Electroacupuncture is a non-pharmacological intervention for analgesia that is widely recognized as therapy for pain. However, the clinical efficacy of electroacupuncture combined with patient-controlled intravenous analgesia for postoperative analgesia after cesarean section remains unclear.
To assess the efficacy of electroacupuncture + patient-controlled intravenous analgesia for postoperative analgesia after cesarean section, determine the optimal frequency for best analgesic effect, and explore the underlying mechanism of action.
This single-center, randomized, single-blinded, sham acupuncture controlled clinical trial was conducted at a tertiary university hospital in China. Female patients who underwent cesarean section and received fentanyl as patient-controlled intravenous analgesia for postoperative analgesia were enrolled. Patients were postoperatively randomized to receive 2 Hz electroacupuncture treatment (n = 53), 20/100 Hz electroacupuncture treatment (n = 53), or sham electroacupuncture treatment (n = 52) (controls). The two electroacupuncture groups received electroacupuncture treatment at 2 or 20/100 Hz at the ST36 and SP6 points, while in the sham electroacupuncture group, sham electroacupuncture was conducted at non-meridian points with non-energized electroacupuncture instruments. Four electroacupuncture treatments were conducted in all groups, at 6, 12, 24, and 48 h after surgery. The primary outcome was the number of analgesic pump compressions at 48 h postoperatively. Secondary outcomes included number of analgesic pump compressions at 6, 12, and 24 h postoperatively; pain scores at 6, 12, 24, and 48 h postoperatively; fentanyl consumption at 48 h postoperatively; interleukin-6 and procalcitonin levels at 12 and 48 h postoperatively; and time to first exhaust.
In total, 174 primigravida women were included in the intention-to-treat analysis. The number of analgesic pump compressions and pain scores at all four time points, as well as fentanyl consumption at 48 h postoperatively, were significantly lower in the electroacupuncture treatment groups than in the sham electroacupuncture group (P < 0.001).
Electroacupuncture + patient-controlled intravenous analgesia had a significantly better analgesic effect than sham electroacupuncture + patient-controlled intravenous analgesia within 48 h postoperatively. Thus, electroacupuncture can be considered safe and effective and may improve the efficacy of patient-controlled intravenous analgesia for pain management after cesarean section. Electroacupuncture can be recommended as a routine complementary therapy for pain control after cesarean section.

Copyright © 2022. Published by Elsevier Inc.

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