title: Electroacupuncture for postoperative pain and gastrointestinal motility after laparoscopic appendectomy (AcuLap): study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Acupuncture is a widely serviced complementary medicine. Although acupuncture is suggested for managing postoperative ileus and pain, supporting evidence is weak. The AcuLap trial is designed to provide high-level evidence regarding whether or not electroacupuncture is effective in promoting gastrointestinal motility and controlling pain after laparoscopic surgery.
  
  
  METHODS
  This study is a prospective randomized controlled trial with a three-arm, parallel-group structure evaluating the efficacy of electroacupuncture for gastrointestinal motility and postoperative pain after laparoscopic appendectomy. Patients with appendicitis undergoing laparoscopic surgery are included and randomized into three groups: 1) electroacupuncture group, 2) sham acupuncture group, and 3) control group. Patients receive 1) acupuncture with electrostimulation or 2) fake electroacupuncture with sham device twice a day or 3) no acupuncture after laparoscopic appendectomy. The primary outcome is time to first passing flatus after operation. Secondary outcomes include postoperative pain, analgesics, nausea/vomiting, bowel motility, time to tolerable diet, complications, hospital stay, readmission rates, time to recovery, quality of life, medical costs, and protocol failure rate. Patients and hospital staff (physicians and nurses) are blinded to which group the patient is assigned, electroacupuncture or sham acupuncture. Data analysis personnel are blinded to group assignment among all three groups. Estimated sample size to detect a minimum difference of time to first flatus with 80 % power, 5 % significance, and 10 % drop rate is 29 × 3 groups = 87 patients. Analysis will be performed according to the intention-to-treat principle.
  
  
  CONCLUSIONS
  The AcuLap trial will provide evidence on the merits and/or demerits of electroacupuncture for bowel motility recovery and pain relief after laparoscopic appendectomy.
  
  
  BACKGROUND
  The trial was registered in Clinical Research Information Service (CRiS), Republic of Korea ( KCT0001486 ) on 14 May 2015.
authors.affiliation: Department of Surgery, Dongguk University College of Medicine, 87 Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do, 780-350, Republic of Korea. gangmikim@gmail.com.
authors.forename: Gangmi
authors.initials: G
authors.lastname: Kim
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D001062:Appendectomy / Q000009:adverse effects* / Q000191:economics / Q000379:methods; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D015671:Electroacupuncture / Q000009:adverse effects / Q000191:economics; D005260:Female; D005769:Gastrointestinal Motility; D017721:Hospital Costs; D006801:Humans; D045823:Ileus / Q000175:diagnosis / Q000191:economics / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D057194:Intention to Treat Analysis; D010535:Laparoscopy / Q000009:adverse effects* / Q000191:economics; D007902:Length of Stay; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D020127:Recovery of Function; D056910:Republic of Korea; D012107:Research Design; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000700:Analgesics