title: Acupuncture vs intravenous morphine in the management of acute pain in the ED.
abstract: BACKGROUND
  Acupuncture is one of the oldest techniques to treat pain and is commonly used for a large number of indications. However, there is no sufficient evidence to support its application in acute medical settings.
  
  
  METHODS
  This was a prospective, randomized trial of acupuncture vs morphine to treat ED patients with acute onset moderate to severe pain. Primary outcome consists of the degree of pain relief with significant pain reduction defined as a pain score reduction ≥50% of its initial value. We also analyzed the pain reduction time and the occurrence of short-term adverse effects. We included in the protocol 300 patients with acute pain: 150 in each group.
  
  
  RESULTS
  Success rate was significantly different between the 2 groups (92% in the acupuncture group vs 78% in the morphine group P<.001). Resolution time was 16±8 minutes in the acupuncture group vs 28±14 minutes in the morphine group (P<.005). Overall, 89 patients (29.6%) experienced minor adverse effects: 85 (56.6%) in morphine group and 4 (2.6%) in acupuncture group (P<.001). No major adverse effects were recorded during the study protocol. In patients with acute pain presenting to the ED, acupuncture was associated with more effective and faster analgesia with better tolerance.
  
  
  CONCLUSIONS
  This article provides an update on one of the oldest pain relief techniques (acupuncture) that could find a central place in the management of acute care settings. This should be considered especially in today's increasingly complicated and polymedicated patients to avoid adverse drug reactions.
authors.affiliation: Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and Research Laboratory (LR12SP18) University of Monastir, Tunisia.
authors.forename: Mohamed Habib
authors.initials: MH
authors.lastname: Grissa
authors.affiliation: Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and Research Laboratory (LR12SP18) University of Monastir, Tunisia.
authors.forename: Houda
authors.initials: H
authors.lastname: Baccouche
authors.affiliation: Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and Research Laboratory (LR12SP18) University of Monastir, Tunisia.
authors.forename: Hamdi
authors.initials: H
authors.lastname: Boubaker
authors.affiliation: Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and Research Laboratory (LR12SP18) University of Monastir, Tunisia.
authors.forename: Kaouthar
authors.initials: K
authors.lastname: Beltaief
authors.affiliation: Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and Research Laboratory (LR12SP18) University of Monastir, Tunisia.
authors.forename: Nasri
authors.initials: N
authors.lastname: Bzeouich
authors.affiliation: Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and Research Laboratory (LR12SP18) University of Monastir, Tunisia.
authors.forename: Nizar
authors.initials: N
authors.lastname: Fredj
authors.affiliation: Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and Research Laboratory (LR12SP18) University of Monastir, Tunisia.
authors.forename: Mohamed Amine
authors.initials: MA
authors.lastname: Msolli
authors.affiliation: Emergency Department, Sahloul University Hospital, Sousse, Tunisia and Research Laboratory (LR12SP18) University of Monastir, Tunisia.
authors.forename: Riadh
authors.initials: R
authors.lastname: Boukef
authors.affiliation: Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and Research Laboratory (LR12SP18) University of Monastir, Tunisia.
authors.forename: Wahid
authors.initials: W
authors.lastname: Bouida
authors.affiliation: Emergency Department, Fattouma Bourguiba University Hospital Monastir, Tunisia and Research Laboratory (LR12SP18) University of Monastir, Tunisia. Electronic address: Semir.nouira@rns.tn.
authors.forename: Semir
authors.initials: S
authors.lastname: Nouira
mesh_terms: D015667:Acupuncture Analgesia / Q000009:adverse effects; D059787:Acute Pain / Q000628:therapy*; D061605:Administration, Intravenous; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D004636:Emergency Service, Hospital; D006801:Humans; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D010147:Pain Measurement; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine