title: Integrative acupoint stimulation to alleviate postoperative pain and morphine-related side effects: a sham-controlled study.
abstract: BACKGROUND
  Although it can be reduced, postoperative pain remains a problem. Acupressure with electric stimulation may be more effective for postoperative pain management than acupressure alone.
  
  
  OBJECTIVE
  This study aimed to evaluate the effects of integrative acupoint stimulation (IAS) on the relief of postoperative pain and on the reduction of morphine-related side effects.
  
  
  METHODS
  A single-blinded, sham-controlled study with three groups.
  
  
  METHODS
  An orthopedic ward in a 2900-bed teaching medical center.
  
  
  METHODS
  Forty-five subjects in each of three groups.
  
  
  METHODS
  Each subject received a multimedia course on patient-controlled analgesia (PCA) before surgery to learn about the use of narcotic analgesics and the operation of the PCA device. Treatment was as follows: (1) for the IAS group, auricular acupressure combined with transcutaneous electric acupoint stimulation (TEAS) at the true acupoint; (2) for the sham group, acupoint stimulation in the same manner but at a sham acupoint or without embedding seeds and pressure; (3) for the control group, no IAS intervention.
  
  
  RESULTS
  Pain scores were significantly lower in the IAS group than the other two groups at 2h and 4h after returning to the ward, and 24h after surgery. The analgesic requirement during the 72h after surgery and the overall incidence of morphine-related side effects were significantly lower in the IAS group.
  
  
  CONCLUSIONS
  The study demonstrates that combined auricular acupressure and TEAS decreased postoperative pain, the use of equianalgesic morphine, and morphine-related side effects. IAS provides better analgesia when used in conjunction with PCA after lumbar spine surgery and can be regarded as a component of multimodal analgesia.
authors.affiliation: School of Nursing, Yuanpei University, No. 306, Yuanpei Street, Hsinchu 30015, Taiwan, ROC. Electronic address: yuchu@mail.ypu.edu.tw.
authors.forename: Yu-Chu
authors.initials: YC
authors.lastname: Chung
authors.affiliation: Physician of Anesthesiology Department, Veterans General Hospital, Taipei, No. 201, Shih-Pai Road, Section 2, PeiTou 112, Taipei, Taiwan, ROC. Electronic address: mytsou@vghtpe.gov.tw.
authors.forename: Mei-Yung
authors.initials: MY
authors.lastname: Tsou
authors.affiliation: Department of Applied Mathematics, Chung-Yuan Christian University, No. 200, Chung Pei Road, Chung Li City 32023, Taiwan, ROC. Electronic address: hsinghsi@cycu.edu.tw.
authors.forename: Hsing-Hsia
authors.initials: HH
authors.lastname: Chen
authors.affiliation: School of Chinese Medicine, China Medical University, No. 91, Hsueh-Shih Road, Taichung 40402, Taiwan, ROC. Electronic address: jglin@mail.cmu.edu.tw.
authors.forename: Jaung-Geng
authors.initials: JG
authors.lastname: Lin
authors.affiliation: School of Nursing, National Taipei University of Nursing and Health Sciences, No. 365, Minte Road, Taipei, Taiwan, ROC. Electronic address: meiling@ntunhs.edu.tw.
authors.forename: Mei-Ling
authors.initials: ML
authors.lastname: Yeh
mesh_terms: D015669:Acupuncture Points; D000368:Aged; D016058:Analgesia, Patient-Controlled; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects*; D010149:Postoperative Pain / Q000188:drug therapy / Q000628:therapy*; D016037:Single-Blind Method
chemical_list: D009020:Morphine
keywords: Auricular acupressure; Morphine-related side effects; Postoperative pain; Sham-controlled study; Transcutaneuos electric acupoint stimulation (TEAS)