Combined electroacupuncture and auricular acupuncture for postoperative pain after abdominal surgery for gynecological diseases: study protocol for a randomized controlled trial

Wing Lok Lam, Wing Fai Yeung, Mei Kuen Wong, Chi Wai Cheung, Karen Kar Loen Chan, Hextan Yuen Sheung Ngan, Carlos King Ho Wong, Hai Yong Chen, Lixing Lao, Wing Lok Lam, Wing Fai Yeung, Mei Kuen Wong, Chi Wai Cheung, Karen Kar Loen Chan, Hextan Yuen Sheung Ngan, Carlos King Ho Wong, Hai Yong Chen, Lixing Lao

Abstract

Background: Postoperative pain is a major complaint following abdominal surgery for gynecological diseases. Effective postoperative pain control after abdominal surgery is particularly important for patient recovery, mobility, and satisfaction. Acupuncture has been commonly used for pain management. However, its efficacy in postoperative pain control is inconclusive and health economic evaluation is limited.

Methods: A randomized, sham-controlled, patient- and- assessor-blind trial is designed to evaluate the efficacy and safety of acupuncture in managing postoperative pain following abdominal surgery of gynecological diseases. Patients who are eligible for laparotomy with a midline incision for gynecological neoplasia, including ovarian mass, uterine mass, and cervical lesions, will be recruited. Seventy-two participants will be randomly allocated to an acupuncture or non-invasive sham control in a 1:1 ratio. Treatment will be done within 2 h before operation, upon arrival to the ward and once daily for 5 days. The Pain Numerical Rating Scale (NRS) on the first 5 days during hospitalization will be the primary outcome and will be analyzed using the area-under-the-curve (AUC) method. The secondary outcome measures include frequency of rescue analgesic use during hospital stay, cumulative morphine consumption; quality of recovery as measured by time to recovery variables and the Quality of Recovery-9 (QoR-9); quality of life as measured by the Short Form-6 dimension (SF-6D) and EuroQol-5 Dimension-5 Level (EQ-5D-5 L). The incremental cost-effectiveness ratio of acupuncture vs sham acupuncture will be calculated.

Discussion: This study protocol provides an example of integrative medicine practice in a hospital setting for the management of postoperative pain using acupuncture treatment. The acupuncture treatment protocol, if proven to be effective, can be implemented in routine settings to play a role in postoperative pain management for patients who have undergone abdominal surgery for gynecological diseases.

Trial registration: ClinicalTrials.gov, ID: NCT02851186 . Registered on 19 July 2016.

Keywords: AUC; Acupuncture; Analgesia; Health economic analysis; Morphine consumption; Operation; Placebo; RCT.

Conflict of interest statement

Ethics approval and consent to participate

This study is approved by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (Reference Number: UW 15-459). Informed consent will be obtained by research staff from subjects.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Study flowchart. Abbreviations: EA electroacupuncture, AA auricular acupuncture
Fig. 2
Fig. 2
SPIRIT - Figure: Study assessment schedule

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