hemodynamic profiles, and level of satisfaction were reassessed once the patients arrived at the hospital.
Patients in the true intervention groups had less pain (F = 28, p = 0.0001) and anxiety (F = 4.3, p = 0.018) and lower heart rate (F = 18, p = 0.0001) on arrival at the hospital than did patients in the sham control group. As a result, the patients in the true intervention group reported higher satisfaction in the care they received during the ride to the hospital.
The authors encourage physicians, health care providers, and emergency rescuers to learn this easy, noninvasive, and inexpensive technique for its effects in decreasing anxiety and pain during emergency transportation.

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    • "has been validated in many different studies and has an appropriate validity and reliability (Barker et al., 2006; Fassoulaki, Paraskeva, Patris , Pourgiezi, & Kostopanagiotou, 2003; Wall & Melzack, 2006; Liberty et al., 2007, Shahrjerdi, 2010; Mohammad-Alizadeh-Charandabi et al., 2010) Content validity was used to validate obstetrics questionnaire. "
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    ABSTRACT: Copper IUD is a long term and reversible contraception which equals tubal ligation in terms of sterilization. One of the barriers to using this contraception method is the fear and the pain associated with its insertion. Eutectic mixture of local anesthetics (EMLA) 5% is a local anesthetic that contains 25 mg lidocaine and 25 mg of prilocaine per gram. Application of topical analgesic cream to the cervix for laser surgery, hysteroscopy and hysterosalpingography is known Aims: this study aimed to determine the effect of EMLA on IUD insertion pain. This triple blind clinical trial was conducted on 92 women in a clinic in Hamedan in 2012. After applying the cream on the cervix, pain in three steps, after using Tenaculum, after inserting hystrometr and after inserting IUD and removing IUD insertion tube were assessed with visual analog scale and were compared in EMLA group and placebo group Statistical analysis used to determine and compare the pain of independent t tests, Mann-Whitney U test and repeated measures analysis of variance and chi-square tests to determine the homogeneity of variables and Fisher's exact test was used. Insertion hystrometr was determined as the most painful IUD insertion. The mean pain at step 2 (inserting hystrometr) was (3.11±2.53) in EMLA group, (5.23±2.31) in placebo group. EMLA cream significantly reduced the pain after using tenaculum (P<0.001), pain inserting Hystrometr (P< 0.001) and pain at IUD insertion and removing insertion tube (P< 0.001) CONCLUSIONS: Topical Application of EMLA 5% cream as a topical anesthetic on the cervix before insertion IUD reduced the pain during this procedure.
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    • "Studies using auricular therapy (including AA, EAS, and AP) have shown promising effects in the pain management of several conditions, including dysmenorrhea [43–45], postoperative pain [46–48], hip fracture [22], low back pain [49, 50], and bone marrow aspiration [51]. A recent meta-analysis (including studies up to December, 2008) of auricular therapy for pain management comprising 17 studies, including three conducted in the U.S. [23, 26, 27], found that auricular therapy reduces analgesic use for perioperative pain (standard mean difference [SMD] = 0.54 (95% confidence interval (CI) 0.30, 0.77)) and reduces pain intensity for acute and chronic pain (SMD = 1.56 (95% (CI): 0.85, 2.26)) compared with control groups [52]. "
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    ABSTRACT: Objective. The objective of this systematic review and meta-analysis was to assess the efficacy of auricular therapy by including a sham therapy control group. Methods. Relevant, randomized clinical trials (RCTs) were identified by searching medical related databases from, depending on journal, 1900 (at the earliest) to 1994 (at the latest) through May 2013. The outcome measure was a pain intensity score. Results. Twenty-two RCTs were identified and 13 RCTs were included for meta-analysis. In these studies, auricular therapy provided significant pain relief when compared to a sham or control group. The overall standardized mean differences (SMD) was 1.59 (95% CI [−2.36, −0.82]) (13 trials, total subject numbers = 806), indicating that, on average, the mean decrease in pain score for auricular therapy group was 1.59 standard deviations greater than the mean decrease for the sham control. In terms of the efficacy of the different treatment methods, auricular acupressure boasts the largest strength of evidence for pain relief, followed by auricular acupuncture. Electroacupuncture stimulation did not show significant evidence for efficacy, which may be due to the small sample size (i.e., only 19 subjects were included). Conclusion. Further large-scale RCTs are needed to determine the efficacy of auricular therapy for pain.
    Full-text · Article · Jul 2014 · Evidence-based Complementary and Alternative Medicine
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    • "Auricular acupuncture has also been used for the treatment of verruca plana or flat warts in a randomized work. Studies have suggested that auricular acupuncture alone can relieve pain and anxiety in the pre-hospital transport phase of hip fracture (Usichenko et al, 2005, Barker et al, 2006), reduce acute pain due to a variety of causes in the emergency department setting (Goertz et al, 2006), and in patient with cancer (Alimi et al, 2003). A systematic review of auriculotherapy for peri-operative pain has concluded its efficacy (Usichenko et al, 2008). "
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    Full-text · Article · Jul 2014 · African Journal of Traditional, Complementary and Alternative Medicines
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