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Research: Pediatric Acupuncture

August 2009
Acupuncture Management of Pain and Emergence Agitation in Children After Bilateral Myringotomy and Tympanostomy [Ear] Tube Insertion
Pediatric Anesthesia, August 26, 2009
Summary Aim: To further investigate the effect of acupuncture in postoperative pain and emergence agitation in children undergoing bilateral myringotomy and tympanostomy tube (BMT) placement. Background: BMT insertion surgery in children is routinely performed under general anesthesia and is associated with a high incidence of postoperative pain and agitation upon emergence from anesthesia. Various medications have been investigated to alleviate the pain and agitation, which have been accompanied by high incidence of adverse effects. In children, anecdotal reports suggest that acupuncture may offer postoperative analgesia. Methods/Materials: This prospective randomized controlled trial is to evaluate the effectiveness of acupuncture to control pain and agitation after initial bilateral myringotomy tube placement in 60 nonpremedicated children. Acupuncture was applied at points LI-4 (he gu) and HT-7 (shen men) immediately after induction of anesthesia. A single-blinded assessor evaluated postoperative pain and agitation using CHEOPS and emergence agitation scale. Pain and agitation scores were significantly lower in the acupuncture group compared to those in the control group at the time of arrival in the post anesthesia care unit and during the subsequent 30 min. Results: Acupuncture treatment provided significant benefit in pain and agitation reduction. The median time to first postoperative analgesic (acetaminophen) administration was significantly shorter in the control group. The number of patients who required analgesia was considerably fewer in the acupuncture group than that in the control. No adverse effects related to acupuncture treatment were observed. Conclusion: Our study suggests that acupuncture therapy may be effective in diminishing both pain and emergence agitation in children after BMT insertion without adverse effects.

February 2009
Using Acupuncture for Acute Pain in Hospitalized Children
Pediatric Critical Care Medicine; February 27, 2009.
OBJECTIVE:: Clinical study to determine the acceptability and feasibility of acupuncture for acute postoperative pain control in hospitalized children. DESIGN:: Nonrandomized clinical trial. SETTING:: A single, tertiary referral pediatric intensive care unit. PATIENTS:: A total of 20 patients aged 7 months to 18 years. Eleven of the patients had posterior spinal fusion surgery and the remaining nine patients had other surgical diagnoses. INTERVENTIONS:: Two 10- to 15-minute sessions of acupuncture 24-48 hours apart. OUTCOME MEASURES AND RESULTS:: The treatment was highly accepted (27 patients were approached and 4 patients refused. Of the 23 patients enrolled, 20 patients completed the study). Acupuncture was well tolerated by patients without adverse events related to treatment. In follow-up interviews, 70% of both parents and patients believed acupuncture helped the child's pain. Eighty-five percent of the parents said they would pay out of pocket for acupuncture if not covered by insurance. The pain scores, vital signs, and narcotic usage were recorded before and at several times after acupuncture. In posterior spinal fusion patients, the mean pain scores (0-10) immediately before, 4, and 24 hours after acupuncture were: 3.7, 1.7, and 3.1, respectively after the first acupuncture session and 3.7, 2.2, and 3.1 after the second session. In the other surgical cohort, the mean pain scores immediately before, 4, and 24 hours after the first session of acupuncture were 2.5, 0.3, and 1.6. CONCLUSIONS:: Our results support that acupuncture is highly accepted and feasible in critically ill, postoperative pediatric patients with acute pain. Our findings suggest that acupuncture may be a potentially useful adjunctive tool for acute pediatric postoperative pain management.

September 2008

Effects of minimal acupuncture in children with infantile colic - a prospective, quasi-randomised single blind controlled trial.
Journal: Acupuncture in Medicine; Volume 26, Issue 3, pages 171-182.
BACKGROUND: Colic causes crying in 10-30% of infants and is one of the primary reasons parents seek health care. Treatments are generally not totally effective and some cause side effects. In this study we aimed to test the effect of light needling (minimal acupuncture) on crying. METHODS: Forty children (median six weeks of age) with excessive crying unresponsive to conventional therapies, were recruited from 21 Child Welfare Clinics within an area of western Sweden, and quasi-randomised to control or light needling treatment. Parents were unaware of which group their child was assigned to. Children were given light needling acupuncture on one point (LI4) on both hands for approximately 20 seconds on four occasions, or received the same care except needling. Parental assessment questionnaires were used pre- and post-treatment to assess crying intensity, frequency, duration of crying and pain related behaviour throughout the day in six hour periods. RESULTS: Light needling resulted in a significant reduction in the rated crying intensity (assessed by a numeric rating scale, 0 to 10). For example, during the morning time period 0600-1200 hours, the median (range) rated crying intensity changed from 6 (1 to 9) pre-treatment to 2 (0 to 5) post-treatment (P=0.002), in the light needling group. The corresponding ratings for the children in the control group was 6 (0 to 10) and 5 (0 to 10) respectively. The difference between the groups was significant (P=0.016). There were also significant differences between the groups for the afternoon (1200-1800 hours), and evening (1800-midnight) time periods. Pain related behaviour like facial expression, was also significantly less pronounced in the light needling group as compared to the control group post-treatment, (P=0.027). The parents rated the light needling as more effective in improving symptoms than the control group (P<0.001). CONCLUSION: Four treatments with light needling on one point in the hand may alleviate crying and pain related behaviour without any noted side effects.

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