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Electroacupuncture-reduced sedative and analgesic requirements for diagnostic EUS: a prospective, randomized, double-blinded, sham-controlled study - 21/06/18

Doi : 10.1016/j.gie.2017.07.029 
Anthony Yuen Bun Teoh, FRCSEd 1, , Charing Ching Ning Chong, FRCSEd 1, , Wing Wa Leung, PhD 1, Simon Kin Cheong Chan, FHKCA 2, Yee Kit Tse, M Phil 3, Enders Kwok Wai Ng, FRCSEd 1, 3, Paul Bo San Lai, FRCSEd 1, 3, Justin Che Yuen Wu, FRCP (Edin) 3, 4, James Yun Wong Lau, FRCSEd 1, 2
1 Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China 
2 Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China 
3 Institute of Digestive Disease, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China 
4 Institute of Integrative Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China 

Reprint requests: Professor Anthony Yuen Bun Teoh, Prince of Wales Hospital, The Chinese University of Hong Kong, Department of Surgery, Hong Kong NA, Hong Kong.Prince of Wales Hospital, The Chinese University of Hong Kong, Department of SurgeryHong Kong NAHong Kong

Abstract

Background and Aims

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.

Methods

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.

Results

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).

Conclusions

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.)

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Graphical abstract




Il testo completo di questo articolo è disponibile in PDF.

Abbreviations : EA, SA, PCA


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 DISCLOSURE: This study was supported by the Health and Medical Research Fund, Hong Kong (Dr Teoh). All other authors disclosed no financial relationships relevant to this publication.
 If you would like to chat with an author of this article, you may contact Dr Teoh at anthonyteoh@surgery.cuhk.edu.hk.


© 2018  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 87 - N° 2

P. 476-485 - febbraio 2018 Ritorno al numero
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