Review Article

Acupuncture-Point Stimulation for Postoperative Pain Control: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Table 4

Characteristics of RCTs examining integrative acupoint stimulation included in the meta-analysis.

First author, year, settingStudy designParticipants (n), age (years)Surgery typeAPS typeInterventionFollow-upMain outcomes
Intervention groupSham/control group

Chung, 2014, Taiwan [24]Single-blind, sham-controlled study, three groupsEnrolled = 135
Completed = 127 
Intervention group: 40, 60.25 (13.42) 
Sham group: 42, 59.79 (12.61) 
Control group: 45, 54.24 (14.63)
Lumbar spinal surgeryAA + EATF4, AH10, CW8, AT5, CO4; BL40 and GB34 acupoints 
Duration:
AA: ten 15 min sessions (1 and 3 h after returning to ward, four each on postoperative days 1 and 2) 
TAES: 20 min 1 and 3 h after returning to ward
Sham group: sham acupressure and sham TAES 
Control group: no acupoint stimulation
NRVAS, morphine consumption, morphine-related side effects

Dias, 2010, Brazil [73]Single-blind RCTRandomized = 33
Completed = 33 
Intervention group: 16, 47 (14) 
Control group: 17, 43.1 (10)
Inguinal hernia repairEAAcupoints on limbs and ear (heart and Shen Men) 
Duration: 5 min at 3 Hz in continuous mode, increased incrementally to 5, 10, 20, 50, 100, 160, and finally 240 Hz after 30 min
Sham TENS at same sites2 weeksAnesthetics requirement, VAS, HR, BP, edema, adverse events

Pfister, 2010, USA [74]Prospective, open-label RCTRandomized = 70
Completed = 58 
Intervention group: 28, 61 
Control group: 30, 57
Neck dissectionManual acupunctureLI4, SP6, GV20, Luo Zhen, and auricular Shen Men acupoints 
Duration: 30 min once a week for 4 weeks
Usual careNRNRS, medication use, adverse events

Deng, 2008, USA [75]Randomized, sham-controlled, subject-blinded trialRandomized = 162
Completed = 106 
Intervention group: 52, 65 
Sham group: 54, 63
ThoracotomyManual acupunctureBL12–BL19, Wei Guan Xia Shu, ST36, and bilateral auricular Shen Men acupoints 
Duration: 4 weeks
Dummy studs placed in back3 months postoperativelyBPI, medication use, MQS, NRS

Mehling, 2007, USA [76]RCTRandomized = 138
Completed = 138 
Intervention group: 93, 55.9 (1.9) 
Control group: 45, 59.2 (1.7)
Cancer-related surgeryMassage + EAAcupressure-type foot massage, large intestine 4, spleen 6, and auricular acupoints 
Duration: 10–30 min massage, depending on participants’ clinical needs and conditions; 20 min acupuncture
Usual care, offered 30 min massageNRNRS, nausea, vomiting, POMS-SF, health care cost

Tavares, 2007, Brazil [77]RCTRandomized = 24, 20.42 (1.44) 
Completed = 24 
Intervention group: 12 
Control group: 12
Mandibular third molar surgeryEAIG4, F3, E44, VB39, TA21, B60, Shen Men, and ponto total acupoints 
Duration: needles rotation every 10 min at beginning of procedure, after 10 min of treatment, and at end of procedure
No acupoint stimulationNRVAS, analgesic dose

Ekblom, 1991, Sweden [78]RCTRandomized = 110
Completed = 110 
PRE-ACU group: 25 
POST-ACU group: 25 
Age, groups 1 and 2: 29.9 (18–50) 
Control group: 60, 30.2 (18–55)
Mandibular third molar extractionManual acupunctureST6, ST7, S119, and LI4 acupoints ipsilateral to extraction site; SJ5 contralateral 
Duration: 20 min
No acupuncture1 week postoperativelyVAS, tension and stress, analgesic consumption, wound healing

RCT, randomized controlled trial; APS, acupoint stimulation; AA, auricular acupuncture; EA, electroacupuncture; TAES, transcutaneous acupoint electrical stimulation; NR, not reported; VAS, visual analog scale; TENS, transcutaneous electrical nerve stimulation; BP, blood pressure; HR, heart rate; NRS, numerical rating scale; BPI, Brief Pain Inventory; MQS, Medication Quantification Scale; POMS-SF, Mood States Short Form; PRE-ACU, preoperative acupuncture; POST-ACU, postoperative acupuncture.