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First published online December 12, 2018

Acupuncture in the Emergency Department: A Systematic Review of Randomised Controlled Trials

Dr Kwan Leung Chia [email protected], Rex Pui Kin Lam, Chung Kwun Lam, and Sik Hon TsuiView all authors and affiliations
Volume 36, Issue 3
https://doi.org/10.1136/acupmed-2017-011547

Abstract

Introduction

A comprehensive review of both English and Chinese language literature to inform acupuncture practice in emergency department (ED) settings is lacking. Accordingly, we aimed to conduct a systematic review of English and Chinese randomised controlled trials (RCTs) of acupuncture use in the ED.

Methods

Four English databases (Embase, PubMed, AMED and CENTRAL) and two Chinese databases (CNKI and Wanfang) were systematically searched using the keywords ‘acupuncture’ and ‘emergency department’, followed by a bibliographic search of references. The data were extracted and assessed by two independent authors. RCTs were selected based on pre-defined criteria. Data were extracted and a risk of bias assessment was performed using the Cochrane risk of bias tool. The quality of evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Results

In total, 1461 articles were screened and six RCTs involving 651 patients were included. For various acute pain conditions, acupuncture was superior to sham acupuncture, more effective than intravenous morphine, comparable to conventional ED treatment, and superior to standard ED care alone when used on an adjuvant basis; however, the overall level of evidence was low. Studies that applied acupuncture in hypertension and cardiac arrest were deemed to be at high risk of bias, and the level of evidence for these outcomes was very low. No major adverse events were reported in the included studies.

Conclusion

There is a lack of high-quality evidence to support the use of acupuncture in the ED. Multicentre RCTs with rigorous designs are warranted.

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Published In

Volume 36, Issue 3
Pages: 183 - 192
Article first published online: December 12, 2018
Issue published: June 2018

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© 2018 British Medical Acupuncutre Society.
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PubMed: 29581138

Authors

Affiliations

Dr Kwan Leung Chia
St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
[email protected]
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Rex Pui Kin Lam
Emergency Medicine Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Chung Kwun Lam
Hong Kong Association for Integration of Chinese-Western Medicine, Hong Kong SAR, China
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Sik Hon Tsui
Department of Accident and Emergency, Queen Mary Hospital, Hong Kong SAR, China
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Notes

St Vincent's Clinical School, University of New South Wales, Sydney, New South Wales 2052, Australia; [email protected]

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