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Summaries of recent papers
  1. Adrian White1,
  2. Sharon Burton2,
  3. Mark Langweiler3,
  4. Michael Meinen4
  1. 1Primary Care Group, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, Devon, UK
  2. 2Wilson Street Surgery, Derby, UK
  3. 3Welsh Institute of Chiropractic, University of South Wales, Treforest, UK
  4. 4Denton Park Health Centre, Newcastle Upon Tyne, UK
  1. Correspondence to Dr Adrian White, Primary Care Group, Plymouth University Peninsula Schools of Medicine and Dentistry, N14 ITTC Building, Plymouth Science Park, Plymouth PL6 8BX, UK; Adrian.white{at}plymouth.ac.uk

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Clinical effectiveness trials

Acute renal colic

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Multicentre randomised controlled trial (RCT) (n=121) of acupuncture versus diclofenac and acetaminophen (paracetamol).

Methods

Patients with confirmed acute renal colic were randomised to receive either 75 mg diclofenac intramuscularly, 1 g paracetamol intravenously over 15 min, or manual acupuncture (BL21, BL22, BL23, BL24, BL45, BL46, BL47, BL48, ipsilaterally) for pain relief. A visual analogue scale (VAS) and a verbal rating scale were used just before treatment and at 10, 30, 60 and 120 min after treatment.

Results

One hundred and twenty-one patients met the inclusion criteria. There was significant improvement in pain scores in all three groups. There were no significant differences between the three groups at 30 and 60 min, but at 120 min there were significant differences between the acupuncture group (higher pain scores) and diclofenac and paracetamol, respectively (but no such difference between the latter two treatments). As shown in figure 1, although acupuncture works quickly the effect also levels off quickly, while diclofenac and paracetamol continue to improve the pain.

Figure 1

Renal colic pain visual analogue scale (VAS). Based on Am J Emerg Med 2015;33:749–53.

Comments

Unfortunately there was no power calculation, so there is no telling whether the study was large enough to be conclusive. The design also did not allow for any blinding of the participants, potentially allowing bias. However, the data suggest that acupuncture works just as well as the commonly used drugs, at least for the first hour. The treatment is very well described, making it easy for the reader to apply it to patients.

Post-tonsillectomy pain (1)

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