Battlefield Acupuncture Pain Reduction Efficacy in Comparison to Post-Surgical Medication, a Non-Superiority Randomized Controlled Trial.

Background

Control of pain after periodontal surgery is typically done with medications. There is a need to explore alternative options due to the risk of opioid addiction, patient desires for non-pharmacologic pain control, and in a military setting the likelihood of operating in a resource constrained environment. Battlefield acupuncture (BFA) was investigated as an alternative in this randomized controlled trial. The primary outcome was determining whether acupuncture as a monotherapy was acceptable, and what its effectiveness was.

Methods

This 2x2 crossover design study compared BFA alone to a regimen of 600mg ibuprofen and 325mg acetaminophen to control post-surgical pain after periodontal surgery. The participants' experiences were measured on a 0-100 numerical rating scale for pain and anxiety, and 0-5 point Likert scale for acupuncture acceptability and effectiveness. Survey data was collected at baseline, 24h, and 1 week after each surgery.

Results

There were no significant differences between pain experienced with BFA alone compared to medication at all time points following periodontal surgery. 30 participants completed all surveys. 67% of participants had complete acceptability of acupuncture needles, and 56% had high willingness to have BFA again. All groups had similar surgical difficulties. Most patients reported comfort with the needles at insertion, during sleep, and at removal. Only four participants experienced breakthrough pain, and only one of the four would not consider acupuncture again in the future.

Conclusion

BFA controls post-surgical pain after periodontal surgery as well as pain medication. In a resource-constrained environment it may be beneficial to utilize BFA as a first line treatment and reserve medications for other medical disciplines.