Published: May 9, 2014
By Ed Susman , Contributing Writer, MedPage Today

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Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

CHICAGO — Pairing traditional Chinese acupuncture with modern technology appears to help patients get through endoscopic ultrasound diagnostic treatments with less pain and anxiety, researchers reported here.

Patients who were assigned to electroacupuncture analgesia required an average use of 0.22 mg/kg of propofol compared with an average use of 0.71 mg/kg of propofol if the patients were given sham electroacupuncture (P<0.001), said Anthony Teoh, MD, at the Chinese University/Prince of Wales Hospital, Hong Kong.

In their presentation at the annual Digestive Disease Week conference, co-author Wing Wa Leung, PhD, senior research consultant at Chinese University, also noted that two of the 32 electroacupuncture subjects used patient-controlled analgesia compared with 10 of the 32 patients receiving the sham procedure (P=0.001).

Leung told MedPage Today that acupuncture needles were placed into plastic foam cubes on the skin of the patients in all cases. The needles were connected to an electric current, set to stimulate the needles but below a discomfort level to the patients. In the sham procedure, the needles did not penetrate the patients’ skin.

The cubes hold the needles in place and also prevent the patients or the endoscopists from knowing which patients are receiving the sham acupuncture. All the patients in the study were Chinese.

Leung also explained that electroacupuncture is applied to the patients for about 45 minutes before they undergo the endoscopic procedure, and it is also applied during the procedure.

Electroacupuncture was applied to acupuncture points relevant to the treatment of upper abdominal pain and anxiety, including Zusanli (stomach meridian ST-36), Hegu (large intestine meridian LI-4), and Neiguan (pericardium meridian PC-6). Electric stimulation was employed to the needles at a frequency of 2 Hz, pulse width of 200 μs, Leung said.

“Because we can quantify the electric pulse and frequency, we know exactly how much stimulation is being given to each person,” said Leung, who performed the acupuncture procedures in the study.

“In the past, people would just wiggle the needles with their fingers to stimulate the nerves at the acupuncture site,” Teoh said.

He said the researchers were trying to reduce pain and anxiety among their patients in the endoscopic ultrasound procedure. “This procedure usually takes a longer period of time and people will usually need to be sedated,” Teoh said.

But in the study, patients were given the opportunity to control the amount of sedation themselves. Teoh said the goal of the trial was to see if electroacupuncture would reduce the use of patient-controlled analgesia.

“Our findings were exceptional,” he told MedPage Today. “Those who were given electroacupuncture used less sedation; they were happier with the procedure; they said they were more likely to return for another examination. With electroacupuncture, the patients don’t need as much drug, and in some cases they don’t need any drugs. They require less recovery time as well.”

The researchers noted:

• The patient pain score in those receiving electroacupuncture was 2.1 versus 6.2 for those who received the sham procedure (P<0.001).
• The patient satisfaction score was 8.2 versus 7.1 for those getting the sham procedure (P=0.002).
• Of 17 patients getting electroacupuncture who were asked if they would be willing to do the procedure again, 15 said Yes; Of the 24 who received the sham operation and were asked about their willingness to undergo the procedure again, eight said Yes (P=0.05).

“We are not doing this procedure routinely in the hospital right now,” Teoh said. “We are trying to develop ways to simplify the procedure. Right now we need an acupuncturist to place the needles.” He said there is some pushback over the use of the traditional Chinese medicine being used in the modern hospital setting.

Teoh and Leung disclosed no relevant relationships with industry.