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Acupuncture for Pain Relief After Total Knee Arthroplasty: A Randomized Controlled Trial
  1. Chun-Chieh Chen, MD*,,
  2. Chien-Chung Yang, MD,,
  3. Chih-Chien Hu, MD*,,
  4. Hsin-Nung Shih, MD*,,
  5. Yu-Han Chang, MD, PhD*, and
  6. Pang-Hsin Hsieh, MD*,
  1. *Department of Orthopaedic Surgery, Chang Gung Memorial Hospital
  2. School of Medicine, Chang Gung University
  3. Center for Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
  1. Address correspondence to: Pang-Hsin Hsieh, MD, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, No. 5, Fuxing St, Guishan Township, Taoyuan County 333, Taiwan (e-mail: hsiehph{at}


Background and Objectives The effectiveness of acupuncture in relieving acute postoperative pain is still controversial. This patient-evaluator blinded and sham auricular acupuncture (AA)–controlled study tested whether acupuncture is effective in controlling acute postoperative pain after total knee arthroplasty.

Methods Patients were randomly assigned to receive true acupuncture (knee, scalp, and AA) or sham AA. All procedures were conducted under general anesthesia, and the AA needles were retained in situ for 3 days. Postoperative pain was managed with intravenous fentanyl using a patient-controlled analgesia pump. The amount of postoperative fentanyl required, the time to the first fentanyl request, pain intensity on a 100-mm visual analog scale, incidence of analgesia-related adverse effects, and success of patients’ blinding were recorded.

Results This study comprised 60 patients (30 in the study group and 30 in the control group). The fentanyl requirement via patient-controlled analgesia in the study group was lower [mean (SD), 620.7 (258.2) vs 868.6 (319.3) μg; P = 0.002). The time to first request for fentanyl was longer in the study group. Pain intensity on a 100-mm visual analog scale was lower in the study group in the first 24 hours after the operation. The incidence of analgesia-related adverse effects of nausea and vomiting was lower in the study group. The success of blinding was not significantly different between the 2 groups (P = 0.731).

Conclusions The data obtained from this clinical trial demonstrate the potential advantages of using acupuncture for postoperative pain control after total knee arthroplasty.

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  • The authors declare no conflict of interest.

    Presented at the Taiwan Orthopaedic Association Spring Meeting, April 2012.

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