Acupuncture for complementary pain relief following tonsillectomy in children

INTERVENTION: Intervention:Intraoperative acupuncture during tonsillectomy procedure Why: To reduce pain postoperatively How:With approval from the Hospital Ethics Committees, we enrolled 251 children who were undergoing tonsillectomy into our studyAll parents of respective patients received written informed consent prior to surgery. All parents were interviewed and consented by the anaesthetist the night before or on the day of surgery. They were all be given a chance to ask questions at the interview and any further queries were addressed prior to the procedure. In the control group, each child was accompanied by their parent into the operating room for induction of general anaesthesia and followed by the standard procedure of tonsillectomy. In the acupuncture group an identical procedure to that described above was followed, with the addition of the insertion of ten (10) acupuncture needles immediately following induction of anaesthesia and prior to surgical stimulation. What: Stainless steel acupuncture needles, 15 mm in length and 0.18 mm in diameter (Serin Co, Shizuoka, Japan), were used for the acupuncture. The positions for the needles inserted, according to Chinese Medicine standards, are: LI4 bilaterally, LI20/Bitong bilaterally, CV(REN)22, GV(DU)20, LU1, PC6, ST44, SP6. Who:All needle acupunctures were performed by Dr David Ho, an anaesthetist and a qualified acupuncturist with certification from the Australian College of Medical Acupuncturist (AMAC). Where: all procedures were performed in operating rooms at Northwest Private Hospital and St Vincents Northside Hospital. When/How much: All acupuncture is done only once.The needles were left in situ for the duration of surgery, and immediately removed at the completion of surgery prior to the patient being transferred to recovery room. CONDITION: Anaesthesiology ‐ Pain management Oral and Gastrointestinal ‐ Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon tonsillectomy; ; tonsillectomy PRIMARY OUTCOME: Pain score following tonsillectomy as assessed by the Face, Legs, Activity, Cry, Consolability (FLACC) scale with the intervention of intraoperative acupuncture. ; ; ; [in the first 24 postoperative hours in hospital and on day 1,2 5 at home.] SECONDARY OUTCOME: Oxycodone requirement following tonsillectomy as assessed by the number of doses given by nurses in hospital and by parents at home with the intervention of intraoperative acupuncture. ; ; [in the first 24 postoperative hours in hospital and on postoperative days 1,2 and 5 at home.] INCLUSION CRITERIA: Healthy children undergoing tonsillectomy