Auriculotherapy for pain management: a systematic review and meta-analysis of randomized controlled trials.
OBJECTIVE
Side-effects of standard pain medications can limit their use. Therefore, nonpharmacologic pain relief techniques such as auriculotherapy may play an important role in pain management. Our aim was to conduct a systematic review and meta-analysis of studies evaluating auriculotherapy for pain management.


METHODS
MEDLINE,(®) ISI Web of Science, CINAHL, AMED, and Cochrane Library were searched through December 2008. Randomized trials comparing auriculotherapy to sham, placebo, or standard-of-care control were included that measured outcomes of pain or medication use and were published in English. Two (2) reviewers independently assessed trial eligibility, quality, and abstracted data to a standardized form. Standardized mean differences (SMD) were calculated for studies using a pain score or analgesic requirement as a primary outcome.


RESULTS
Seventeen (17) studies met inclusion criteria (8 perioperative, 4 acute, and 5 chronic pain). Auriculotherapy was superior to controls for studies evaluating pain intensity (SMD, 1.56 [95% confidence interval (CI): 0.85, 2.26]; 8 studies). For perioperative pain, auriculotherapy reduced analgesic use (SMD, 0.54 [95% CI: 0.30, 0.77]; 5 studies). For acute pain and chronic pain, auriculotherapy reduced pain intensity (SMD for acute pain, 1.35 [95% CI: 0.08, 2.64], 2 studies; SMD for chronic pain, 1.84 [95% CI: 0.60, 3.07], 5 studies). Removal of poor quality studies did not alter the conclusions. Significant heterogeneity existed among studies of acute and chronic pain, but not perioperative pain.


CONCLUSIONS
Auriculotherapy may be effective for the treatment of a variety of types of pain, especially postoperative pain. However, a more accurate estimate of the effect will require further large, well-designed trials.
Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. gasher@med.unc.edu
Gary N
GN
Asher
Daniel E
DE
Jonas
Remy R
RR
Coeytaux
Aimee C
AC
Reilly
Yen L
YL
Loh
Alison A
AA
Motsinger-Reif
Stacey J
SJ
Winham
D020831:Acupuncture, Ear; D000698:Analgesia; D006801:Humans; D059408:Pain Management; D010147:Pain Measurement; D059035:Perioperative Period; D016032:Randomized Controlled Trials as Topic