Vous ne pouvez pas changer la sélection. Uniquement autorisé quand vous avez aussi accès au gestionnaire de livre.
Rédacteur : Johan Nguyen

Sommaire

Perioperative Care

Soins péri-opératoires : évaluation de l'acupuncture

1. Systematic Reviews and Meta-Analysis

1.1. Generic Acupuncture

1.1.1. Lederer 2018

Lederer AK, Schmucker C, Kousoulas L, Fichtner-Feigl S, Huber R. Naturopathic Treatment and Complementary Medicine in Surgical Practice. Dtsch Arztebl Int. 2018;115(49):815-821. [200295].

Background Many patients in Germany use naturopathic treatments and complementary medicine. Surveys have shown that many also use them as a concomitant treatment to surgery.
Methods Multiple databases were systematically searched for systematic reviews, controlled trials, and experimental studies concerning the use of naturopathic treatments and complementary medicine in the management of typical post-operative problems (PROSPERO CRD42018095330).
Results Of the 387 publications identified by the search, 76 fulfilled the inclusion criteria. In patients with abnormal gastrointestinal activity, acupuncture can improve motility, ease the passing of flatus, and lead to earlier defecation. Acupuncture and acupressure can reduce postoperative nausea and vomiting, as well as pain. More-over, aromatherapy and music therapy seem to reduce pain, stress and anxiety and to improve sleep. Further studies are needed to determine whether phytotherapeutic treatments are effective for the improvement of gastrointestinal function or the reduction of stress. It also remains unclear whether surgical patients can benefit from the methods of mind body medicine.
Conclusion Certain naturopathic treatments and complementary medical methods may be useful in postoperative care and deserve more intensive study. In the publications consulted for this review, no serious side effects were reported.

1.2. Special outcome

1.2.1. Length of stay and hospitalization costs

1.2.1.1. Liu 2024

Liu Y, Fan J, Zhang X, Xu W, Shi Z, Cai J, Wang P. Transcutaneous electrical acupoint stimulation reduces postoperative patients' length of stay and hospitalization costs: a systematic review and meta-analysis. Int J Surg. 2024 Aug 1;110(8):5124-5135. https://doi.org/10.1097/JS9.0000000000001598

ObjectiveTo study the effects of transcutaneous electrical acupoint stimulation (TEAS) on length of stay (LOS) and hospitalization costs in postoperative inpatients.
MethodsTwo researchers searched PubMed, Embase, Cochrane Library, China Network Knowledge Infrastructure, and Wanfang Database from database inception to 25 April 2023 to identify randomized controlled trials. Statistical analyses were performed using Stata 16.0. Risk of bias was assessed with the Cochrane risk-of-bias tool. Publication bias was evaluated using funnel plots and Egger’s test. Certainty of evidence was assessed using the GRADE approach.
ResultsThirty-four randomized controlled trials were included. TEAS significantly reduced hospitalization costs (SMD −1.92; 95% CI −3.40 to −0.43), overall LOS (SMD −1.00; 95% CI −1.30 to −0.70), and postoperative LOS (SMD −0.70; 95% CI −0.91 to −0.49). Subgroup analyses showed consistent reductions in both overall and postoperative LOS across multiple surgical procedures. Heterogeneity was substantial and likely related to differences in surgical types, stimulation frequencies, and acupoint selections.
ConclusionTEAS appears to reduce length of stay and hospitalization costs in postoperative patients. However, due to heterogeneity and identified risk of bias, these findings should be interpreted with caution and confirmed by further high-quality trials.

2. Overviews of Systematic Reviews

2.1. Lee 2014

Lee MS, Ernst E. Acupuncture for surgical conditions: an overview of systematic reviews. Int J Clin Pract. 2014;68(6):783-9. [170714].

AimSeveral systematic reviews (SRs) of acupuncture for surgical conditions have recently been published with sometimes contradicting results. The aim of this overview was to summarise recent SRs of acupuncture for surgical conditions.
Method Thirteen electronic databases were searched for relevant reviews published since 2000. Data were extracted by two independent reviewers according to predefined criteria.
Results Twelve SRs met our inclusion criteria. They related to the prevention or treatment of postoperative nausea and vomiting as well as to surgical or postoperative pain. Their results were far from uniform, and several caveats need to be considered.
ConclusionThe evidence is insufficient to suggest that acupuncture is an effective intervention in surgical settings. More rigorous research seems warranted. This protocol was registered with PROSPERO database (registration number: CRD42013004817).