Acupuncture may be useful as adjunctive therapy to relieve kidney stone pain in patients seeking care in an emergency department, according to a recent study.
In a randomized controlled trial (RCT) that enrolled 80 patients seeking care for acute renal colic in an emergency department in China, acupuncture applied immediately after intramuscular (IM) administration of diclofenac significantly decreased pain compared with diclofenac alone.
“The findings of this RCT suggest that acupuncture combined with intramuscular injection of diclofenac is safe and provides fast and substantial pain relief for patients with renal colic compared with sham acupuncture in the emergency setting,” Dr Liu’s team concluded. “However, no difference in rescue analgesia was found, possibly because of the ceiling effect caused by subsequent but robust analgesia of diclofenac. Acupuncture can be considered an optional adjunctive therapy in relieving acute renal colic.”
All patients received 50 mg/2 mL diclofenac sodium IM injection immediately followed by a 30-minute acupuncture treatment or sham acupuncture. The primary outcome was the response rate at 10 minutes after needle manipulation, defined as the proportion of participants whose visual analog score (VAS) decreased by at least 50% from baseline.
The primary outcome was achieved by 77.5% of the acupuncture arm compared with 10.0% in the sham acupuncture group, corresponding author Cun-Zhi Liu, PhD, of Beijing University of Chinese Medicine, and colleagues reported in JAMA Network Open. The response rate in the acupuncture group also was significantly higher than in the control arm at 0, 5, 15, 20, and 30 minutes. The investigators observed no significant between-group difference at 45 and 60 minutes. They also found no significant difference between the groups in the need for rescue analgesia.
The authors acknowledged limitations of their study. As a single-center trial, it was subject to potential biases that could influence generalizability of the findings, they noted. In addition, the acupuncturists could not be blinded and the study’s limited sample size precluded subgroup analysis by kidney stone size and location.
Tu JF, Cao Y, Wang LQ, et al. Effect of adjunctive acupuncture on pain relief among emergency department patients with acute renal colic due to urolithiasis. JAMA Netw Open. Published online August 9, 2022. doi:10.1001/jamanetworkopen.2022.25735
This article originally appeared on Renal and Urology News