Reduction of Pain After Laparoscopic Bariatric Surgery by Personalized Checkpoint Acupuncture-Data of a STRICTA Conform Pilot Study.


Journal

Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714

Informations de publication

Date de publication:
07 2023
Historique:
received: 12 12 2022
accepted: 17 05 2023
revised: 13 05 2023
medline: 26 6 2023
pubmed: 29 5 2023
entrez: 28 5 2023
Statut: ppublish

Résumé

It remains challenging in clinical practice to perform optimal pain management following bariatric surgeries. Acupuncture (AC) is an effective method of postoperative pain management, but its clinical efficacy depends on the rationale used to select AC points. We developed a method to identify individual patterns of pain and a corresponding set of acupoints (corrAC) based on the relative pressure sensitivity of six abdominal visceral pressure points, i.e., the gastrointestinal (GI) checkpoints (G1-G6). Patients with moderate to severe pain were included and received a single AC treatment following surgery. The visual analog scale (VAS) score, pain threshold, and skin temperature were assessed before AC and at 5 min, 1 h, and 24 h following AC. AC was performed with 1-mm-deep permanent needles. From April 2021 to March 2022, 72 patients were included in the analysis. Fifty-nine patients received corrAC, whereas 13 received a noncorresponding AC (nonAC) as an internal control. Patients receiving corrAC showed a significant reduction (74%) in pain at 5 min after treatment (p < 0.0001) and a significant increase (37%) in the pain threshold (p < 0.0001). In this group, a significant increase in skin temperature above G1, G3, G4, and G5 was observed. Patients receiving nonAC showed neither significant pain reduction nor significant changes in pain threshold. The skin above G3 and G4 did not reveal temperature changes. Checkpoint AC may be an effective tool in postoperative pain therapy after bariatric surgery. Vegetative functional involvement might be associated with pain relief.

Sections du résumé

BACKGROUND
It remains challenging in clinical practice to perform optimal pain management following bariatric surgeries. Acupuncture (AC) is an effective method of postoperative pain management, but its clinical efficacy depends on the rationale used to select AC points.
METHODS
We developed a method to identify individual patterns of pain and a corresponding set of acupoints (corrAC) based on the relative pressure sensitivity of six abdominal visceral pressure points, i.e., the gastrointestinal (GI) checkpoints (G1-G6). Patients with moderate to severe pain were included and received a single AC treatment following surgery. The visual analog scale (VAS) score, pain threshold, and skin temperature were assessed before AC and at 5 min, 1 h, and 24 h following AC. AC was performed with 1-mm-deep permanent needles.
RESULTS
From April 2021 to March 2022, 72 patients were included in the analysis. Fifty-nine patients received corrAC, whereas 13 received a noncorresponding AC (nonAC) as an internal control. Patients receiving corrAC showed a significant reduction (74%) in pain at 5 min after treatment (p < 0.0001) and a significant increase (37%) in the pain threshold (p < 0.0001). In this group, a significant increase in skin temperature above G1, G3, G4, and G5 was observed. Patients receiving nonAC showed neither significant pain reduction nor significant changes in pain threshold. The skin above G3 and G4 did not reveal temperature changes.
CONCLUSION
Checkpoint AC may be an effective tool in postoperative pain therapy after bariatric surgery. Vegetative functional involvement might be associated with pain relief.

Identifiants

pubmed: 37246204
doi: 10.1007/s11695-023-06654-8
pii: 10.1007/s11695-023-06654-8
pmc: PMC10289919
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2176-2185

Informations de copyright

© 2023. The Author(s).

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Auteurs

Erfan Ghanad (E)

Heidelberg School of Chinese Medicine, 69126, Heidelberg, Germany.
Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Sophie Staff (S)

Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Christel Weiß (C)

Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, 68167, Mannheim, Germany.

Mario Goncalves (M)

Heidelberg School of Chinese Medicine, 69126, Heidelberg, Germany.
Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313, Porto, Portugal.

Maria Joao Santos (MJ)

Institute Piaget, Gaia, 4405-678, Vila Nova de Gaia, Portugal.

Nuno Correia (N)

Institute Piaget, Gaia, 4405-678, Vila Nova de Gaia, Portugal.

Georgi Vassilev (G)

Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Florian Herrle (F)

Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Christoph Reissfelder (C)

Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Henry Johannes Greten (HJ)

Heidelberg School of Chinese Medicine, 69126, Heidelberg, Germany.
Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313, Porto, Portugal.
Institute Piaget, Gaia, 4405-678, Vila Nova de Gaia, Portugal.

Mirko Otto (M)

Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Cui Yang (C)

Heidelberg School of Chinese Medicine, 69126, Heidelberg, Germany. cui.yang@umm.de.
Department of Surgery, Medical Faculty Mannheim, University Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. cui.yang@umm.de.

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