title: Effects of acupuncture on pain and inflammation in pediatric emergency department patients with acute appendicitis: a pilot study.
abstract: OBJECTIVE
  Acupuncture has been shown to treat various medical conditions, including acute and chronic pain, and there is limited evidence that acupuncture produces anti-inflammatory effects. This pilot study evaluated the use of acupuncture to treat pain and determine if acupuncture can reduce the inflammatory response in pediatric patients diagnosed with acute appendicitis.
  
  
  METHODS
  This pilot study used convenience sampling and was conducted in the Pediatric Emergency Department (PED) of an urban tertiary care children's hospital. Patients conventionally evaluated and definitively diagnosed with appendicitis were eligible to voluntarily participate.
  
  
  METHODS
  The diagnostic homogeneity of the target population allowed for a standardized intervention protocol. A licensed acupuncturist performed a specific form of Japanese acupuncture known as the Kiiko Matsumoto Style on all study patients.
  
  
  METHODS
  Subjective pain was assessed immediately before the intervention and 20 minutes postintervention, using 3 measures: Faces Pain Scale-Revised (FPS-R), colored analog scale (CAS), and visual analog scale (VAS). Evidence of inflammation was assessed using two biomarkers: white blood cell (WBC) count and C-reactive protein (CRP). WBC and CRP were drawn and recorded 3 times: before the intervention, 2 minutes before removal of needles, and 30 minutes after needling.
  
  
  RESULTS
  Six Latino/Hispanic patients (4 males, 2 females, median age=15 years) with no previous acupuncture experience participated in the study. Median pre/postacupuncture pain scores were as follows: FPS-R, 5 vs. 4; CAS, 6.1 vs. 4.8; VAS, 46 vs. 32. Median WBC (10(3)/μL) and CRP (mg/dL) across time were as follows: WBC, 13.2, 11.8, and 11.4; CRP, 4.5, 4.9, and 5.1. Median acupuncture duration was 28.5 minutes (range 22-32) and no complications were observed.
  
  
  CONCLUSIONS
  Pilot data suggest that acupuncture may be a feasible and effective treatment modality for decreasing subjective pain and inflammation as measured by WBC. Acupuncture may be a useful nonpharmacological PED intervention for treating patients with acute appendicitis pain.
authors: 1 Division of Emergency and Transport Medicine, Department of Pediatrics, Children's Hospital Los Angeles , Los Angeles, CA.
authors: Alan L
authors: AL
authors: Nager
authors: Monika
authors: M
authors: Kobylecka
authors: Phung K
authors: PK
authors: Pham
authors: Leighanne
authors: L
authors: Johnson
authors: Jeffrey I
authors: JI
authors: Gold
mesh_terms: D015746:Abdominal Pain / Q000097:blood / Q000209:etiology* / Q000628:therapy*; D015670:Acupuncture Therapy / Q000379:methods*; D000293:Adolescent; D001064:Appendicitis / Q000097:blood / Q000150:complications* / Q000628:therapy*; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D010865:Pilot Projects
chemical_list: D002097:C-Reactive Protein