Acupuncture and Post-Operative Ileus

Not Applicable

Completed

Brief Summary: Postoperative ileus, the transient cessation of normal bowel function, is a universal aspect of colon surgery. Its occurrence may lead to increased patient discomfort and additional time and cost to hospital stay. Evidence from previous studies indicate that acupuncture may be beneficial in decreasing time to recovery of bowel function and decrease the body's inflammatory response. However, this has not been studied in a randomized, prospective fashion in colon surgery. The goal of this study is to determine if acupuncture may be utilized as a therapeutic modality to decrease time to return of bowel function and discharge from the hospital.

Detailed Description: The pathogenesis of post-operative ileus is not completely known. It is thought that post-operative ileus involves trauma to the bowel. This traumatizing of the intestine and peritoneal surfaces results in production and release of inflammatory mediators. These in turn, lead to inactivation of inhibitory neural reflexes. There is also an additive effect of opioids used for post-operative pain, aggravating and adding to the duration of post-operative ileus. Acupuncture has shown promise in both human and animal model studies to reduce post-operative nausea and vomiting and post-operative ileus. It is the investigator's hypothesis that acupuncture will minimize or reduce both post-operative ileus and nausea following elective colon surgery and will lead to a decrease in inflammatory markers that are known to be elevated following abdominal surgery.

The study goals are to determine if acupuncture:

* Leads to earlier return of bowel function

* Leads to earlier time to discharge following colon surgery

* Leads to earlier return of colonic motility

* Leads to decreased postoperative nausea and vomiting

* Leads to a decrease in inflammation

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

pregnancy
pacemaker or implantable electronic devices
bowel obstruction
intra-abdominal abscess or sepsis
colorectal tumors invading other organs or surrounding tissues
diverticulitis complicated by fistula
known immunodeficiency disorders
tumors requiring an anastomosis below 7cm above the anal verge as measured by rigid proctosigmoidoscope exam at surgery
chronic pain medications
surgeries requiring temporary or permanent ostomies
emergent operations
receiving preoperative radiation/chemotherapy
major deformities of the upper or lower extremities and/or any active skin lesions or ulcers in acupunctural treatment areas

Arm && Interventions

Group	Intervention	Description
1	Acupuncture	Treatment Acupuncture Group (Therapeutic Acupuncture Treatment): treatment with actual acupuncture needles
2	Sham acupuncture	SHAM (control) acupuncture group: non-therapeutic acupuncture treatment

Primary Outcome Measures

Name	Time	Method
Determine if acupuncture leads to earlier return of bowel function and earlier time to discharge following colon surgery.	Randomized acupuncture will be performed within 24 hours of completion of standard elective colon surgery

Secondary Outcome Measures

Name	Time	Method
Acupuncture will lead to decreased time to return of colonic motility, as measured by earlier progression of radiological markers through the colon	radiological markers will be given preoperatively and then will be tracked via abdominal x-rays postoperatively
Acupuncture will lead to decreased postoperative nausea and vomiting, resulting in less requirement of antiemetic medication	number of doses of antiemetic meds and number of episodes of vomiting and nausea will be recorded postoperatively
Acupuncture will blunt the inflammatory response, which is associated with development of postoperative ileus	serum inflammatory markers will be measured preoperatively and postoperatively

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