Acupuncture for Pain Control in the Emergency Department

• Published in: Integrative medicine alert 2018-12, Vol.21 (12)
• Main Author: Feldman, Ellen
• Format: Article
• Language: English
• Subjects: Acupuncture; Ankle; Back pain; Confidence intervals; Drug therapy; Emergency medical care; Intervention; Migraine; Nonsteroidal anti-inflammatory drugs; Pain management; Patient satisfaction; Psychopharmacology; Studies
• ISSN: 2325-2812; 2325-2820

According to the authors, a difference of at least 1.5 VNRS units between groups was clinically significant and indicated nonequivalence. Selected Outcomes Equivalence testing (pharmacotherapy vs. acupuncture alone) * The migraine group alone demonstrated nonequivalence between treatments, with a mean difference in pain level between acupuncture and pharmacotherapy = 0.5 (favoring pharmacotherapy) and a relatively large confidence interval of 2.5.* Both other diagnoses (low back pain and ankle sprain) demonstrated equivalence in pain reduction with both interventions. Noninferiority testing (acupuncture only vs. pharmacotherapy and combined treatment) * The migraine group was alone in failing to demonstrate noninferiority, with a mean pain score difference between the groups of 0.5 (favoring pharmacotherapy and combined group) and a relatively large confidence interval of 2.* Both other diagnoses (low back pain and ankle sprain) demonstrated noninferiority in pain reduction with these interventions. Rescue Therapy Needs, Willingness to Repeat Therapy, and Adverse Effects for the Different Treatment Groups Rescue therapy within one hour of presentation (P = 0.016) Rescue therapy any point after one hour of presentation (P = 0.008) Willingness to repeat at one hour post presentation (definitely yes) (P = 0.015) Willingness to repeat at 48 hours post presentation (definitely yes) (P = 0.64) Adverse events All participants 19% (98 participants) 8.5 % (45 participants) 50.7% (259 participants) 56.6% (237 participants) 51.7% (216 participants) Acupuncture only 25% (45 participants) 14% (24 participants) 47% (81 participants) 61% (88 participants) 51% (73 participants) Combined treatment 15% (27 participants) 4.5% (8 participants) 49% (86 participants) 57% (80 participants) 50 % (71 participants) Medication only 15% (26 participants) 7.5% (13 participants) 57% (92 participants) 52 % (69 participants) 54% (72 participants) Bold = important findings COMMENTARY These results are best understood by looking closely at the context, setting, and goals of the study.