Sven Asmussen1,2,3, Rene Przkora2,4, Dirk M Maybauer2,5, John F Fraser3, Filippo Sanfilippo6,7, Kristofer Jennings2, Michael Adamzik1, Marc O Maybauer2,3,5,8. 1. 1 Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Knappschaftskrankenhaus, Ruhr-University Bochum, Bochum, Germany. 2. 2 Departments of Anesthesiology and Epidemiology and Biostatistics, The University of Texas Medical Branch, Galveston, TX, USA. 3. 3 Critical Care Research Group, Prince Charles Hospital, The University of Queensland, Brisbane, Queensland, Australia. 4. 4 Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL, USA. 5. 5 Department of Cardiothoracic Anaesthesia and Critical Care, St George's Hospital, London, UK. 6. 6 Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy. 7. 7 Department of Anaesthesiology and Intensive Care, Philipps University, Marburg, Germany. 8. 8 Cardiothoracic Anaesthesia and Intensive Care, Central Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, University of Manchester, UK.
Abstract
BACKGROUND: Acupuncture treatment has been employed in China for over 2500 years and it is used worldwide as analgesia in acute and chronic pain. Acupuncture is also used in general anesthesia (GA). The aim of this systematic review and meta-analysis was to assess the efficacy of electroacupuncture (EA) in addition to GA in patients undergoing cardiac surgery. METHODS: We searched 3 databases (Pubmed, Cochrane Library, and Web of Science-from 1965 until January 31, 2017) for randomized controlled trials (RCTs) including patients undergoing cardiac surgery and receiving GA alone or GA + EA. As primary outcomes, we investigated the association between GA + EA approach and the dosage of intraoperative anesthetic drugs administered, the duration of mechanical ventilation (MV), the postoperative dose of vasoactive drugs, the length of intensive care unit (ICU) and hospital stay, and the levels of troponin I and cytokines. RESULTS: The initial search yielded 477 citations, but only 7 prospective RCTs enrolling a total of 321 patients were included. The use of GA + EA reduced the dosage of intraoperative anesthetic drugs (P < .05), leading to shorter MV time (P < .01) and ICU stay (P < .05) as well as reduced postoperative dose of vasoactive drugs (P < .001). In addition, significantly lower levels of troponin I (P < .01) and tumor necrosis factor α (P < .01) were observed. CONCLUSION: The complementary use of EA for open-heart surgery reduces the duration of MV and ICU stay, blunts the inflammatory response, and might have protective effects on the heart. Our findings stimulate future RCT to provide definitive recommendations.
BACKGROUND: Acupuncture treatment has been employed in China for over 2500 years and it is used worldwide as analgesia in acute and chronic pain. Acupuncture is also used in general anesthesia (GA). The aim of this systematic review and meta-analysis was to assess the efficacy of electroacupuncture (EA) in addition to GA in patients undergoing cardiac surgery. METHODS: We searched 3 databases (Pubmed, Cochrane Library, and Web of Science-from 1965 until January 31, 2017) for randomized controlled trials (RCTs) including patients undergoing cardiac surgery and receiving GA alone or GA + EA. As primary outcomes, we investigated the association between GA + EA approach and the dosage of intraoperative anesthetic drugs administered, the duration of mechanical ventilation (MV), the postoperative dose of vasoactive drugs, the length of intensive care unit (ICU) and hospital stay, and the levels of troponin I and cytokines. RESULTS: The initial search yielded 477 citations, but only 7 prospective RCTs enrolling a total of 321 patients were included. The use of GA + EA reduced the dosage of intraoperative anesthetic drugs (P < .05), leading to shorter MV time (P < .01) and ICU stay (P < .05) as well as reduced postoperative dose of vasoactive drugs (P < .001). In addition, significantly lower levels of troponin I (P < .01) and tumor necrosis factor α (P < .01) were observed. CONCLUSION: The complementary use of EA for open-heart surgery reduces the duration of MV and ICU stay, blunts the inflammatory response, and might have protective effects on the heart. Our findings stimulate future RCT to provide definitive recommendations.
Authors: Marek Zubrzycki; Andreas Liebold; Christian Skrabal; Helmut Reinelt; Mechthild Ziegler; Ewelina Perdas; Maria Zubrzycka Journal: J Pain Res Date: 2018-08-24 Impact factor: 3.133
Authors: J Fleckenstein; P Baeumler; C Gurschler; T Weissenbacher; T Annecke; T Geisenberger; D Irnich Journal: Sci Rep Date: 2018-10-24 Impact factor: 4.379