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Author Topic: Magnetic noninvasive acupuncture for infant comfort  (Read 35 times)

YanTing

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Magnetic noninvasive acupuncture for infant comfort
« on: July 13, 2018, 11:56:36 PM »

Acta Paediatrica Volume106, Issue11 November 2017 Pages 1780-1786

Magnetic noninvasive acupuncture for infant comfort (MAGNIFIC) – a single-blinded randomised controlled pilot trial

Kerry L. Chen (1), Kwee Bee Lindrea (2), Im Quah-Smith (3,4), Georg M. Schmölzer (5,6), Mary Daly (2), Timothy Schindler(1,2), Ju Lee Oei (1,2)

1.School of Women’s and Children’s Health, University of New South Wales, Kensington, NSW, Australia
2.Department of Newborn Care, The Royal Hospital for Women, Randwick, NSW, Australia
3.Research Associate, Centre for Healthy Brain Aging, CHeBA, University of New South Wales, Randwick, NSW, Australia
4.Roseville Wellness Group, Roseville, NSW, Australia
5.Centre for the Studies of Asphyxia and Resuscitation, Neonatal Research Unit, Royal Alexandra Hospital, Edmonton, Alberta,Canada
6.Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada

Abstract

Aim: To determine the safety and feasibility of auricular noninvasive magnetic acupuncture (MA) to decrease infant pain during heel pricks.
Methods: Infants requiring heel pricks for blood collection were randomised to either MA (n = 21) or placebo (P) (n = 19) after parental informed consent. MA or placebo stickers were placed on both ears according to the Battlefield Protocol by an unblinded investigator and left on for 3 days. Pain was assessed with the Premature Infant Pain Profile (PIPP) by blinded clinicians.
Results: Mean gestation (MA:34.1, P:34.4 weeks) and age of infants (MA:5.3, P:4.5 days) were similar as were mean (SD) pre (MA:1.7(1.4), P:2.1(1.9)) and post (MA:1.6(1.4), P: 2.1(1.7)) heel prick PIPP scores. PIPP scores were significantly lower in MA infants during heel pricks (MA:5.9(3.7), P: 8.3(4.7), p = 0.04). One-way ANCOVA modelling showed that MA was significantly associated with lower PIPP scores after controlling for analgesic use (p = 0.043). No differences in heart rate, oxygen saturation, analgesic use or adverse effects (e.g. local skin reactions) noted.
Conclusion: This pilot study shows that auricular MA is feasible in neonates and may reduce PIPP scores during heel pricks. Further study is required to determine the impact of MA on other painful or stressful conditions and on neurodevelopment.

Free full text:
https://onlinelibrary.wiley.com/doi/full/10.1111/apa.14002


Excerpts:

“Acupuncture has been recognised by the World Health Organization (WHO) as an effective clinical intervention in children and adults for pain and various health conditions 17. There are many forms of acupuncture, including needling 18, electrical currents 19, laser 20 and pressure 21, all of which aim to modulate the activity of key nociceptive structures, endogenous opioid and neurotransmitter secretions and parasympathetic activity, and thus regulate complex neurological, endocrine and immunological interactions 22.

“There are now an increasing number of reports of the safety and efficacy of acupuncture in the NICU [neonatal intensive care unit] environment 18-21 with a recent review concluding current evidence indicates acupuncture is safe for infants 23. However, some of these techniques may be difficult to incorporate into routine NICU care. For example, needling may interfere with infant swaddling and laser or electrical stimulation requires specialised equipment.

“In this study, we examined the use of auricular noninvasive magnetic acupuncture (MA) to decrease pain perception in newborn infants in the NICU. MA is administered at the same sites as traditional acupuncture. Static, magnetic fields resulting from the continuous placement of magnets in MA induce analgesia by causing sensory neurone blockades, changes in local blood flow and remodelling of the local microvasculature 24. The use of MA has not previously been described in the NICU. Our study aimed to determine the safety, feasibility and efficacy of MA for infants undergoing heel pricks in the NICU. We hypothesised that MA was safe and feasible.”

“Following parental consent, infants were randomised to receive either MA or placebo stickers that were applied bilaterally to the five auricular acupuncture points as per the Battlefield Acupuncture (BFA) protocol 25 (Fig. 1A) at least two hours prior to a heel prick by the unblinded investigator. The BFA protocol has been used in both adults and children for the effective management of acute pain conditions 25. Placebos were constructed by removing the magnet ball from precommercially available MA stickers (Sakamura, Helio Acupuncture, Japan). The magnet site on placebo and magnetic stickers was concealed prior to sticker placement with a thick application of white, opaque correction fluid (Fig. 1B). Stickers remained for a maximum of three days after which they were removed. Each infant was followed for the whole three days. Stickers were checked every eight hours by bedside nurses and replaced by the unblinded investigator if displaced.

“Magnets had a strength of 100G and measured 1.7 mm in diameter on a circular sticker of surgical tape with diameter 10 mm. Although magnets of greater strength have been reported in the literature, there have been no reports of use in infants, and thus 100G magnets were chosen as a conservative measure of effective therapy to minimise potential adverse effects associated with the magnetic field, such as local skin irritation. The unblinded investigator responsible for administering the intervention underwent a one-hour workshop with an experienced BFA practitioner (I.Q-S.), which has been reported as sufficient training for nonacupuncturist healthcare workers 26.”

“There was no difference in mean PIPP scores before and after heel pricks (see Fig. 3). However, mean PIPP scores during heel pricks were significantly lower in the magnet group (mean (SD): 5.9 (3.7) v 8.3 (4.7), p = 0.04). Post hoc parameter estimate tests using ANCOVA modelling demonstrated a significant impact of the intervention (i.e. magnets) on heel prick PIPP scores after adjusting for confounding variables, including preheel prick PIPP scores and analgesic use (eta squared=0.07, p = 0.043).”

“This study demonstrates that using magnetic stickers to provide acupuncture for infants in the NICU is safe, feasible and reduces pain caused by heel pricks, one of the most common procedures conducted on newborn babies. Infants who received MA had significantly lower mean PIPP scores compared to the placebo group (5.9 v 8.3) even after adjustment for preheel prick PIPP scores and analgesic use. There was no obvious trend of PIPP scores in infants with multiple heel pricks most likely because of the small number of babies. A larger study would allow examination of any possible cumulative effects of MA with repeated noxious stimuli.”

“In conclusion, the results of our pilot study suggest that auricular MA in infants in the NICU is feasible, safe and reduces pain perception in newborn infants during a painful procedure, such as heel pricks. MA did not interfere with routine care of the infant, nor require specialised equipment to apply. Further study of the effects of MA for the management of common newborn conditions causing stress and pain are warranted.”
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