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Elektrische Punktualstimulation (P-STIM) mittels Ohrakupunktur

Eine randomisierte, doppelblinde, kontrollierte Pilotstudie bei laparoskopischen Nephrektomien

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Zusammenfassung

Fragestellung

Wir untersuchten, ob P-STIM (Akupunktur mit Stimulation), bei laparoskopischen Nephrektomien im Hinblick auf akute Schmerzen peri- und postoperativ eingesetzt, einen niedrigeren Analgetikaverbrauch bzw. eine Verbesserung des Schmerzscores gegenüber Placebo bewirkt.

Methode

Die Studie wurde doppelblind, randomisiert, kontrolliert durchgeführt. 44 Patienten wurden randomisiert 2 Gruppen zugeordnet. Die Patienten erhielten P-STIM 30 min präoperativ angelegt. Die Stimulation erfolgte über 96 h. In der P-STIM-Verumgruppe wurde unterschwellig stimuliert, in der P-STIM-Placebogruppe erfolgte keine Stimulation. Prämedikation und Narkoseführung waren standardisiert, die Wirksamkeit wurde postoperativ anhand einer visuellen Analogskala (in Ruhe und Belastung)und dem postoperativen Analgetikaverbrauch evaluiert.

Ergebnisse

Die Werte der visuellen Analogskala in Ruhe und Belastung zeigen einen signifikanten Unterschied zu gewissen Zeitpunkten zugunsten der P-STIM-Verumgruppe. Der postoperative Analgetikaverbrauch von Morphinhydrochlorid war in den ersten 6 h signifikant niedriger und auch zu den übrigen Zeitpunkten in der P-STIM-Verumgruppe deutlich niedriger als in der P-STIM-Placebogruppe. Der Schmerzscore bei Belastung vor der 1. Analgetikaanforderung war signifikant niedriger in der P-STIM-Verumgruppe und auch der Zeitpunkt der 1. Analgetikaanforderung war deutlich später in der P-STIM-Verum- gegenüber der P-STIM-Placebogruppe.

Schlussfolgerung

Wir konnten in unserer Studie zeigen, dass P-STIM prä- und postoperativ, bei laparoskopischen Nephrektomien angewendet, eine einfache Methode, nebenwirkungsarm und effektiv zu sein scheint.

Abstract

Aim

The aim of this study was to determine whether P-STIM-verum in patients undergoing laparoscopic nephrectomies resulted in a lower consumption of analgesics and an improvement of pain scores compared with P-STIM-placebo when administered for acute peri- and postperative pain.

Methods

The study was carried out in a double-blind, randomized, controlled manner. Forty-four patients were randomised into 2 groups. The P-STIM device was applied to each patient 30 minutes pro-operatively. The Stimulation was applied over 96 hours. The P-STIM-verum group received subthreshold stimulation. The P-STIM-placebo group received no stimulation. Premedication and anaesthesia were applied in a standardised fashion. The efficacy of treatment was evaluated using a postoperative visual analogue scale (at rest and on exertion) and by dermining postoperative analgesic consumption.

Results

The P-STIM-verum group demonstrated better visual analogue at rest and on exertion then the P-STIM-placebo group. The postoperative consumption of morphine-hydrochloride in the first 6 h significantly less in the P-STIM-verum group. The time of first analgesic request was significantly later in the P-STIM-verum group compared with the P-STIM-placebo group.

Conclusions

In this study we were able to demonstrate, that pre- and postoperative P-STIM applied in patients undergoing laparoscopic nephrectomies seems to be an effective, simply applied method with few side-effects for reducing pain and postoperative analgesic consumption.

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Literatur

  1. Alimi D, Rubino C, Pichard-Leandri E et al. (2003 ) Analgesic effect of auricular acupuncture for cancer pain: a randomized, blinded, controlled trial. J Clin Oncol 21(22): 4120–4126

    Article  PubMed  Google Scholar 

  2. Anderson SA, Ericson T, Holmgren E, Hachisu M (1973) Electroacupuncture: effect on pain threshold measured with electrical stimulation of teeth. Brain 63: 393–396

    Article  Google Scholar 

  3. Ballantyne JC, Carr DB, DeFerranti S et al. (1998) The comparative effects of postoperative analgesic therapies on pulmonary outcome: cumulative meta-analyses of randomized, controlled trials. Anesth Analg 86: 598–612

    Article  PubMed  Google Scholar 

  4. Chen L, Tang J, White PF et al. (1998) The effect of location of transcuteaneous electrical nerve stimulation on postoperative requirement: acupoint versus non-acupoint stimulation. Anesth Analg 87: 1129–1134

    PubMed  Google Scholar 

  5. Chernjak GV, Sessler DI (2005) Perioperative acupuncture and relanted techniques. Anesthesiology 102: 1031–1049

    Article  Google Scholar 

  6. Dolin SJ, Cashman JN, Bland JM (2002) Effectiveness of acute postoperative painmanagement: I. Evidence from published data. Br J Anaesth 89: 409–423

    Article  PubMed  Google Scholar 

  7. Ezzo J, Berman B, Hadhazy VA et al. (2000) Is acupuncture effective for the treatment of chronic pain? A systemic review. Pain 86: 217–225

    Article  PubMed  Google Scholar 

  8. Grammel B (1981)Die Verbrauchsreduzierung postoperativer Analgetika durch intraoperative Applikation von Dauernadeln im OP-Korrespondenzgebiet des Ohres. Akupunkturarzt/Aurikulotherapeut 5: 160–162

    Google Scholar 

  9. Greif R, Laciny S, Mokhtarani M et al. (2002) Transcutaneous electrical stimulation of an auricular acupuncture point decreases anesthetic requirement. Anesthesiology 96: 306–312

    Article  PubMed  Google Scholar 

  10. Kotani N, Hashimoto H, Sato Y et al. (2001) Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses. Anesthesiology 95: 349–356

    Article  PubMed  Google Scholar 

  11. Lao L, Bergman S, Hamilton GR et al. (1999) Evaluation of acupuncture for pain control after oral surgery: a placebo-controlled trial. Arch Otolaryngol Head Neck Surg 125: 567–572

    PubMed  Google Scholar 

  12. Lee Tl (1999) Role of acupuncture in chronic pain. J Anaesth Clin Pharmacol 15: 536–537

    Google Scholar 

  13. Mayer DJ (2000) Biological mechanisms of acupuncture. Prog Brain Res 122: 457–477

    PubMed  Google Scholar 

  14. Nogier P (1987) Points reflexes auriculares. Moulins-les-Metz, Maisonneuve

  15. Pomeraz B, Worma N (1988) Electroacupuncture suppression of a nociceptive reflex is potentiated by two repeated electroacupuncture treatments: the first opioid effect potentiates a second non-opioid effect. Brain Res 452: 232–236

    Article  PubMed  Google Scholar 

  16. Sandkühler J (1996)The organization and function of endogenous antinociceptive systems. Prog Neurobiol 1: 49–81

    Google Scholar 

  17. Sator-Katzenschlager SM, Szeles JC, Scharbert G et al. (2003) Electrical stimulation of auricular acupuncture points is more effective than conventional manual auricular acupuncture in chronic cervical pain: a pilot study. Anesth Analg 97: 1469–1473

    Article  PubMed  Google Scholar 

  18. Schug SA, Torrie JJ (1993) Safety assessment of postoperative pain management by an acute pain service. Pain 55: 387–391

    Article  PubMed  Google Scholar 

  19. Taguchi A, Sharma N, Ali SZ et al. (2003)The effect of auricular acupuncture on anaesthesia with desflurane. Anaesthesia 58: 928–929

    Google Scholar 

  20. Tsui SL, Law S, Fok M et al. (1997) Postoperative analgesia reduces mortality and morbidity after esophageoktomy. Am J Surg 173: 472–478

    Article  PubMed  Google Scholar 

  21. Usichenko TI, Lysenjuk VP, Groth M, Pavlovic D (2003a) Measurement of theelectrical skin resistance of ear acupuncture points in patients before, during and after orthopedic surgery performed under general anesthesia. Acupunct Electrother Res 28: 167–173

    PubMed  Google Scholar 

  22. Vorobiev VV, Dymnikov AA (2000) The effectiveness of auricular microneedle acupuncture at the early postoperative period underconditions of the day surgical department. Vestn Khir im I I Grek 159: 48–50

    Google Scholar 

  23. Wang SM, Kain ZN (2001) Auricular acupuncture: a potential treatment for anxiety. Anesth Analg 92: 548–553

    Article  PubMed  Google Scholar 

  24. Wang SM, Peloquin C, Kain ZN (2001)The use of auricular acupuncture to reduce preoperative anxiety. Anesth Analg 93: 178–180

    Google Scholar 

  25. White PF, Li S, Chiu JW (2001)Electroanalgesia: ist role in acute and chronic pain management. Anesth Analg 92: 505–513

    Article  PubMed  Google Scholar 

  26. White PF, Craig WF, Vakharia S et al. (2000) Percutaneous neuromodulation therapy: does the location of electrical stimulation effect the acute analgesic response? Anesth Analg 91: 949–954

    Article  PubMed  Google Scholar 

  27. White AR, Filshie J, Cummings TM (2002) Clinical trials on acupuncture: consensus recommendations for optimal treatment, sham controls and blinding. Complement Ther Med 9: 237–245

    Article  Google Scholar 

  28. Willer JC, Roby A, Le Bars D (1984) Psychophysical and electrophysiological approaches to the pain-relieving effects of heterotopic nociceptive stimuli. Brain 4: 1095-1112

    Article  Google Scholar 

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Authors and Affiliations

  1. Abteilung für Anästhesiologie und Intensivmedizin, LKH Klagenfurt, St. Veiter Straße 47, A-9020, Klagenfurt, Österreich

    R. Likar, H. Jabarzadeh, I. Kager, E. Trampitsch & C. Breschan

  2. Abteilung für Gefäßchirurgie, Medizinische Universität Wien, Wien, Österreich

    J. Szeles

Authors
  1. R. Likar
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  2. H. Jabarzadeh
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  3. I. Kager
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  4. E. Trampitsch
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  5. C. Breschan
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  6. J. Szeles
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Correspondence to R. Likar.

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Likar, R., Jabarzadeh, H., Kager, I. et al. Elektrische Punktualstimulation (P-STIM) mittels Ohrakupunktur. Schmerz 21, 154–159 (2007). https://doi.org/10.1007/s00482-006-0519-y

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  • DOI: https://doi.org/10.1007/s00482-006-0519-y

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