Acupuncture and acupressure, rooted in Traditional Chinese Medicine, are used to treat a variety of symptoms. One specific and easy-to-apply method is ear acupuncture/acupressure following the NADA protocol (developed by the National Acupuncture Detoxification Association in 1985 in New York). This technique has been used successfully in Germany since 1995. It is known for its balancing and stabilizing effects on both body and mind, helping to reduce symptoms such as anxiety and stress, and promoting relaxation and inner calm. Open-heart surgery can be emotionally overwhelming for patients, often triggering intense existential fears. Preoperative anxiety may worsen physical and psychological symptoms and negatively affect surgery outcomes. Therefore, non-pharmacological interventions like acupuncture are gaining importance alongside medication. Several studies have demonstrated the effectiveness of preoperative acupuncture in reducing pain, anxiety, and nausea across various surgeries. Randomized trials show significant anxiety reduction through both body and ear acupuncture. One study found that ear acupuncture can rapidly improve psychological well-being, with effects noticeable within five minutes. This suggests its potential use not only the day before surgery but also immediately beforehand. In contrast, research on ear acupressure before heart surgery is limited. However, one study reported improvements in sleep quality and reduced anxiety. A recent review highlighted the positive effects of ear stimulation on stress, blood pressure, and heart rate, and even suggested that acupressure may be more effective than acupuncture.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
66
Ear acupressure following the NADA Protocol is carried out using special acupuncture patches that press a small bead onto defined points on the ear: Shen Men, kidney, lung, liver, and vegetative. NADA ear acupressure is a non-invasive and low-risk intervention. In addition, the protocol is carried out exclusively by NADA-certified doctors, medical assistants, or nursing staff.
Robert Bosch Krankenhaus
Stuttgart, Germany
RECRUITINGAnxiety
State-Trait Anxiety Inventory - state (STAI-s) The range of possible scores varies from a minimum of 20 to a maximum of 80, where higher scores represent higher anxiety.
Time frame: Preoperative (Day 1)
Anxiety
State-Trait Anxiety Inventory - state (STAI-s) The range of possible scores varies from a minimum of 20 to a maximum of 80, where higher scores represent higher anxiety.
Time frame: Baseline (Day 0, preoperative), Immediately after the acupressure session (Day 0, preoperative), Postoperative (Day 2 - Day 10 daily until discharged from hospital, on average 10 days)
Specific preoperative anxiety
Amsterdam Preoperative Anxiety and Information Scale (APAIS) For the anxiety subscale, scores range between 4 and 20, higher scores reflect higher anxiety. For the need for information subscale, scores range between 2 and 10, higher scores reflect higher need for information
Time frame: Baseline (Day 0, preoperative), Immediately after the acupressure session (Day 0, preoperative), Preoperative (Day 1)
Quality of life
EQ5D
Time frame: Baseline (Day 0, preoperative), Discharge from hospital (Day 10 on average)
Pain intensity
Numerical Rating Scale Scores range between 0 and 10, higher scores indicate higher pain intensity
Time frame: Baseline (Day 0, preoperative), Postoperative (Day 2 - Day 10 daily until discharged from hospital
Depression
Beck Depression Inventory (BDI) Scores range between 0 and 63, with higher scores representing more severe depression symptoms.
Time frame: baseline (Day 0, preoperative)
Postoperative Nausea and Vomiting
PONV
Time frame: Postoperative (Day 2)
Major Adverse Cardiac and Cerebrovascular Events
MACCE
Time frame: Discharge from hospital (Day 10 on average)
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