Laser acupuncture reduces pain in pediatric kidney biopsies: a randomized controlled trial

Abstract

Evaluate laser acupuncture (LA) as an adjuvant therapy in pain management during percutaneous kidney biopsy procedure in children and adolescents. This prospective, double-blinded, randomized controlled trial enrolled patients aged 7 to 26 years admitted to a children's hospital for percutaneous kidney biopsy. Patients received LA to treatment points (acupuncture group) or sham points (control group) before the procedure. The laser delivered a dose of 42 J/cm over 10 acupoints. Patients and parents rated the pain during and after the biopsy, and change in pain scores were calculated for each patient. Anxiety, vital signs, sedation medication, and patient's biopsy experience were secondary outcomes. Sixty-nine treatments (33 in the acupuncture group and 36 in the control group) were eligible for analysis. Patients in the acupuncture group reported a significantly improved change in the pain score after the biopsy compared with the controls (0.8 vs -0.5, P = 0.044). Patients in the acupuncture group had a statistically significant decrease in procedure vital signs including heart rate (-1.8 vs 5.6, P = 0.043) and respiratory rate (-2.4 vs 0.4, P = 0.045) when compared with controls. Parents also perceived a correspondingly greater improvement in their child's pain for those in the acupuncture group compared with the controls (2.3 vs 0.3, P = 0.04). Adjunctive LA significantly improved pain after pediatric percutaneous kidney biopsies.

Trial registration: ClinicalTrials.gov NCT01879826.

Figures

Figure 1

Microlight ML830 Acupuncture Laser. Laser treatment prescription used wavelength 830nm, power output 90mW, power density 3.8 W/cm2, and dose 42 J/cm2.

Figure 2

Location of Acupoints. Both groups received a LA session. TG patients had LA to treatment acupoints, noted above. For sham points, points 2 cuns (patient finger breadths) above GB-25, and 2 cuns lateral to BL-52, BL-23, BL-22, BL-21 were used as the corresponding points.

Figure 3

Biopsy Patient Flow Chart. °Study Period from September 01, 2013 – April 30, 2015 (period of 20 months).

Figure 4

Patient Pain Scores During Procedure and Post-Procedure. Mean pain scores rating procedure and post-pocedure pain on a scale of 0 to 10. There was no statistical difference seen between the groups comparing patient reported procedure or post-procedure pain scores.

Figure 5

Mean Pain Score Change During Procedure Compared to Post-Procedure. Pain change was calculated as a difference in procedure pain score as compared to post-procedure pain score. Improving pain after the procedure is reflected as a positive value. *Statistically significant with ρ value < 0.05.

Figure 6

Mean Vital Sign Changes Prior to Procedure and Following Procedure. Vital sign changes were calculated as a difference in initial procedure vital signs as compared to post-procedure vital signs. Values reported as a percent change. *Statistically significant with ρ value < 0.05.