A Double-blinded, Randomized, Controlled Trial of Acupuncture for the Control of Intra-operative Dental Pain

Download or read book A Double-blinded, Randomized, Controlled Trial of Acupuncture for the Control of Intra-operative Dental Pain written by Eric Jonathan Goldlust and published by . This book was released on 2003 with total page 706 pages. Available in PDF, EPUB and Kindle. Book excerpt: Background. Acupuncture analgesia (AA) has been reported for the control of pain during dental surgery in numerous case reports and largely uncontrolled studies. Rigorous, blinded, controlled trials are needed to confirm the utility of AA in dentistry. Current methodology for such studies remains inadequate. Objectives. These studies include (1) a case series ("Pilot Study") to determine the feasibility of electro-acupuncture for pain control during various dental procedures; (2) a double-blinded, randomized trial ("Validation Study") to develop credible, novel, non-invasive placebo acupuncture methods; and (3) a double-blinded, randomized trial ("Clinical Trial") to compare peak pain levels during tooth extraction in patients receiving either 1.8mL of 2% lidocaine with epinephrine 1:100,000 plus placebo electroacupuncture ("control" treatment), 1.8mL of plain 2% lidocaine plus true electroacupuncture ("experimental" treatment), or 1.8mL of 2% lidocaine with epinephrine 1:100,000 plus true electro-acupuncture ("combination" treatment). Results. In the pilot study (n = 12), AA was effective at controlling pain during extractions, fillings, scaling and root planing. Among pilot subjects, 58% reported moderate pain or less, without elective anesthetic. In the validation study, true acupuncture was virtually indistinguishable from sham acupuncture. Kappa statistics for agreement between actual and perceived treatment, for all subjects and personnel (n = 83 observations) were 0.25 for anesthetic type and 0.17 for acupuncture type. Similar observations for patients only (n = 15) were 0.22 and 0.03, respectively. In the clinical trial, peak pain and additional anesthetic usage were similar across treatment groups (p = 0.75 for peak pain, p = 0.17 for anesthetic). Combination subjects (n = 19) reported peak pain levels of 3.7 ± 2.8 (mean ± SD; 0-10 scale), while experimental and control subjects (n = 22 each) reported peak pain levels of 4.6 ± 3.2 and 4.1 ± 3.2, respectively. Combination subjects received 1.0 ± 1.5 mL of elective anesthetic on average, while experimental and control subjects received 1.3 ± 1.4 and 1.9 ± 1.6 mL, respectively. Conclusions. There was no difference in pain control during tooth extraction between an electro-acupuncture protocol and lidocaine with epinephrine, although trends suggest a small additive effect in those receiving both. Blinding methods developed for this study were effective throughout study procedures and are suitable for use in similar future studies, as well as trials of electro-acupuncture in general