Evidence-Based Research And Clinical Study Of Acupoint Stimulation Alleviates Postoperative Pain In Posterior Lumbar Surgery

Objective To analyze,evaluate and summarize the current status and trends of randomized controlled trials(RCTs)on the ability of acupoint stimulation to alleviate postoperative pain;to study the effectiveness of elect-acupuncture combined with general anesthesia on postoperative pain of lumbar spine.Methods 1.Evidence analysis: A search of RCTs on acupoint stimulation alleviates postoperative pain from PubMed,Cochrane Library,EMBASE,web of science,China biomedical literature database(CBM)and China Knowledge Network(CNKI)database,and all related literatures were included from the establishment to May 2019 of the database.The bibliometric analysis was used for analyzing the publication characters,and Cochrane risk bias assessment tool was used for quality assessment.2.Randomized controlled trials: 120 patients with lumbar posterior surgery were randomly divided into the experimental group and the control group.The score of pain,consumption of anesthetics,intraoperative hemodynamic index and postoperative adverse reactions were observed.Results 1.Evidence status: A total of 198 RCTs on acupoint stimulation to relieve postoperative pain were included;the researchers were identified across 20 countries,more than half of the articles(66.67%)were published in China;the first authors were mainly distributed in anesthesiology(30.32%).92.42% of the studies confirmed that acupoint stimulation can relieve postoperative pain;however,only 8.59% of the studies mentioned test registration,and 37.37% of the studies mentioned acupuncture operator qualification.Electroacupuncture(46.46%)was the most common used acupuncture method,Hegu(30.30%),Zusanli(25.25%)and Neiguan(18.69%)were often commonly selected;the effective rate of electro acupuncture in relieving postoperative pain was higher than that of others.Most of the studies(94.44%)reported incomplete details of acupoint stimulation operation,and 73.74% of the studies were assessed as high-risk bias due to substandard sample size estimation.2.Randomized controlled trials: the pain score of the experimental group was significantly lower than that in the control group at 24 h and 48 h after operation(P < 0.05);the rising range of MAP in the experimental group was significantly lower than that in the control group at the time of endotracheal intubation and skin cutting(P < 0.05);the incidence of nausea and vomiting in the experimental group was significantly lower than that in the control group(P < 0.05).Conclusion 1.Acupoint stimulation technologies have been applied in many disciplines to relieve postoperative pain.However,the report rate of research in this field is generally low in the aspects of test registration,operator qualification and operating details of acupoint stimulation technique.Different acupoint stimulation technologies have their own advantages and disadvantages in relieving postoperative pain.2.Electroacupuncture combine general anesthesia can effectively relieve the postoperative pain of lumbar spine opening,stabilize the hemodynamic indexes during operation,reduce the postoperative adverse reactions.However,in this study,electroacupuncture combined with general anesthesia did not significantly reduce the amount of anesthetic used during the operation.