Opioids continue to be prescribed, and at unacceptable rates considering the number of clinical guidelines recommending nondrug pain-relief options first and limited use second in most cases. One possible exception: patients experiencing chronic cancer-related pain. For this population, opioids remain a cornerstone management option.
However, as with opioids in particular and all pharmaceuticals in general, the potential side effects can be problematic. Case in point: opioid-related constipation (OIC), which affects more than half of noncancer patients (and up to 90% of cancer patients) taking them, according to research. One possible remedy for this common, frustrating side effect of treatment: electroacupuncture.
Published in JAMA Network Open by Dr. Weiming Wang, et al., a new clinical trial conducted at six tertiary hospitals in China randomized 100 cancer patients (ages 18-85) into two equal groups for comparison. "After a 1-week run-in period without the use of laxatives or stool softeners," both groups received eight weeks of treatment (24 sessions) of either electroacupuncture or sham EA.
Each 30-minute session featured bilateral needling of acupoints ST 25 (Tianshu), SP 14 (Fujie) and ST 37 (Shangjuxu) in the EA group. Electrodes provided a continuous wave of 10 Hz and a current intensity of 0.5 to 4 mA, depending on patient comfort.
Sham EA featured needle insertion without manipulation at non-acupoints. Electrodes were attached, but with a current intensity of 0.1-0.2 mA for only 30 seconds.
The primary outcome measure: ability to have at least three spontaneous bowel movements (without the need for rescue medication / other interventions in the previous 24 hours) per week (and an increase of at least one bowel movement from baseline in the same week) for at least 75% of the treatment period.
At week eight (end of treatment window), electroacupuncture patients achieving the primary outcome measure ("responders") topped sham EA responders significantly: 40.1% of the EA group vs. only 9% of the sham EA group. Electroacupuncture also "provided greater relief for most OIC symptoms and improved quality of life among patients with OIC," according to study findings.
Reference
- Wang W, et al. Effects of electroacupuncture for opioid-induced constipation in patients with cancer in China: a randomized clinical trial. JAMA Netw Open, 2023;6(2):e230310. Click here for free full-text access.
