Electroacupuncture for Opioid-Induced Constipation in Cancer Patients
Acupuncture Research

Electroacupuncture for Opioid-Induced Constipation in Cancer Patients

Editorial Staff

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

  1. 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.
May 2023
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