Assessing the efficacy of acupuncture as the sole analgesic for canine chronic pain

Jianjian Gong, Mary F Thompson
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Abstract

PICO Question In dogs with chronic pain, is acupuncture alone, compared to a placebo, more efficacious in alleviating pain and pain-related dysfunction?   Clinical bottom line Category of research Treatment. Number and type of study designs reviewed Four randomised, placebo-controlled clinical trials were critically appraised. Strength of evidence Weak. Outcomes reported A single study evaluating the efficacy of gold bead implantation, a form of permanent acupuncture, on pain associated with canine hip dysplasia (CHD) endorsed acupuncture’s superior pain alleviation and locomotion improvement through owner and veterinarian subjective outcome evaluation. Three studies concluded that, overall, acupuncture was not efficacious regarding pain reduction or dysfunction improvement compared with placebo treatment. Conclusion Based on the limited current evidence, acupuncture could have analgesic effects as perceived by owners, but acupuncture, as a sole analgesic, is unlikely to be effective in alleviating pain and pain-related dysfunction in canine chronic pain associated with musculoskeletal causes. Evidence is lacking on chronic pain due to neurological and oncological causes. Further studies need to focus on researching various acupuncture modalities’ effects on chronic pain with musculoskeletal, neuropathic and oncological causes when utilised as a component of multimodal therapy. Currently, for canine patients with chronic pain, there is insufficient evidence for a veterinarian to recommend that a client utilise acupuncture as the sole method for pain management.   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
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评估针灸作为犬类慢性疼痛唯一镇痛剂的疗效
PICO问题在患有慢性疼痛的狗中,与安慰剂相比,单独针灸在减轻疼痛和疼痛相关功能障碍方面是否更有效?对四项随机、安慰剂对照临床试验进行了严格评估。证据强度弱。结果报告一项评估金珠植入术(一种永久性针灸)对犬髋关节发育不良(CHD)相关疼痛疗效的研究,通过主人和兽医的主观结果评估,认可针灸在缓解疼痛和改善运动方面的优势。结论基于目前有限的证据,针灸可能具有犬主认为的镇痛效果,但针灸作为唯一的镇痛药,不太可能有效缓解犬类肌肉骨骼原因引起的慢性疼痛中的疼痛和疼痛相关功能障碍。关于神经和肿瘤引起的慢性疼痛,目前还缺乏证据。进一步的研究需要重点研究各种针灸方式作为多模式疗法的组成部分,对肌肉骨骼、神经病理性和肿瘤性慢性疼痛的影响。目前,对于犬类慢性疼痛患者而言,还没有足够的证据表明兽医可以建议客户将针灸作为治疗疼痛的唯一方法。如何在实践中应用这些证据在实践中应用证据时应考虑多种因素,不限于:个人的临床专业知识、患者的情况和主人的价值观、你工作的国家、地点或诊所、你面前的个案、疗法和资源的可用性。知识摘要是一种资源,可帮助加强决策或为决策提供信息,但并不凌驾于从业人员的责任或判断之上,即如何做对其护理的动物才是最好的。
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Thank you to our reviewers 2023 Evaluating the effect of equine tetanus antitoxin on mortality rates of dogs affected by tetanus Comparing the effectiveness of clomipramine and fluoxetine in dogs with anxiety-related behaviours Assessing the efficacy of acupuncture as the sole analgesic for canine chronic pain Comparing internal versus external fixation for diaphyseal tibial and fibular fractures in skeletally immature dogs
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