The efficacy of acupuncture adding to standard postoperative care in patients undergoing laparoscopic cholecystectomy: a randomized controlled trial

Abstract

Objective

To investigate the effects of acupuncture added to standard postoperative care on postoperative pain and nausea-vomiting after laparoscopic cholecystectomy.

Design

A prospective randomized clinical trial.

Setting

University of Health Science Kartal Dr Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey.

Participants

Eighty patients, 18-65 years old, American Society of Anesthesiologist's physical status of I-III: 40 subjects in the acupuncture (real points) group and 40 in sham (1 cm lateral to the real points and more superficial) group.

Interventions

Acupuncture needles were inserted in 7 points including bilateral ST 36, LI 4, P 6 and extra 1 10 minutes before starting anesthesia induction. The needles were manually rotated periodically throughout the surgical procedure. All patients were given 1.5 mg/kg tramadol and 10 mg metoclopramide intravenously 10 minutes before surgical completion. When the visual analog scale was ≥ 5, 1 g of paracetamol was administered intravenously and then 75 mg of diclofenac sodium was administered intramuscularly. Acupuncture needles were removed after extubation.

Main measurements

Hemodynamic parameters were recorded during the surgical procedure and visual analog scale, first analgesic requirement, total amount of analgesic requirement during postoperative 24-hours, nausea-vomiting, necessity for antiemetic medication and side effects were evaluated at postoperative 0, 2nd, 6th, 12th, and 24th hours.

Results

In the acupuncture group, visual analogue scale values were lower (p < 0.001), the first analgesic requirement was later (p < 0.001), the time to first analgesic requirement was longer (p < 0.001) and the incidence of nausea-vomiting was lower during the 0, 2nd, and 6th hours (p = 0.003, p = 0.01, p = 0.02). Analgesic and antiemetic requirements were also lower in the first 24 hours (p < 0.001).

Conclusions

Acupuncture treatment reduces postoperative pain and nausea-vomiting incidence, antiemetic and analgesic requirements especially in the first 6 hours, and its combination with conventional postoperative treatment is effective and safe.