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In this Issue

In this Issue Highlights doi:10.1136/acupmed-2014-010597 Adrian White, Editor Regular readers will know the cortisol levels. Figure 1 shows the pain research may not be applic- Editor’s fixation with acupuncture’s pain scores on deep breath and on able. The novel study by Plaster specific effects: acupuncture has relaxation, and readers will calcu- and colleagues is all the more shown itself to be effective enough late that the effect size of pain important—for its concept more overall to be useful in care of some reduction was about two SD at 45 than its results. The authors mea- conditions but, arguably, public minutes, and more than one SD at sured acupuncture’s short-term funds should not be spent on treat- every time point up to 24 hours. effects on pain and function in ments that are entirely psycho- Acupuncture is clearly a significant osteoarthritis. The effect size was logical (unless they are entirely benefit for patients and for their about 0.24 in favour of electroacu- psychological!). A recent update of hospitals. This paper is followed by puncture, though the sample size NICE guidelines (http://guidance. an RCT by Zhang et al which rein- for this Master’s project was too nice.org.uk/CG177) has moved the forces one of the secondary find- small to be definitive for comparing goalposts further away: no therapy ings—that acupuncture reduces the two active treatments. Because of will be recommended for osteo- need for opioids and therefore the opportunities for blinding and arthritis unless its effect size com- their side effects. control of variables, laboratory pared with placebo/sham is 0.5 In their linked editorial, studies are an interesting option for (half a standard deviation, SD). Usichenko and Streitberger put future research. This is not the place to argue the these studies in the context of the Our next report is another rigor- rights and wrongs of this threshold, whole literature on the subject. The ous, sham controlled RCT from but it puts our first paper into dra- technique is simple, the points are that productive clinical trials centre matic context. easily accessed, the process inter- run by Vas and his colleagues. This Postoperative pain is a great scen- feres little with the progress of the time they find that auriculo- ario for testing acupuncture, with operation, and the benefits are acupressure leads to a difference of possibilities for blinding and object- clear. Their title says it all: 10 points on the VAS for back pain ive measurement using patient- ‘Perioperative acupuncture: why are compared with sham – an effect controlled analgesia. Ntritsou and we not using it?’ The answer seems recognised as clinically significant, colleagues used a sound design for to be some combination of preju- even though its effect size of 0.3 is a sham-controlled study in major dice and ignorance. Usichenko nowhere near that demanded of surgery where postoperative pain is finds indwelling needles particu- NICE for osteoarthritis. severe for 48 hours. They found larly useful in theatre, and this This issue has plenty of other significant effects of acupuncture issue also has his letter describing clinical interest: diabetic neur- on primary pain scores, supported his wife’s positive experience after opathy, emergency care, pregnancy, by several secondary outcomes— childbirth. schizophrenia—and pneumothorax; other pain scores, pain threshold, Acupuncture is more widely used and basic research on heart rate analgesic requirement, and serum for chronic pain, for which acute variability and needle rotation— Benham and Johnson showing that rotation increases the pain threshold. And finally, for something com- pletely different, Vivien Shaw argues that at least one of the ancient meridians simply describes human anatomy. Tell everyone acu- puncture is based in science, not metaphysics: prejudice and ignor- ance, be gone! Figure 1 Progress of pain scores (PS) on the Numerical Rating Scale (NRS) scale (0–10) Competing interests None. during movement (deep breath) and at relaxation in the two groups. Electroacupuncture (EA) group treated with tramadol+ketamine+EA; control group Provenance and peer review Not commissioned; internally peer reviewed. treated with tramadol+ketamine. ***p<0.001, **p<0.01, *p<0.05. White A. Acupunct Med 2014;32:211. doi:10.1136/acupmed-2014-010597 211 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Acupuncture in Medicine SAGE

In this Issue

White, Adrian
Acupuncture in Medicine , Volume 32 (3): 1 – Jun 1, 2014
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Publisher
SAGE
Copyright
© 2014 British Medical Acupuncutre Society
ISSN
0964-5284
eISSN
1759-9873
DOI
10.1136/acupmed-2014-010597
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Abstract

Highlights doi:10.1136/acupmed-2014-010597 Adrian White, Editor Regular readers will know the cortisol levels. Figure 1 shows the pain research may not be applic- Editor’s fixation with acupuncture’s pain scores on deep breath and on able. The novel study by Plaster specific effects: acupuncture has relaxation, and readers will calcu- and colleagues is all the more shown itself to be effective enough late that the effect size of pain important—for its concept more overall to be useful in care of some reduction was about two SD at 45 than its results. The authors mea- conditions but, arguably, public minutes, and more than one SD at sured acupuncture’s short-term funds should not be spent on treat- every time point up to 24 hours. effects on pain and function in ments that are entirely psycho- Acupuncture is clearly a significant osteoarthritis. The effect size was logical (unless they are entirely benefit for patients and for their about 0.24 in favour of electroacu- psychological!). A recent update of hospitals. This paper is followed by puncture, though the sample size NICE guidelines (http://guidance. an RCT by Zhang et al which rein- for this Master’s project was too nice.org.uk/CG177) has moved the forces one of the secondary find- small to be definitive for comparing goalposts further away: no therapy ings—that acupuncture reduces the two active treatments. Because of will be recommended for osteo- need for opioids and therefore the opportunities for blinding and arthritis unless its effect size com- their side effects. control of variables, laboratory pared with placebo/sham is 0.5 In their linked editorial, studies are an interesting option for (half a standard deviation, SD). Usichenko and Streitberger put future research. This is not the place to argue the these studies in the context of the Our next report is another rigor- rights and wrongs of this threshold, whole literature on the subject. The ous, sham controlled RCT from but it puts our first paper into dra- technique is simple, the points are that productive clinical trials centre matic context. easily accessed, the process inter- run by Vas and his colleagues. This Postoperative pain is a great scen- feres little with the progress of the time they find that auriculo- ario for testing acupuncture, with operation, and the benefits are acupressure leads to a difference of possibilities for blinding and object- clear. Their title says it all: 10 points on the VAS for back pain ive measurement using patient- ‘Perioperative acupuncture: why are compared with sham – an effect controlled analgesia. Ntritsou and we not using it?’ The answer seems recognised as clinically significant, colleagues used a sound design for to be some combination of preju- even though its effect size of 0.3 is a sham-controlled study in major dice and ignorance. Usichenko nowhere near that demanded of surgery where postoperative pain is finds indwelling needles particu- NICE for osteoarthritis. severe for 48 hours. They found larly useful in theatre, and this This issue has plenty of other significant effects of acupuncture issue also has his letter describing clinical interest: diabetic neur- on primary pain scores, supported his wife’s positive experience after opathy, emergency care, pregnancy, by several secondary outcomes— childbirth. schizophrenia—and pneumothorax; other pain scores, pain threshold, Acupuncture is more widely used and basic research on heart rate analgesic requirement, and serum for chronic pain, for which acute variability and needle rotation— Benham and Johnson showing that rotation increases the pain threshold. And finally, for something com- pletely different, Vivien Shaw argues that at least one of the ancient meridians simply describes human anatomy. Tell everyone acu- puncture is based in science, not metaphysics: prejudice and ignor- ance, be gone! Figure 1 Progress of pain scores (PS) on the Numerical Rating Scale (NRS) scale (0–10) Competing interests None. during movement (deep breath) and at relaxation in the two groups. Electroacupuncture (EA) group treated with tramadol+ketamine+EA; control group Provenance and peer review Not commissioned; internally peer reviewed. treated with tramadol+ketamine. ***p<0.001, **p<0.01, *p<0.05. White A. Acupunct Med 2014;32:211. doi:10.1136/acupmed-2014-010597 211

Journal

Acupuncture in Medicine – SAGE

Published: Jun 1, 2014

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