Acupuncture for Pain Control After Cesarean Section - A Randomized, Placebo-Controlled Investigation

ObjectiveDespite recent advances in perioperative analgesia, pain control in patients after caesarean section (CS) remains insufficient. Acupuncture is a promising method for treatment of acute postoperative pain. The aim was to compare acupuncture with placebo intervention as add-on therapy for pain control after CS.MethodPatients scheduled to elective CS in spinal anesthesia were enrolled according to eligibility criteria and randomly allocated into acupuncture group (AG) or placebo acupuncture group (PG). Each patient in AG received acupuncture with indwelling fixed needles in addition to standard pain treatment according to previously tested methodology. Patients in PG received placebo needles in addition to standard treatment. Patients and practitioners were blinded in regard to group allocation. postoperative pain intensity at rest and during movement on a Verbal Rating Scale (VRS-11; 0 = no pain; 10 = maximal pain) was the primary endpoint. Analgesic requirement, analgesia induced side effects, recovery profile, patients’ satisfaction with pain therapy and quality of patents blinding were also registered and analyzed using Student’s t-test and chi-square test as appropriate between study groups.ResultsAll 120 patients were included in the intention-to-treat analysis. Pain intensity on movement in the AG at the first postoperative day was 4.7 ± 1.7 vs. 6.0 ± 2.0 in the PG (mean ± SD; VRS-11; p = 0.001). The ambulation of patients in AG was faster than in PG (p > 0.01). Other endpoints were comparable between the study groups.ConclusionAcupuncture reduces clinically relevant pain and accelerates the ambulation of patients after caesarean section. With additional consideration of personnel costs and time expenditures acupuncture can be recommended for the routine use in treatment of acute postoperative pain in patients after elective caesarian section.