Abstract: PD35-01
Sources of Funding: None.

Introduction

Percutaneous nephrolithotomy (PCNL) is the gold standard procedure for large renal calculi, but post-operative pain remains a major concern. Modifications of the PCNL technique have been developed in part to decrease pain. More recently, acupuncture has been described as an adjunct to reduce pain following abdominal, spinal, and orthopedic surgeries. Among the benefits of acupuncture are its ease of performance, non-invasiveness, and lack of significant side effects. In comparison to traditional acupuncture, electro-acupuncture has shown enhanced efficacy, possibly due to central endorphin release. We sought to investigate the effects of electro-acupuncture on patients undergoing PCNL.

Methods

A double blind, randomized, sham controlled study design was used. Fifty patients undergoing PCNL by a single surgeon were randomized to one of three groups: true electro-acupuncture (EA, n = 17), sham electro-acupuncture (Sham, n = 20), and no acupuncture (Control, n = 13). Acupuncture was performed by a licensed acupuncturist 1 hr prior to surgery. All study personnel, except the acupuncturist were blinded to the intervention. PCNL was performed according to standard protocol and without intra-operative nerve block or local anesthetic. Pain scores (visual analog scale (VAS)), narcotic use (morphine equivalents (ME)), and side effects were recorded at set intervals post-operatively.

Results

Mean VAS scores for flank and abdomen in the EA group were lower at all time periods compared to sham and control groups. In fact, 2 patients in the EA group did not require any post-operative narcotics. Mean cumulative opioid usage was lower in the EA group immediately post-operatively compared to both sham and control groups (Table 1). No differences between groups were found for nausea and vomiting. No adverse effects of EA were noted.

Conclusions

Electro-acupuncture significantly reduces acute post-operative pain and narcotic usage without any adverse effects. This promising adjunct for post-operative pain control warrants further validation.

Funding

None.