Acupuncture for Prophylaxis of Intrathecal Morphine Induced Itch in Elective Caesarean Delivery: a Randomized Controlled Double Blind Study
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Ramamoorthy KG et al./Journal of Acupuncture and Herbs 1 (2015)22-31
Acupuncture for Prophylaxis of Intrathecal Morphine Induced
Itch in Elective Caesarean Delivery: A Randomized Controlled
Double Blind Study
Karthik Ganesh Ramamoorthy FCARCSIa*, Mohammed Ibrahim MRCSb, Nasir Z.
Ahmad FRCS, MMScc, Kevin Bailey FFARCSIb, Paul O’ Connor. FFARCSIb
a.
Department of Anaesthesia, Fortis Malar Hospital, Chennai, India
b.
Department of Anaesthesia, Letterkenny General Hospital, Letterkenny, Ireland
c.
Department of Surgery,Letterkenny General Hospital, Letterkenny, Ireland
Received: August 3, 2015
Accepted: August 19, 2015
Abstract
Objective: The objective of this prospective randomised double blinded placebo controlled trial was to assess the efficacy of acupuncture for prophylaxis of intrathecal morphine induced pruritis in patients undergoing Elective
Caesarean delivery.
Methods: After ethical approval and informed consent parturients scheduled for elective Caesarean section under spinal anaesthesia with intrathecal morphine, were randomised to receive acupuncture (Group 1) or sham acupuncture (Group 2). In Group 1 acupuncture was applied unilaterally at the Quchi acupoint for 30 minutes before initiation of spinal anaesthesia. In Group 2 sham acupuncture was applied at a non – acupoint 2 cm lateral to Quchi for 30 minute before initiation of spinal anaesthesia. The primary outcome was the incidence of pruritis
and the secondary outcomes were severity of pruritis, patient’s satisfaction with anti-pruritic prophylaxis and the need for rescue anti-pruritic medications.
Results: The results showed statistically significant favour of acupuncture.
differences between acupuncture and sham acupuncture, in
There was significant difference in the incidence of pruritis ( 27 % vs 77%)
and VNRS
consistantly at 1 h, 4h, 8h and 24h between the groups.
Conclusion: Acupuncture at Quchi (LI 11) significantly reduces the incidence and severity of pruritis after subarachnoid opioids as a part of prophylactic multimodal approach.
Keywords: Acupuncture, Pruritis, Caesarean section, Quchi (LI11), Randomized double blinded clinical trial
Caesarean section is the most common surgery among
incidence of pruritis varies between 30% and 100%2.
women and spinal anaesthesia is the preferred choice
The exact mechanisms of neuraxial opioid-induced
of anaesthesia for majority of them. Intrathecal
pruritis remain unclear. Pruritis can be disturbing and
morphine is commonly used for pain relief for
often causes dissatisfaction in these parturient
Caesarean delivery and has been shown to be highly
especially in the postnatal period. Many drugs like
effective1. However it is associated with many side