L Lao1, S Bergman, G R Hamilton, P Langenberg, B Berman. 1. Department of Family Medicine, School of Medicine, University of Maryland at Baltimore, 21207-6697, USA. Llao@compmed.ummc.ab.umd.edu
Abstract
BACKGROUND:Acupuncture is increasingly being used by the general population and investigated by conventional medicine; however, studies of its effects on pain still lack adequate control procedures. OBJECTIVES: To evaluate the (1) efficacy of Chinese acupuncture in treating postoperative oral surgery pain, (2) validity of a placebo-controlled procedure, and (3) effects of psychological factors on outcomes. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING:Dental School Outpatient Clinic, University of Maryland at Baltimore. PARTICIPANTS: Thirty-nine healthy subjects, aged 18 to 40 years, assigned to treatment (n=19) and control (n=20) groups. MAIN OUTCOME MEASURES: Patients' self-reports of time until moderate pain, time until medication use, total pain relief, pain half gone, and total pain medication consumption. RESULTS:Mean pain-free postoperative time was significantly longer in the acupuncture group (172.9 minutes) than in the placebo group (93.8 minutes) (P=.01), as was time until moderate pain (P=.008). Mean number of minutes before requesting pain rescue medication was significantly longer in the treatment group (242.1 minutes) than in the placebo group (166.2 minutes) (P=.01), as was time until medication use (P=.01). Average pain medication consumption was significantly less in the treatment group (1.1 tablets) than in the placebo group (1.65 tablets) (P=.05). There were no significant between-groups differences on total-pain-relief scores or pain-half-gone scores (P>.05). Nearly half or more of all patients were uncertain of or incorrect about their group assignment. Outcomes were not associated with psychological factors in multivariate models. CONCLUSIONS:Acupuncture is superior to the placebo in preventing postoperative dental pain; noninsertion placebo procedure is valid as a control.
RCT Entities:
BACKGROUND: Acupuncture is increasingly being used by the general population and investigated by conventional medicine; however, studies of its effects on pain still lack adequate control procedures. OBJECTIVES: To evaluate the (1) efficacy of Chinese acupuncture in treating postoperative oral surgery pain, (2) validity of a placebo-controlled procedure, and (3) effects of psychological factors on outcomes. DESIGN: Randomized, double-blind, placebo-controlled trial. SETTING: Dental School Outpatient Clinic, University of Maryland at Baltimore. PARTICIPANTS: Thirty-nine healthy subjects, aged 18 to 40 years, assigned to treatment (n=19) and control (n=20) groups. MAIN OUTCOME MEASURES: Patients' self-reports of time until moderate pain, time until medication use, total pain relief, pain half gone, and total pain medication consumption. RESULTS: Mean pain-free postoperative time was significantly longer in the acupuncture group (172.9 minutes) than in the placebo group (93.8 minutes) (P=.01), as was time until moderate pain (P=.008). Mean number of minutes before requesting pain rescue medication was significantly longer in the treatment group (242.1 minutes) than in the placebo group (166.2 minutes) (P=.01), as was time until medication use (P=.01). Average pain medication consumption was significantly less in the treatment group (1.1 tablets) than in the placebo group (1.65 tablets) (P=.05). There were no significant between-groups differences on total-pain-relief scores or pain-half-gone scores (P>.05). Nearly half or more of all patients were uncertain of or incorrect about their group assignment. Outcomes were not associated with psychological factors in multivariate models. CONCLUSIONS: Acupuncture is superior to the placebo in preventing postoperative dental pain; noninsertion placebo procedure is valid as a control.
Authors: Karen J Sherman; Daniel C Cherkin; Laura Ichikawa; Andrew L Avins; Kristin Delaney; William E Barlow; Partap S Khalsa; Richard A Deyo Journal: Spine (Phila Pa 1976) Date: 2010-07-01 Impact factor: 3.468
Authors: Hugh MacPherson; Douglas G Altman; Richard Hammerschlag; Li Youping; Wu Taixiang; Adrian White; David Moher Journal: PLoS Med Date: 2010-06-08 Impact factor: 11.069