Effectiveness of Acupuncture for Pain Control After Cesarean Delivery: A Randomized Clinical Trial
- PMID: 35226080
- PMCID: PMC8886541
- DOI: 10.1001/jamanetworkopen.2022.0517
Effectiveness of Acupuncture for Pain Control After Cesarean Delivery: A Randomized Clinical Trial
Erratum in
-
Errors in Results and Table 3.JAMA Netw Open. 2022 Apr 1;5(4):e229622. doi: 10.1001/jamanetworkopen.2022.9622. JAMA Netw Open. 2022. PMID: 35416999 Free PMC article. No abstract available.
Abstract
Importance: A pharmacological approach to pain control after cesarean delivery is often insufficient on its own. Acupuncture is a promising method for mitigating postoperative pain and reducing postoperative opioid requirements.
Objective: To evaluate the efficacy and effectiveness of acupuncture as an adjunctive therapy for pain control after cesarean delivery, compared with a placebo intervention and standard care alone.
Design, setting, and participants: This single-center, placebo-controlled, patient- and assessor-blinded randomized clinical trial was conducted from January 13, 2015, to June 27, 2018, at a tertiary university hospital in Greifswald, Germany. Participants were women who were scheduled for elective cesarean delivery under spinal anesthesia and were randomized to either the acupuncture group (n = 60) or placebo group (n = 60). Another 60 consecutive patients who met the eligibility criteria and received the standard postoperative analgesia were selected to form a nonrandomized standard care group. The intention-to-treat analysis was performed from August 19, 2019, to September 13, 2019.
Interventions: In addition to standard pain treatment, each patient in the acupuncture group received auricular and body acupuncture with indwelling intradermal needles, whereas patients in the placebo group were treated with nonpenetrating placebo needles.
Main outcomes and measures: The primary outcome was pain intensity on movement, which was measured using an 11-item verbal rating scale. Secondary outcomes were analgesia-related adverse effects, analgesics consumption, time to mobilization and Foley catheter removal, quality of patient blinding to randomization, and patient satisfaction with treatment of pain.
Results: A total of 180 female patients (mean [SD] age, 31 [5] years) were included in the intention-to-treat analysis. The mean pain intensity on movement in the acupuncture group on the first postoperative day was lower than in the placebo group (4.7 [1.8] vs 6.0 [2.0] points; Cohen d, 0.73; 95% CI, 0.31-1.01; P = .001) and the standard care group (6.3 [1.3] points; Cohen d, 1.01; 95% CI, 0.63-1.40; P < .001). On the first postoperative day, 59 patients (98%) in the acupuncture group were fully mobilized vs 49 patients (83%) in the placebo group (relative risk [RR], 1.18; 95% CI, 1.06-1.33; P = .01) and 35 patients (58%) in the standard care group (RR, 1.69; 95% CI, 1.36-2.09; P < .001). The Foley catheter was removed in a total of 57 patients (93%) from the acupuncture group vs 43 patients (72%) from the placebo group (RR, 1.33; 95% CI, 1.12-1.57; P = .003) and 42 patients (70%) from the standard care group (RR, 1.37; 95% CI, 1.14-1.62; P = .002). Other parameters were comparable across the 3 study groups.
Conclusions and relevance: Results of this trial showed that acupuncture was safe and effective in reducing pain and accelerating mobilization of patients after cesarean delivery. With consideration for personnel and time expenditures, acupuncture can be recommended as routine, supplemental therapy for pain control in patients after elective cesarean delivery.
Trial registration: ClinicalTrials.gov Identifier: NCT02364167.
Conflict of interest statement
Figures
Similar articles
-
Efficacy and Safety of Esketamine for Supplemental Analgesia During Elective Cesarean Delivery: A Randomized Clinical Trial.JAMA Netw Open. 2023 Apr 3;6(4):e239321. doi: 10.1001/jamanetworkopen.2023.9321. JAMA Netw Open. 2023. PMID: 37083664 Free PMC article. Clinical Trial.
-
Postoperative Pain Therapy with Laser Acupuncture after Cesarean Section under Spinal Anesthesia: A Double-Blinded, Randomized, Placebo-Controlled Trial.Complement Med Res. 2022;29(3):235-241. doi: 10.1159/000522470. Epub 2022 Feb 8. Complement Med Res. 2022. PMID: 35134798 Clinical Trial. English.
-
Acupuncture or acupressure for induction of labour.Cochrane Database Syst Rev. 2017 Oct 17;10(10):CD002962. doi: 10.1002/14651858.CD002962.pub4. Cochrane Database Syst Rev. 2017. PMID: 29036756 Free PMC article. Review.
-
Patient-controlled analgesia with remifentanil versus alternative parenteral methods for pain management in labour.Cochrane Database Syst Rev. 2017 Apr 13;4(4):CD011989. doi: 10.1002/14651858.CD011989.pub2. Cochrane Database Syst Rev. 2017. PMID: 28407220 Free PMC article. Review.
-
Acupuncture for pain control after Caesarean section: a prospective observational pilot study.Acupunct Med. 2016 Feb;34(1):14-9. doi: 10.1136/acupmed-2015-010852. Epub 2015 Aug 25. Acupunct Med. 2016. PMID: 26307554
Cited by
-
Using the right design controls for acupuncture trials: Methodological rigor and validity in research.Integr Med Res. 2024 Mar;13(1):101026. doi: 10.1016/j.imr.2024.101026. Epub 2024 Feb 17. Integr Med Res. 2024. PMID: 38434794 Free PMC article.
-
Effectiveness and safety of auricular acupuncture on adjuvant analgesia in patients with total knee arthroplasty: a randomized sham-controlled trial.Front Neurol. 2024 Feb 16;15:1275192. doi: 10.3389/fneur.2024.1275192. eCollection 2024. Front Neurol. 2024. PMID: 38434200 Free PMC article.
-
Reporting and influencing factors of patient-reported outcomes in acupuncture randomised controlled trials: a cross-sectional study protocol.BMJ Open. 2024 Feb 7;14(2):e079218. doi: 10.1136/bmjopen-2023-079218. BMJ Open. 2024. PMID: 38326262 Free PMC article.
-
Effects and mechanisms of acupuncture on women related health.Front Med. 2024 Feb;18(1):46-67. doi: 10.1007/s11684-023-1051-5. Epub 2023 Dec 27. Front Med. 2024. PMID: 38151668 Review.
-
Acupuncture Effect on Analgesic Consumption and Cortisol Levels Following Total Knee Arthroplasty: A Randomized Controlled Trial.Med Acupunct. 2023 Oct 1;35(5):230-235. doi: 10.1089/acu.2023.0024. Epub 2023 Oct 17. Med Acupunct. 2023. PMID: 37920858
References
Publication types
MeSH terms
Substances
Associated data
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous