128 The Effects of Acupuncture on Pain on the Burn Service

Abstract

Abstract Introduction Acupuncture is a well known modality in traditional Chinese medicine to treat various ailments including pain. There is increasing evidence that acupuncture reduces postoperative pain, but it is poorly studied, especially in burn and wound patients. We report our initial experience with acupuncture treatment associated with burns and wounds on our burn service. Methods Our hospital now employs acupuncturists as part of implementation of integrative health modalities. Data on Burn service patients who underwent acupuncture were prospectively collected. Patients consented prior to treatment. Additional reasons for treatment other than pain were collected. Pain scores before and after the session were recorded. If patients were sleeping at the end of treatment and a pain score could not be obtained, the pain score was assigned zero. Side effects, including local bleeding, bruising, needling discomfort and short-term nerve irritation, were followed. Results From March to October 2019, nineteen patients on the Burn service were treated with acupuncture for a total of 178 sessions. Median age was 56 years (IQR:46–64.5). One pediatric patient was treated. Most (70%, n=14) were burn patients and 6 patients had other types of wounds. Median TBSA for burn patients was 8.5% (IQR:5.4–10.4). The number of treatments per patient ranged from 1–23 with a median of 5 (IQR:2.5–19). The median pain score prior to acupuncture treatment was 3 (IQR:0–5) and after treatment was 0 (IQR:0–2.25). Almost half (48%) of the treatments included other symptoms besides pain, most commonly for sleeping disorders (n=33) and anxiety (n=28). No side effects of acupuncture were reported. The most common auricular acupuncture points were shenmen and sympathetic, which targets relaxation and pain. Large Intestine 4, located on the hand, and Liver 3, located on the foot, were the most common body acupuncture points, which target relaxation and generalized pain. Conclusions Acupuncture appears to mitigate burn and wound pain and can be used to treat other acute ailments besides pain. There are few side effects of acupuncture on burn and wound patients. Based on our initial experience, a prospective observational study to identify the efficacy of acupuncture in burn patients for pain control and other symptoms is being developed. Applicability of Research to Practice In light of the opioid crisis, new applications of nonopioid modalities for pain management should be investigated. Acupuncture is low risk with potential benefit without opioids. Furthermore, other symptoms such as sleep disturbances and anxiety may be treated without pharmacologic medications.