Efficacy of acupuncture for pain relief in patients receiving extracorporeal shock wave lithotripsy: a meta-analysis of randomized controlled studies

Hsiao-Tien Chen; Kuo-Chuan Hung; Yao-Chin Hsu; Jinn-Rung Kuo; Ying-Jen Chang; I-Wen Chen; Cheuk-Kwan Sun

doi:10.3389/fmed.2023.1114485

Efficacy of acupuncture for pain relief in patients receiving extracorporeal shock wave lithotripsy: a meta-analysis of randomized controlled studies

Front Med (Lausanne). 2023 Jun 2:10:1114485. doi: 10.3389/fmed.2023.1114485. eCollection 2023.

Authors

Hsiao-Tien Chen^#¹, Kuo-Chuan Hung^#², Yao-Chin Hsu¹, Jinn-Rung Kuo^{3

4}, Ying-Jen Chang^{2

5}, I-Wen Chen^#⁶, Cheuk-Kwan Sun^#^{7

8}

Affiliations

¹ Department of Chinese Medicine, Chi Mei Medical Center, Tainan, Taiwan.
² Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.
³ Department of Neurosurgery, Chi Mei Medical Center, Tainan, Taiwan.
⁴ Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.
⁵ Department of Recreation and Health-Care Management, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
⁶ Department of Anesthesiology, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
⁷ Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung City, Taiwan.
⁸ School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung City, Taiwan.

^# Contributed equally.

Abstract

Background: This meta-analysis aimed at investigating the efficacy of acupuncture for pain relief in patients receiving extracorporeal shock wave lithotripsy (ESWL).

Methods: Randomized controlled trials comparing the efficacy of acupuncture with conventional treatments were retrieved from major electronic databases (e.g., MEDLINE, EMBASE, and Cochrane Library) until August 28, 2022. The primary outcome was the response rate (i.e., rate of pain relief), while secondary outcomes included stone-free rate, satisfaction rate, duration of ESWL, peri-/post-procedural pain score, and risk of adverse events.

Results: Thirteen eligible studies involving 1,220 participants published between 1993 and 2022 were analyzed. Pooled results indicated that acupuncture had a better response rate compared to conventional treatments (RR = 1.17, 95% CI: 1.06-1.3, p = 0.003, seven trials, n = 832). Despite no difference in ESWL duration (MD = 0.02 min, 95% CI: -1.53 to 1.57, p = 0.98, three trials, n = 141), stone-free rate (RR = 1.11, 95% CI: 1-1.25, p = 0.06, six trials, n = 498), and satisfaction rate (RR = 1.51, 95% CI: 0.92-2.47, p = 0.1, three trials, n = 334) between the two groups, the acupuncture group had a lower risk of adverse events (RR = 0.51, 95% CI: 0.33-0.79, p = 0.003, five trials, n = 327), peri- (MD = -1.91 points, 94% CI: -3.53 to -0.28, p = 0.02, four trials, n = 258 patient) and post-procedural (MD = -1.07, 95% CI: -1.77 to -0.36, p = 0.003, four trials, n = 335) pain score.

Conclusion: The results of this meta-analysis showed that the use of acupuncture in patients receiving ESWL was associated with a higher pain relief rate and a lower risk of adverse events, suggesting feasibility of its use in this clinical setting.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42022356327.

Keywords: acupuncture; extracorporeal shock wave lithotripsy; meta-analysis; pain; urolithiasis.

Publication types

Systematic Review