Auriculotherapy for Prolonged Postoperative Pain Management Following Rotator Cuff Surgery: A Randomized, Placebo-Controlled Study.

Abstract

Introduction: Pain after rotator cuff surgery is prolonged. This has led to the need for opioids and the risk of developing opioid use disorder. This study was designed to investigate the role that active auriculotherapy treatment (AT) may play in reducing opioid consumption following rotator cuff surgery.

Methods: Fifty patients who underwent a primary ambulatory unilateral rotator cuff surgery participated in this randomized, placebo-controlled study. Each patient was randomized to either the AT group or the placebo group (P group). The primary endpoint was overall opioid consumption (oral morphine equivalent in mg) in the first five days after surgery. Secondary endpoints included pain at rest and with movement, non-narcotic analgesic consumption, functional recovery, time to discharge from the recovery room and hospital, patient satisfaction, and the number of patients readmitted to the hospital because of pain.

Results: The use of AT (n = 20) significantly decrease by 35% opioid consumption (p = 0.0307). The pain with movement in the AT group was significantly lower compared to the P group at 14 days (4.47 ± 2.12 vs. 5.84 ± 2.39, respectively; p = 0.0394). No differences in time to discharge from the recovery room and the hospital and functional recovery were recorded. The use of AT was also associated with an increase in satisfaction at 90 days compared to the P group (5.9 ± 0.3 vs. 4.9 ± 1.9, respectively; p = 0.0267).

Discussion: Our data, based on a randomized, placebo-controlled study, demonstrated that AT using cryogenic needles and nine ear points is an effective technique to reduce postoperative opioid requirement in opioid-naïve patients following rotator cuff surgery.

Conclusion: Our data suggest that the use of AT may help reduce opioid consumption following ambulatory rotator-cuff surgery.