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Auricular Acupuncture as Part of Multimodal Analgesia After Lower Leg Fracture

Not Applicable
Recruiting
Conditions
Pain, Postoperative
Fracture, Ankle
Pilon Fracture of Tibia
Foot Fracture
Interventions
Device: Auricular acupuncture
Registration Number
NCT05984433
Lead Sponsor
Baylor College of Medicine
Brief Summary

The purpose is to find out if incorporation of an intraoperative electro auricular acupuncture protocol when added to a standard multimodal analgesic regimen for patients undergoing surgery to repair lower leg fracture under spinal anesthesia will help reduce postoperative opioid use.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
140
Inclusion Criteria
  1. Patient ages 18-64
  2. American Society of Anesthesiology Physical Status I, II or III
  3. Inpatients scheduled to undergo ankle ORIF at Harris Health System Ben Taub Hospital
Exclusion Criteria
  1. Renal dysfunction (Serum Cr > 1.2) - excluded due to potential altered metabolism of anesthetic and perioperative medications
  2. Allergy to any of the standard anesthetic agents
  3. Patient inability to properly communicate with investigators (language barrier, dementia, delirium, psychiatric disorder)
  4. Patient or surgeon refusal

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Electroauricular acupunctureAuricular acupunctureImmediately after Level 2 sedation is achieved, an enhanced auricular trauma protocol (ATP) will be administered on the ear ipsilateral to the operative side at 8 ear points (Hypothalamus, Amygdala, Hippocampus, Prefrontal Cortex, Point Zero, Shen Men, Insula, Vagus) as described by Cheng (2022). The original ATP was described by Helms (2011). Seirin L 0.2 x 30 mm needles will be placed at Hypothalamus and Shen Men points. Seirin J 0.18 x 15 mm needles will be placed at Amygdala, Hippocampus, Prefrontal Cortex, Point Zero, Vagus, and Insula points. Electrostimulation using an ITO ES 130 microstimulator at 30 HZ with Level 4 intensity, will be applied with the positive lead (red) on Hypothalamus and negative lead (black) at Shen Men for 60 minutes. All needles will be removed 1 hour after insertion.
Primary Outcome Measures
NameTimeMethod
Total opioid analgesic use for 14 days after surgery14 days

Total opioid given in hospital and taken at home, converted to oral morphine equivalents

Secondary Outcome Measures
NameTimeMethod
Incidence of side effects associated with opioid use14 days

PONV, pruritus, headache, constipation, urinary retention, fatigue, difficulty with concentration, drowsiness, lightheadedness, dry mouth

Pain scores14 days

Pain scores (1-10) in PACU and at the 7 and 14 day mark post surgery

Trial Locations

Locations (1)

Ben Taub Hospital

🇺🇸

Houston, Texas, United States

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