Analgesic effect of combined therapy of medication and acupuncture in PVP for osteoporotic vertebral compression fracture: a randomized controlled trial

Abstract

To evaluate the analgesic effect and application advantage of acupuncture combined with local anesthesia of lidocaine in percutaneous vertebroplasty (PVP) for the patients with osteoporotic vertebral compression fracture (OVCF). A total of 60 patients with OVCF and receiving PVP at single vertebra under local anesthesia were selected and randomized into an acupuncture plus medication group and a simple medication group, 30 cases in each one. In the simple medication group, the local laying infiltration anesthesia with 1% lidocaine 30 mL was used. In the acupuncture plus medication group, firstly, filiform needles were used to stimulate Hegu (LI 4), Neiguan (PC 6), Jinmen (BL 63) and Yintang (GV 29) with reducing technique, and then the epidermal infiltration anesthesia was followed with 1% lidocaine 4 mL. The needles were retained till the end of operation. Successively, before operation (T0), during skin incision (T1), at the time of working channel completion (T2) and at the time of the injection of bone cement by half a dose (T3), as well as at the end of operation (T4), the mean arterial pressure (MAP), heart rate (HR), oxygen saturation (SpO2) and numerical rating scale (NRS) score were recorded. Besides, the key time of operation and adverse reactions during the operation were recorded, as well as the hospital stays after operation and the subjective satisfaction of the patients. In the acupuncture plus medication group, MAP and HR were lower than those in the simple medication group at T2, T3 and T4 respectively (P<0.05). NRS scores in the acupuncture plus medication group were lower than the simple medication group at T1 and T2 respectively (P<0.05). The key time of operation in the acupuncture plus medication group was shorter than the simple medication group (P<0.05). The incidence of adverse reaction in the acupuncture plus medication group was lower than the simple medication group (P<0.05) and the excellence rate of subjective satisfaction was higher than the simple medication group (P<0.05). Acupuncture combined with medication reduces the dose and adverse reactions of anesthetics, alleviates pain degree of patients, shortens the duration of operation and improves patients' subjective satisfaction in PVP for OVCF.