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Int J Nurs Stud. 2014 Mar;51(3):370-8. doi: 10.1016/j.ijnurstu.2013.06.007. Epub 2013 Jul 16.

Integrative acupoint stimulation to alleviate postoperative pain and morphine-related side effects: a sham-controlled study.

Author information

  • 1School of Nursing, Yuanpei University, No. 306, Yuanpei Street, Hsinchu 30015, Taiwan, ROC. Electronic address: yuchu@mail.ypu.edu.tw.
  • 2Physician of Anesthesiology Department, Veterans General Hospital, Taipei, No. 201, Shih-Pai Road, Section 2, PeiTou 112, Taipei, Taiwan, ROC. Electronic address: mytsou@vghtpe.gov.tw.
  • 3Department of Applied Mathematics, Chung-Yuan Christian University, No. 200, Chung Pei Road, Chung Li City 32023, Taiwan, ROC. Electronic address: hsinghsi@cycu.edu.tw.
  • 4School of Chinese Medicine, China Medical University, No. 91, Hsueh-Shih Road, Taichung 40402, Taiwan, ROC. Electronic address: jglin@mail.cmu.edu.tw.
  • 5School of Nursing, National Taipei University of Nursing and Health Sciences, No. 365, Minte Road, Taipei, Taiwan, ROC. Electronic address: meiling@ntunhs.edu.tw.



Although it can be reduced, postoperative pain remains a problem. Acupressure with electric stimulation may be more effective for postoperative pain management than acupressure alone.


This study aimed to evaluate the effects of integrative acupoint stimulation (IAS) on the relief of postoperative pain and on the reduction of morphine-related side effects.


A single-blinded, sham-controlled study with three groups.


An orthopedic ward in a 2900-bed teaching medical center.


Forty-five subjects in each of three groups.


Each subject received a multimedia course on patient-controlled analgesia (PCA) before surgery to learn about the use of narcotic analgesics and the operation of the PCA device. Treatment was as follows: (1) for the IAS group, auricular acupressure combined with transcutaneous electric acupoint stimulation (TEAS) at the true acupoint; (2) for the sham group, acupoint stimulation in the same manner but at a sham acupoint or without embedding seeds and pressure; (3) for the control group, no IAS intervention.


Pain scores were significantly lower in the IAS group than the other two groups at 2h and 4h after returning to the ward, and 24h after surgery. The analgesic requirement during the 72h after surgery and the overall incidence of morphine-related side effects were significantly lower in the IAS group.


The study demonstrates that combined auricular acupressure and TEAS decreased postoperative pain, the use of equianalgesic morphine, and morphine-related side effects. IAS provides better analgesia when used in conjunction with PCA after lumbar spine surgery and can be regarded as a component of multimodal analgesia.

Copyright © 2013 Elsevier Ltd. All rights reserved.


Auricular acupressure; Morphine-related side effects; Postoperative pain; Sham-controlled study; Transcutaneuos electric acupoint stimulation (TEAS)

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