title: [Application and effect of auricular acupoint pressing for analgesia in perioperative period of total knee joint replacement].
abstract: OBJECTIVE
  To observe the effect of auricular acupoint pressing (AAP) for analgesia during perioperative period of total knee joint replacement.
  
  
  METHODS
  Sixty patients with osteoarthritis of ASA grade I - III scheduled to receive unilateral total knee joint replacement were equally randomized into the AAP group and the control group, 30 in each group. The general anesthesia on all patients was implemented by physicians of an identical group through endotracheal intubation. To the patients in the AAP group, AAP with Vaccaria seed was applied before operation, and the local analgesia on affected limb with acupoint pasting was used after operation. Besides, administering of celecoxib 400 mg on the day before operation, and celecoxib 200 mg twice daily post-operation was given to all patients. When the visual analogue scales (VAS) reached more than 7 points, 0.1 g of bucinnazine hydrochloride was given for supplement. Meantime, same post-operative training methods were adopted in both groups. The resting VAS pain scores, contentment of sedation, incidence of adverse event, postoperative range of motion (ROM) of knee joint and Hospital for Special Surgery (HSS) score were recorded.
  
  
  RESULTS
  The resting VAS pain scores at 6 h and 24 h after operation was 5.99 +/- 0.67 scores and 4.26 +/- 0.59 scores in the AAP group respectively, which was significantly lower than that in the control group at the corresponding time (7.02 +/- 0.85 scores and 4.92 +/- 0.43 scores, P < 0.01); but it showed insignificant difference between the two groups at 1 h and 48 h after operation (P > 0.05); sedation contentment in the two groups was similar; incidence of adverse event in the AAP groups seemed lower (4 cases vs. 11 cases), but the intergroup difference was statistically insignificant (P > 0.05). ROM before surgery were 75.63 degrees +/- 5.74 degrees and 75.43 degrees +/- 5.63 degrees in the two groups respectively, showing no significant difference (P > 0.05), two weeks after operation, the initiative ROM raised to 96.50 degrees +/- 3.79 degrees and 93.50 degrees +/- 3.50 degrees, and the passive ROM reached 107.8 degrees +/- 3.37 degrees and 105.27 degrees +/- 3.25 degrees in the two groups respectively, with statistical significance between them (P < 0.05). HSS score was similar between groups before operation (60.23 +/- 3.44 scores vs. 61.70 +/- 2.83 scores, P > 0.05); while it became 86.97 +/- 2.33 scores and 85.37 +/- 2.30 scores after operation, showing significant difference between groups (P < 0.05).
  
  
  CONCLUSIONS
  Applying auricular acupoint pressing in perioperative period of knee joint replacement is favorable for alleviating postoperative pain, decreasing narcotic consumption, and promoting early rehabilitation, and it has the advantages of low cost, less complication, simple manipulation and high safety.
authors.affiliation: Department of Orthopaedics, First Affiliated Hospital of Zhejiang Medical University, Hangzhou. tongpeijian@163.com
authors.forename: Pei-Jian
authors.initials: PJ
authors.lastname: Tong
authors.forename: Hai-Dong
authors.initials: HD
authors.lastname: Wang
authors.forename: Zhen-Chuan
authors.initials: ZC
authors.lastname: Ma
mesh_terms: D019050:Acupressure / Q000379:methods*; D015669:Acupuncture Points; D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D054644:Ear Auricle; D005260:Female; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000628:therapy*; D059035:Perioperative Period