The Efficacy of Acupuncture in Post-Operative Pain Management: A Systematic Review and Meta-Analysis

Ming-Shun Wu, Kee-Hsin Chen, I-Fan Chen, Shihping Kevin Huang, Pei-Chuan Tzeng, Mei-Ling Yeh, Fei-Peng Lee, Jaung-Geng Lin, Chiehfeng Chen, Ming-Shun Wu, Kee-Hsin Chen, I-Fan Chen, Shihping Kevin Huang, Pei-Chuan Tzeng, Mei-Ling Yeh, Fei-Peng Lee, Jaung-Geng Lin, Chiehfeng Chen

Abstract

Background: Postoperative pain resulting from surgical trauma is a significant challenge for healthcare providers. Opioid analgesics are commonly used to treat postoperative pain; however, these drugs are associated with a number of undesirable side effects.

Objective: This systematic review and meta-analysis evaluated the effectiveness of acupuncture and acupuncture-related techniques in treating postoperative pain.

Data source: MEDLINE, Cochrane Library, and EMBASE databases were searched until Sep 30, 2014.

Study eligibility criteria: Randomized controlled trials of adult subjects (≥ 18 years) who had undergone surgery and who had received acupuncture, electroacupuncture, or acupoint electrical stimulation for managing acute post-operative pain were included.

Results: We found that patients treated with acupuncture or related techniques had less pain and used less opioid analgesics on Day 1 after surgery compared with those treated with control (P < 0.001). Sensitivity analysis using the leave-one-out approach indicated the findings are reliable and are not dependent on any one study. In addition, no publication bias was detected. Subgroup analysis indicated that conventional acupuncture and transcutaneous electric acupoint stimulation (TEAS) were associated with less postoperative pain one day following surgery than control treatment, while electroacupuncture was similar to control (P = 0.116). TEAS was associated with significantly greater reduction in opioid analgesic use on Day 1 post surgery than control (P < 0.001); however conventional acupuncture and electroacupuncture showed no benefit in reducing opioid analgesic use compared with control (P ≥ 0.142).

Conclusion: Our findings indicate that certain modes of acupuncture improved postoperative pain on the first day after surgery and reduced opioid use. Our findings support the use of acupuncture as adjuvant therapy in treating postoperative pain.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Flowchart of study selection.
Fig 1. Flowchart of study selection.
Fig 2. Results of quality assessment of…
Fig 2. Results of quality assessment of included randomized controlled trials or prospective comparative studies.
(A) Potential risk of bias of each included study. (B) Summarized risk of included studies.
Fig 3. Publication bias for pain score…
Fig 3. Publication bias for pain score at Day 1 post-surgery.
Fig 4. Meta-analysis for pain score on…
Fig 4. Meta-analysis for pain score on the first day after surgery.
Fig 5. Meta-analysis for the cumulative amount…
Fig 5. Meta-analysis for the cumulative amount of opioid analgesics used.

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