Ear acupuncture might be the form of acupuncture best suited to improving acute pain management in the emergency department (ED). The primary aim of this review was to assess the analgesic efﬁcacy of ear acupuncture in the ED. Secondary outcomes included measures of patient satisfaction, adverse effects, cost, administration techniques, and reduction of medication usage.
Seven databases and Google Scholar were searched up to April 27, 2017, using MeSH descriptors for three overarching themes (ear acupuncture, pain management, and emergency medicine). Meta-analyses were performed in 3 comparator groups: (1) ear acupuncture versus sham; (2) ear acupuncture-as-adjunct to standard care; and (3) ear acupuncture (both as sole therapy and adjuvant) versus control to calculate the standardized mean difference (SMD) and weighted mean difference (WMD) for pain scores out of 10.
Six randomized controlled trials and 2 observational studies, totaling 458 patients, were retrieved after exclusions. The meta-analysis used data from 4 randomized studies representing 286 patients. The above 3 comparator groups resulted in SMDs of 1.69, 1.68, and 1.66, and WMDs of 2.47, 2.84, and 2.61 respectively, all favoring acupuncture. Battleﬁeld (ear) acupuncture was the most commonly used technique. There were no signiﬁcant adverse effects and patient satisfaction improved. Results regarding if acupuncture reduced medication use were equivocal. Signiﬁcant study bias and heterogeneity were found.
While study numbers are limited, ear acupuncture, either as stand-alone or as-an-adjunct technique, signiﬁcantly reduced pain scores and has potential beneﬁts for use in the ED. Further studies will deﬁne acupuncture’s role and if it reduces use of analgesic medications.
Authors: Andrew L. Jan, MBBS, FACEM, BA, FAMAC, MPhil, 1 Emogene S. Aldridge, BHlthSc, 1 Ian R. Rogers, MBBS, FACEM,1,2 Eric J. Visser, MBBS, FANZCA, FFPMANZCA, 3 Max K. Bulsara, PhD, MSc, BSc, 4 and Richard C. Niemtzow, MD, PhD, MPH5
Quelle: MEDICAL ACUPUNCTURE Volume 29, Number 5, 2017 # Mary Ann Liebert, Inc. DOI: 10.1089/acu.2017.1237