title: Acupuncture for pain relief after total knee arthroplasty: a randomized controlled trial.
abstract: OBJECTIVE
  The effectiveness of acupuncture in relieving acute postoperative pain is still controversial. This patient-evaluator blinded and sham auricular acupuncture (AA)-controlled study tested whether acupuncture is effective in controlling acute postoperative pain after total knee arthroplasty.
  
  
  METHODS
  Patients were randomly assigned to receive true acupuncture (knee, scalp, and AA) or sham AA. All procedures were conducted under general anesthesia, and the AA needles were retained in situ for 3 days. Postoperative pain was managed with intravenous fentanyl using a patient-controlled analgesia pump. The amount of postoperative fentanyl required, the time to the first fentanyl request, pain intensity on a 100-mm visual analog scale, incidence of analgesia-related adverse effects, and success of patients' blinding were recorded.
  
  
  RESULTS
  This study comprised 60 patients (30 in the study group and 30 in the control group). The fentanyl requirement via patient-controlled analgesia in the study group was lower [mean (SD), 620.7 (258.2) vs 868.6 (319.3) μg; P = 0.002). The time to first request for fentanyl was longer in the study group. Pain intensity on a 100-mm visual analog scale was lower in the study group in the first 24 hours after the operation. The incidence of analgesia-related adverse effects of nausea and vomiting was lower in the study group. The success of blinding was not significantly different between the 2 groups (P = 0.731).
  
  
  CONCLUSIONS
  The data obtained from this clinical trial demonstrate the potential advantages of using acupuncture for postoperative pain control after total knee arthroplasty.
authors.affiliation: From the *Department of Orthopaedic Surgery, Chang Gung Memorial Hospital; †School of Medicine, Chang Gung University; and ‡Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Chen
authors.forename: Chien-Chung
authors.initials: CC
authors.lastname: Yang
authors.forename: Chih-Chien
authors.initials: CC
authors.lastname: Hu
authors.forename: Hsin-Nung
authors.initials: HN
authors.lastname: Shih
authors.forename: Yu-Han
authors.initials: YH
authors.lastname: Chang
authors.forename: Pang-Hsin
authors.initials: PH
authors.lastname: Hsieh
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000175:diagnosis* / Q000628:therapy*; D011446:Prospective Studies