Nurse Initiated Acupressure for Pain Management

Wake Forest University Health Sciences65 enrolled

Overview

The purpose of pilot study is to test the feasibility of nurse initiated post-operative bilateral auricular acupressure as an adjunct to medication for post-operative pain management.

Postoperative pain management has become an area of concern over the last decade due to the opioid epidemic and concerns related to their use as the primary pain management strategy. Joint Commission requires that hospitals have additional pain non-pharmacologic pain management tools at their disposal to an effort decrease the reliance on opioids. Acupuncture and acupressure have been used for centuries in the management of a variety of disorders including pain. Unlike acupuncture, acupressure can be easily applied with limited training and is within the scope of practice for nurses, according to the North Carolina Board of Nursing. Thus evidence based non-pharmacologic strategies that can be deployed by nursing are of benefit to hospital organizations.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Pain, Postoperative Pain, Acute

Interventions

Auricular acupressureDEVICE

Trained nurses in auricular acupressure will place acupressure beads on 5 acupoints on each ear (cingulate gyrus, thalamus, omega-2, point zero, and Shen Men). The nurse will do the initial activation of the acupressure site by applying pressure for 30 seconds to each point until the participant reports tingling or moderate degree of pressure. Participant will be given instructions to do this three times a day for a total of 5 days. Acupoints were selected based on recommendation of faculty acupuncturist.

Standard of care pain managementOTHER

The participant post-operative pain will be managed following the standard protocol by the treating physician.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults 18-80 admitted for knee or hip arthroplasty * Pre-surgery morphine equivalent \< 50 * American Society of Anaesthesiologists (ASA) score \< 3 Exclusion Criteria: * Participants with a history of skin disease (psoriasis), adhesive allergy, history of delirium, or cognitive impairment

Locations (1)

Davie Medical Center

Bermuda Run, North Carolina, United States

Outcomes

Primary Outcomes

Visual Analogue Pain Scale

Average "pain upon awakening" score from 0 to 10 using visual analogue scale (0= no pain, 10= worst pain). Pain score averaged across post-op days 1 - 4.

Time frame: Up to Post-operatively day 4, at rising approximately 6 am

Visual Analogue Pain Scale

Average "pain before bed" score from 0 to 10 using visual analogue scale (0= no pain, 10= worst pain).Pain score averaged across post-op days 0 - 4.

Time frame: Up to Post-operatively day 4, at the end of the day approximately 10 pm

Medication Use - Outpatient Opioids

Amount of medication use after discharge recorded in total morphine equivalent dose from discharge through day 4 postoperatively

Time frame: Up to post-operatively day 4

Medication Use - Inpatient Opioids

Amount of medication recorded in morphine equivalent dose while in hospital (not including anesthesia)

Time frame: Up to post-operatively day 4

Medication Use - Total Other Analgesics

Amount of of other analgesics other than aspirin and not part of anesthesia record from immediate post-operative period to day 4 post-op in reported milligrams.

Time frame: Up to post-operatively day 4

Secondary Outcomes

Visual Analogue Pain Scale

Average "pain upon awakening" score from 0 to 10 using visual analogue scale (0= no pain, 10= worst pain).

Time frame: Baseline

Visual Analogue Pain Scale

Average "pain upon awakening" score from 0 to 10 using visual analogue scale (0= no pain, 10= worst pain).

Data from ClinicalTrials.gov

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