Deng, G., Rusch, V., Vickers, A., Malhotra, V., Ginex, P., Downey, R., . . . Cassiletha, B. (2008). Randomized controlled trial of a special acupuncture technique for pain after thoracotomy. The Journal of Thoracic and Cardiovascular Surgery, 136(6), 1464-1469.

To determine whether use of intradermal acupuncture needles is superior to sham acupuncture in the treatment of acute and chronic pain after thoracotomy

Patients were stratified according to use of epidural anesthesia and then randomized to receive acupuncture or a sham technique. Within 2 hours before the operation and before induction of anesthesia, 9 intradermal acupuncture needles were inserted on each side of the spine corresponding to BL-12 to BL-19 acupuncture points and to an extra point. These needles had the appearance of miniature thumbtacks, and a ring at the end of the needle keeps it from entering the skin completely. Needles were exchanged for new ones 1 week after initially placed. The duration of acupuncture was 4 weeks, with different needles removed at different time-points. Patients in the control group underwent the same procedure, except that dummy studs were used that had the same appearance and ring, but no needle. Sham studs were placed at areas to prevent tactile stimulation of acupuncture points. Pain was measured at days 10, 30, 60 and 90 post surgery.

Sample Size: 106 Mean age = 64, range = 57-72 Females: 51% Males: 49% Patients had cancer and were scheduled for unilateral thoracotomy that did not involve the chest wall, esophagectomy or extrapleural approaches. No other disease related information is provided. Patients were excluded if they had previous acupuncture or platelet counts< 20,000.

Single site, Other Memorial Sloan Kettering

Randomized controlled trial

Brief Pain Inventory Medication Quantification Scale for opioid use

There were no differences between groups for any pain measures at any of the follow-up time points.

Acupuncture as used here does not appear to be effective for the management of acute or chronic thoracotomy related pain

No information was provided regarding any background chronic pain among the sample, which may have also affected findings. Authors point out that the needles used here were shorter than those used in other studies. It is not clear how these factors and needle placement affect results.

Findings suggest that perioperative acupuncture does not effectively prevent or reduce pain associated with the operation. Acupuncture techniques in terms of needle types, placement, frequency of replacement etc., vary among providers of this treatment. These aspects increase the complexity of research in this area.