total knee replacement

 

Researchers conclude that acupuncture improves pain relief outcomes in patients receiving pain-relieving drugs after total knee arthroplasty (TKA). Researchers from the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine combined acupuncture with standard drug therapy. Patients receiving both pain-relieving drugs and acupuncture in a combined treatment protocol had superior patient outcomes compared with patients receiving only pain-relieving drugs. The researchers conclude that the addition of acupuncture to a traditional drug treatment regimen significantly reduces pain intensity and frequency, the total dosage requirements for pain-relieving drugs, and mitigates relevant complications. [1]

A total of 40 patients that received TKA due to severe knee osteoarthritis were treated and evaluated in this study. The patients received TKA between May 2017 and February 2018. They were randomly divided into an electroacupuncture (EA) treatment group and a control group, with 20 patients in each group. For the control group patients, a pain pump was provided. The treatment group received electroacupuncture in addition to the identical PCEA treatment administered to the drug control group.

Treatment
Before the end of the operation, both groups received a single dose of 1–2 mg of morphine through an epidural injection. Immediately after the operation, all patients were given pain pump. day for seven consecutive days.

Patients in the acupuncture group received electro acupuncture at points around the knee where the surgery had been done.

Evaluations
Assessment of pain intensity or frequency was done, as well as measurement of active and passive knee flexion range of motion (ROM). Third, the frequency of pushing a pain medicine pump and the dosage as well as frequency of pain drug use was recorded. Fourth, patient safety was evaluated by observing whether there is swelling of the affected limb, redness of the wound, skin irritation, etc. Fifth, complications were measured by monitoring blood pressure and heart rate and also by recording the incidence rate of respiratory depression, nausea and vomiting, and urinary retention. Sixth, infection risks were evaluated through monitoring plasma white blood cell and C-reactive protein levels.

After treatment, the pain scores at rest and upon movement in the electroacupuncture group were both significantly lower than that in the control group. There were no significant differences between the two groups regarding active and passive knee flexion range of motion. The frequency of pushing a pain pump in the acupuncture group was significantly lower than that in the control group.

Results
The results indicate that electroacupuncture combined with pain-relieving drugs into an integrated treatment protocol is more effective than pain-relieving drugs as a single therapy. Zhou et al. conclude that acupuncture is safe and effective for the relief of postoperative pain after TKA. Taking a broader view, the results of this study suggest that acupuncture may reduce addiction to pain medications after surgery by reducing pain levels and the need for medications.

 

References
[1] Chen D, Sheng D, Xu JL, Zhang YY, Lin TY, Zhang QW. Electroacupuncture Intervention Reduces Post-Surgical Pain of Patients Undergoing Total Knee Arthroplasty [J]. Acupuncture Research, 2018, 43 (10):616-621.
[2] Fang JQ, Liu F, Shao XM, et al. Effect of Electroacupuncture on Carrageenan-induced Inflammation Interleukin-1β and Tumor Necrosis Factor-α Concentrations and mRNA Expressions in Toe Tissue in Rats [J]. Acupuncture Research, 2007, 32(4): 224-228.
[3] Han JS. Further Evidence of Acupuncture’S Frequency Specificity Analgesic Effect [J]. Acupuncture Research, 2001, 26(3): 224-227.
[4] Han JS. Further Evidence of Acupuncture’S Frequency Specificity Analgesic Effect [J]. Acupuncture Research, 2001, 26(3): 224-227.
[5] Han JS. Study of Factors That Affect the Analgesic Effect of Acupuncture [J]. Acupuncture Research, 1994, 19(Z1): 1-3
[6] Han JS. Further Evidence of Acupuncture’S Frequency Specificity Analgesic Effect [J]. Acupuncture Research, 2001, 26(3): 224-227.
[7] Chen D, Sheng D, Xu JL, Zhang YY, Lin TY, Zhang QW. Electroacupuncture Intervention Reduces Post-Surgical Pain of Patients Undergoing Total Knee Arthroplasty [J]. Acupuncture Research, 2018, 43 (10):616-621.
[8] Chen D, Sheng D, Xu JL, Zhang YY, Lin TY, Zhang QW. Electroacupuncture Intervention Reduces Post-Surgical Pain of Patients Undergoing Total Knee Arthroplasty [J]. Acupuncture Research, 2018, 43 (10):616-621.
[9] Wang XQ, Jiang YF, Qin KF. 282 Cases of Knee Joint Pain Treated by Oblique Acupuncture at Xuehai and Liangqiu [J]. Chinese Acupuncture, 2003, 23(5): 311
[10] Zhou JZ, Wang CF, Ma Y, Hu YH. Effect of Intra-articular Injection with Paeonol and Acupuncture at Zusanli on Serum Interleukin 1-beta and Tumor Necrosis Factor-alpha Contents in a Rabbit Model of Knee Osteoarthritis [J]. Chinese Journal of Tissue Engineering Research, 2012, 16 (22): 4096-4099.
[11] Chen D, Sheng D, Xu JL, Zhang YY, Lin TY, Zhang QW. Electroacupuncture Intervention Reduces Post-Surgical Pain of Patients Undergoing Total Knee Arthroplasty [J]. Acupuncture Research, 2018, 43 (10):616-621.
[12] Chen D, Sheng D, Xu JL, Zhang YY, Lin TY, Zhang QW. Electroacupuncture Intervention Reduces Post-Surgical Pain of Patients Undergoing Total Knee Arthroplasty [J]. Acupuncture Research, 2018, 43 (10):616-621.
[13] Chen D, Sheng D, Xu JL, Zhang YY, Lin TY, Zhang QW. Electroacupuncture Intervention Reduces Post-Surgical Pain of Patients Undergoing Total Knee Arthroplasty [J]. Acupuncture Research, 2018, 43 (10):616-621.

Source: HealthCMi