Reflexotherapy as an effective component of postoperative pain relief

Zagorulko O.I.; Medvedeva L.A.; Shevtsova G.E.; Tyurina E.A.

doi:https://doi.org/10.17116/pain20242204141

Zagorulko O.I.

Clinic for the Study and Treatment of Pain — B.V. Petrovsky Russian Scientific Center of Surgery — B.V. Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0002-2713-9577

Medvedeva L.A.

Clinic for the Study and Treatment of Pain — B.V. Petrovsky Russian Scientific Center of Surgery — B.V. Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0002-4191-7224

Shevtsova G.E.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0003-1436-4465

Tyurina E.A.

Clinic for the Study and Treatment of Pain — B.V. Petrovsky Russian Scientific Center of Surgery — B.V. Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0001-5875-3134

Reflexotherapy as an effective component of postoperative pain relief

Authors:

Zagorulko O.I., Medvedeva L.A., Shevtsova G.E., Tyurina E.A.

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Journal: Russian Journal of Pain. 2024;22(4): 41‑45

DOI: 10.17116/pain20242204141

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To cite this article:

Zagorulko OI, Medvedeva LA, Shevtsova GE, Tyurina EA. Reflexotherapy as an effective component of postoperative pain relief. Russian Journal of Pain. 2024;22(4):41‑45. (In Russ.)
https://doi.org/10.17116/pain20242204141

Подписка 2025 Российский журнал боли (Russian Journal of Pain)

Использование инфографики авторами научных работ

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THE AIM OF THE STUDY

To evaluate the effectiveness of classical corporal acupuncture for the treatment of acute and prevention of chronic postoperative pain.

MATERIAL AND METHODS

The study included 100 patients (65 women and 35 men), aged 23 to 75 years, who underwent cardiac surgery in the period from August 2023 to June 2024, who had postoperative pain 1 month after the operation. Randomized into the main and control groups of 50 people, all patients received drug therapy (lornoxicam 16 mg / day, 14 days, omeprazole 20 mg / day, 14 days and gabapentin at a dose of 1200—2700 mg / day for a long time), and patients of the main group additionally received acupuncture (IRT) — 3 procedures per week for 4 weeks (12 sessions). At the time of inclusion in the study and after 2 months, all patients had their pain intensity assessed using the VAS; the DN-IV questionnaire was used to identify the neuropathic nature of the pain. All patients were tested using the Hospital Anxiety and Depression Scale (HADS), the Pain Catastrophizing Scale (PCS) — at the time of inclusion in the study and after 2 months — to assess the treatment results. Statistical data processing was performed using IBM SPSS Statistics and MS Excel. Differences were considered statistically significant at p < 0.05.

RESULTS

Demographic characteristics had no reliable differences — the average age in the main group was 59.07±12.46 years, in the control group — 58.63±9.17 years, p = 0.26, the male / female ratio in the main group was 17/33, in the control group — 18/32. The pain intensity according to VAS was high and did not differ between the groups, amounting to 6.7±0.8 points in the main group and 6.9±0.9 points in the control group (p=0.15). The anxiety level was 8.5±2.3 points for the main group and 8.6±2.4 points in the control group (p>0.05). The depression level was 7.7±2.2 and 7.9±2.3 points (p>0.05) for the main and control groups, the PCS scale was 16.5±4.8 and 16.9±5.0 points in the main and control groups, respectively (p>0.05). One month after the IRT course, the pain intensity according to VAS in the main group decreased to 3.2±1.2 points and to 4.1±1.5 points in the control group (p<0.05). After two months (by the end of the third postoperative month), the pain intensity was 1.9±1.0 and 2.8±1.4 points (p<0.05) in the main and control groups, the anxiety level was 3.5±1.3 and 5.9±1.9 points (p<0.05) in the main and control groups, the depression level was 4.1±0.6 and 6.4±0.8 points (p<0.05) in the main and control groups, the average score on the PCS scale was 12.7±2.4 and 19.8±2.9 points in the main and control groups, respectively. After 2 months of observation (i.e. 3 months after surgery), only 6 (12%) respondents in the main and 18 (35%) patients in the control groups met the criteria for chronic obstructive pulmonary disease.

CONCLUSION

The use of IRT in complex postoperative pain relief increases its effectiveness and reduces the incidence of chronic postoperative pain.

Keywords:

postoperative pain

chronic postoperative pain

acupuncture

Authors:

Zagorulko O.I.

Clinic for the Study and Treatment of Pain — B.V. Petrovsky Russian Scientific Center of Surgery — B.V. Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0002-2713-9577

Medvedeva L.A.

Clinic for the Study and Treatment of Pain — B.V. Petrovsky Russian Scientific Center of Surgery — B.V. Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0002-4191-7224

Shevtsova G.E.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0003-1436-4465

Tyurina E.A.

Clinic for the Study and Treatment of Pain — B.V. Petrovsky Russian Scientific Center of Surgery — B.V. Petrovsky Russian Scientific Center of Surgery

ORCID: 0000-0001-5875-3134

Received:

26.10.2024

Accepted:

10.11.2024

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References:

National Institute of Academic Anaesthesia (NIAA) Health Services Research Centre. Perioperative Quality Improvement Programme Annual Report 2018-19. NIAA: London, 2019.
Gerbershagen HJ, Aduckathil S, van Wijck AJM, Peelen LM, Kalkman CJ, Meissner W. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology. 2013;118:934-944.
Chou R, Gordon DB, de Leon-Casasola OA, Rosenberg JM, Bickler S, Brennan T, Carter T, Cassidy CL, Chittenden EH, Degenhardt E, Griffith S, Manworren R, McCarberg B, Montgomery R, Murphy J, Perkal MF, Suresh S, Sluka K, Strassels S, Thirlby R, Viscusi E, Walco GA, Warner L, Weisman SJ, Wu CL. Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Committee, and Administrative Council. J Pain. 2016;17(2):131-157.
Ovechkin AM, Bayalieva AZh, Ezhevskaya AA, Eremenko DV, Zabolotskiy AA, Zabolotskikh IB, Karelov AE, Koryachkin VA, Spasova AP, Khoronenko VE, Uvarov DN, Ulrikh GE, Shadrin RV. Postoperative analgesia. Guidelines. Vestnik intensivnoi terapii im. A.I. Saltanova. 2019;4:9-33. (In Russ.). https://doi.org/10.21320/1818-474X-2019-4-9-33
Humble SR, Dalton AJ, Li L. A systematic review of therapeutic interventions to reduce acute and chronic post-surgical pain after amputation, thoracotomy or mastectomy. Eur J Pain. 2015;19(4):451-465. https://doi.org/10.1002/ejp.567
Nielsen A, Dusek JA, Taylor-Swanson L, Tick H. Acupuncture Therapy as an Evidence-Based Nonpharmacologic Strategy for Comprehensive Acute Pain Care: The Academic Consortium Pain Task Force White Paper Update. Pain Medicine. 2022;23(9):1582-1612. https://doi.org/10.1093/pm/pnac056
Vickers AJ, Linde K. Acupuncture for chronic pain: individual patient data meta-analysis. Arch Intern Med. 2012;172(19):1444-1453.
Bae H, Bae H, Min BI, Cho S. Efficacy of acupuncture in reducing preoperative anxiety: a meta-analysis. Evid Based Complement Alternat Med. 2014; 2014:850367.
Timmerman H, Steegers MAH, Huygen FJPM, Goeman JJ, van Dasselaar NT, Schenkels MJ, Wilder-Smith OHG, Wolff AP, Vissers KCP. Investigating the validity of the DN4 in a consecutive population of patients with chronic pain. PLoS One. 2017 Nov 30;12(11):e0187961.
Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002 Feb;52(2):69-77.
Sullivan MJL, Bishop SR, Pivik J. The Pain Catastrophizing Scale: Development and validation. Psychological Assessment. 1995;7(4):524-532.
Schug SA, Lavand’homme P, Barke A, Korwisi B, Rief W, Treede RD. The IASP Taskforce for the Classification Chronic Pain. The IASP classification chronic pain for ICD-11: chronic postsurgical or posttraumatic pain. PAIN. 2019;160(1):45-52.
Wu MS, Chen KH, Chen IF, et al. The efficacy of acupuncture in post-operative pain management: A systematic review and meta-analysis. PLoS One. 2016;11(3):e0150367.
Lee JH, Choi TY, Lee MS, et al. The effectiveness of acupuncture in reducing pain after spine surgery: a randomized controlled trial. J Pain. 2020;21(5):623-630.
Zhang R, Lao L, Ren K, et al. Long-term effects of acupuncture on chronic postsurgical pain: a follow-up study. J Pain Res. 2019;12:303-312.
Li X, Zhang Z, Wang C, et al. Acupuncture for chronic postsurgical pain: a long-term follow-up study. J Pain Res. 2019;12:1943-1951.
Briggs AM, Towler SC, Lombardo S, et al. Chronic pain and its impact on patient outcomes after surgery: a meta-analysis of studies with acupunctural interventions. Eur J Pain. 2019;23(1):110-121.
Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of tension-type headache. Cochrane Database Syst Rev. 2016 Apr 25;4:CD007587.
Hsiao SH, Chen TH, Chiu CC, et al. Efficacy of acupuncture in improving quality of life in patients with chronic pain: a meta-analysis of randomized controlled trials. Clin J Pain. 2017;33(7):653-661.
Vickers AJ, Vertosick EA, Lewith G, et al. Acupuncture for chronic pain: an individual patient data meta-analysis of trials. J Pain. 2018;19(5):455-474.