ACUPUNCTURE IN GASTROSCOPY

doi:10.1016/S0140-6736(78)90614-1

The Lancet

Volume 311, Issue 8057, 28 January 1978, Pages 182-183

https://doi.org/10.1016/S0140-6736(78)90614-1 Get rights and content

Abstract

The analgesic effect of acupuncture was evaluated by a double-blind controlled trial in 90 patients undergoing gastroscopy. The endoscopy was much easier and better tolerated after real acupuncture had been performed.

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There are more references available in the full text version of this article.

Cited by (35)

Electroacupuncture-reduced sedative and analgesic requirements for diagnostic EUS: a prospective, randomized, double-blinded, sham-controlled study
2018, Gastrointestinal Endoscopy
Citation Excerpt :
This could positively influence a range of symptoms experienced during endoscopy including gagging, pain, and anxiety.24 A number of studies in animals and humans suggest that acupuncture may have an effect on GI motility and sensation, gastric acid secretion, emesis, cancer pain management, postoperative ileus, and functional bowel disease.2-16 However, many of these studies are not reported in English, and they often have design flaws with lack of objective outcome measurements.
The role of electroacupuncture (EA) in reducing sedative and analgesic requirements during EUS is uncertain. The aim of this study was to investigate the efficacy of EA in reducing procedure-related pain and discomfort during EUS.
This was a double-blinded randomized controlled study conducted between March 2014 and July 2016. Consecutive patients who were scheduled for diagnostic EUS were recruited and randomized to receive EA or sham-electroacupuncture (SA). The primary outcome was the dosage of propofol used. Other outcome measurements included pain scores, anxiety scores, satisfaction scores, patients’ willingness to repeat the procedure, total procedure time, and adverse events.
A total of 128 patients were recruited to the study. The patients who received EA had significantly fewer requirements for patient-controlled sedation and analgesia (PCA). The median (interquartile range) number of demands for PCA (2 [1-5] vs 16.5 [8.5-33.8]; P < .001), the number of successful demands (2 [1-4] vs 9 [5.3-13]; P < .001), and the total dose of propofol (0.15 [0.08-0.34] vs 0.77 [0.38-1.09]; P < .001) and alfentanil (0.38 [0.20-0.86] vs 1.92 [0.94-2.72]; P < .001) were all significantly less. Patients who received EA also had significantly lower procedural pain scores and anxiety scores (P < .001), and higher satisfaction scores (P < .001), and they were more willing to repeat the procedure (P < .001). Being in the SA group and the procedure time were significant predictors of increased PCA demands (P < .001 and P = .009, respectively).
In conclusion, the use of EA reduced sedative and analgesia demands, improved patient experience, and was associated with a low risk of adverse events during diagnostic EUS. (Clinical trial registration number: NCT02066194.)
History of acupuncture research
2013, International Review of Neurobiology
Citation Excerpt :
Acupuncture management for gastroenterological problems has always been a hot spot. Early literature has implied acupuncture could induce more tolerance to gastroscopy in patients than placebo acupuncture (Cahn et al., 1978). This efficacy of acupuncture was verified in another study in 2003 (Fanti et al., 2003).
The acupuncture has been practiced in China for more than 3000 years and was spread to Europe and American from the sixteenth to the nineteenth century. The history of acupuncture research was initiated in the eighteenth century and developed rapidly since then. In the past, physicians tried hard to apply acupuncture into clinical practice, while scientists were focused on the possible characteristics of acupoints and meridians. In the modern time, scientists have strived hard to evaluate the real effectiveness of acupuncture and the underlying physiological and biological mechanisms of acupuncture. Reviewing research history from past to present, we are delighted to witness this wonderful development. Accumulated evidences that acupuncture is beneficial in various conditions significantly enhanced our understanding the mechanisms of acupuncture treatment. However, there is still no conclusive evidence in acupuncture clinical studies. The clinical research still needs great improving, while the basic research results need to be appropriately transformed into clinical outcomes. Based on current achievements, we believe that although the challenges and difficulties exist, a more collaborative, innovative, and integrated approach will help us to achieve further progress in future acupuncture research.
Acupuncture for GI endoscopy: A systematic review
2004, Gastrointestinal Endoscopy
Citation Excerpt :
Needling non-acupuncture points has been reported to generate some physiologic effect,22 and this may be particularly relevant in relation to analgesia, because needling, even of random points, could result in endorphin release.23 It is noteworthy, therefore, that the two sham-controlled RCTs evaluated in this review found acupuncture to be superior to sham intervention for GI endoscopy.14,19 The only actual difference between real and sham acupuncture in two studies was the needle points used.
Electroacupuncture analgesia for colonoscopy: A prospective, randomized, placebo-controlled study
2003, American Journal of Gastroenterology
A study was undertaken to compare the effectiveness of acupuncture in reducing patient’s discomfort and anxiety during colonoscopy with a standard sedation protocol.
Thirty patients scheduled to undergo colonoscopy were randomly assigned to receive acupuncture, sham, or no acupuncture. A verbal rating scale was used to measure patient’s pain when the endoscope reached four scheduled positions. Midazolam was administered at baseline and again anytime patients complained of “severe” pain. The amount of midazolam administered was recorded. A verbal rating scale was used to assess patient’s satisfaction with the level of sedation achieved.
Pain level was lower, although not significantly, in the acupuncture group. Midazolam boluses were required in three patients with acupuncture (30%), eight in the sham group (80%), and nine in the control group (90%) (p = 0.01). Six patients in the acupuncture group (60%) reported optimum acceptance of colonoscopy compared with only one in the sham group (10%) and none in the control group (0%) (p = 0.016). Satisfaction scores, assessed 24–72 h after colonoscopy, were extremely high (median score 90 of 100) in the three groups.
Acupuncture may decrease the demand for sedative drugs during colonoscopy by reducing discomfort and anxiety of the patient and the well-known adverse effects of pharmacologic sedation.
Controlling for non-specific effects of acupuncture in clinical trials
2003, Clinical Acupuncture and Oriental Medicine
Placebo controlled trials are used to examine the relative size of the specific effects of a therapy. When the therapy is a manual treatment like acupuncture, placebo control models are very complex due to the range of non-specific effects that can occur and issues such as blinding. This article examines ten different research models that have been used to control for placebo or other non-specific effects in clinical trials of acupuncture. Through an examination of the different non-specific effects that can occur in acupuncture therapy, it explores the relative ability of these ten models to control for the placebo and other non-specific effects. Three models are eliminated as probably unable to adequately control for these effects and therefore unable to explore the specific effects of acupuncture. The strengths and weaknesses of the remaining seven models are analyzed. Finally, methods and assessments needed to control for non-specific effects are discussed so that these seven models can be used to control for these effects and thus the models can examine the specific effects of acupuncture treatment.
Overview of models used in controlled acupuncture studies and thoughts about questions answerable by each
2002, Clinical Acupuncture and Oriental Medicine

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ACUPUNCTURE IN GASTROSCOPY

Abstract

Br. med. J.

New Engl. J. Med.