Acupuncture is effective for some ED patients with intractable pain

PHILADELPHIA — Acupuncture can reduce pain and reduce return visits to the emergency department (ED) for patients with intractable pain, researchers said at the American College of Emergency Physicians’ annual meeting. Ta.

“Pain is very difficult to treat. [ED]”This is one of the hardest things for us to do,” said Dr. Emily Chao, a fourth-year resident at Chicago’s Cook County Hospital.

In Cook County, “what we have in our ED is access to acupuncture,” she continued. She said, “We have certified acupuncturists who can come into the emergency room and provide acupuncture to patients, so we would like to bring this into the emergency department.”

To see if acupuncture can help treat intractable pain, Zhao et al. conducted a retrospective cohort analysis in Cook County. They offered acupuncture to adult ED patients with intractable acute or chronic pain that did not improve with standard ED pain treatments. Researchers identified patients who required medical or surgical treatment for pain, did not speak English or Spanish, had missing data, or had incomplete 3-month follow-up. Excluded. They looked at demographics, pain medications used before and during the emergency department visit, and 3-month follow-up data.

Researchers ultimately had data on 158 patients who visited the emergency department between July 1, 2021, and June 30, 2022. The mean age of the patients was 52 years (range 21-94 years). 60% were women. Regarding race and ethnicity, 58% were African American/Black, 29% Latino, 5% Asian, and 5% non-Hispanic White.

Before receiving acupuncture, 79% of patients received non-opioid pain medications in the emergency department and 11% received opioids. Only 3.8% received a prescription for opioids upon discharge. Acupuncture was performed by a board-certified acupuncturist. However, due to the limited working hours of the acupuncturist on duty, he was only available from 7am to 7pm, Monday to Friday, and was unavailable on weekends and holidays, so I received my first acupuncture treatment at the emergency department. Only 30% of patients , all patients were referred to an acupuncture clinic for outpatient treatment.

Patients presented to the ED with a mean pain score of 7.96, and the mean pain score after acupuncture in the ED was 3.88. Over the next 30 days, 5% of patients visited the emergency department for pain treatment. “We also surveyed people to see what they thought after treatment and 98% said they were very likely or likely to recommend acupuncture for pain,” she said. In addition, 65% of emergency medical staff said the availability of acupuncture reduced the need for patients to prescribe opioids, and 35% said acupuncture in the emergency department reduced the need for opioid prescriptions for pain. The need to admit patients has decreased, he said.

The study results suggest that “acupuncture, if available, could be a viable option for treating pain in the emergency department,” Zhao said. “Patients are generally satisfied with their care in the emergency department, and staff see a decrease in opioid prescribing and hospitalization rates.”

Limitations of this study include the fact that it was a retrospective cohort study and that the emergency department staff did not know which conditions were appropriate for acupuncture treatment, so it was not possible to target all areas of neck, back, arm, and abdominal pain. ”, Zhao said. . There was also no comparison group.

Session moderator Kevin Weaver, M.D., director of emergency medicine at Lehigh Valley Health Network in Allentown, Pennsylvania, praised the research and said the next great step is “to treat patients with a specific diagnosis. If the research is based on patients, [finding out] Whether you actually received medication, whether it was opiates or non-opioids, whether you received acupuncture. ”