Postoperative pain is pain that arises after a surgical procedure, resulting from trauma
during the surgical incision process. It is generally acute in nature and is accompanied by
an inflammatory response. Spinal surgery is a surgical procedure used to address issues
typically involving pain in the spinal or back area. Commonly used postoperative analgesics
are opioid types administered intravenously. All types of opioids exhibit similar side
effects, particularly in terms of respiratory depression, which can lead to hypoxia and
respiratory arrest. Other side effects include nausea, vomiting, itching, decreased
intestinal motility leading to ileus, and constipation.
The press needle acupuncture, a specialized acupuncture needle developed from intradermal
needles, is being used. The advantage of the press needle is its minimally invasive nature,
relative affordability, safety, and the ability to continuously stimulate acupuncture points
for several days, generally without causing serious side effects.
This study aims to determine the effectiveness of the combined therapy of press needle
acupuncture and medication in treating postoperative pain in patients who have undergone open
spinal surgery. The study follows a double-blind randomized clinical trial design and is
conducted at the inpatient units of Dr. Cipto Mangunkusumo National General Hospital (Rumah
Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo), University of Indonesia Hospital (Rumah
Sakit Universitas Indonesia), and Fatmawati General Hospital. The research is a collaboration
between the Medical Acupuncture Department of Faculty of Medicine at the University of
Indonesia and the Orthopedics and Traumatology Department. The study employs press needle
acupuncture on 8 acupuncture points, 4 ear acupuncture points, and 4 body acupuncture points.
There are three hypothesis for this trial included, first there is a change in the mean pain
intensity before the placement of press needles and 24 hours after open spine surgery,
following the placement of press needles, in the press needle and medication group at LI4
Hegu, LR3 Taichong, ear acupoint MA TF-1 Shenmen, and MA AT-1 Thalamus compared to the change
in mean pain intensity before the placement of sham press needles and 24 hours after open
spine surgery, following the placement of sham press needles in the sham press needle and
medication group, as measured using the visual analog scale. Second there is a lower mean
postoperative pain intensity in the press needle and medication group at LI4 Hegu, LR3
Taichong, ear acupoint MA TF-1 Shenmen, and MA AT-1 Thalamus compared to the sham press
needle and medication group, as measured using the visual analog scale at 24 hours and 72
hours after open spine surgery. Third, there is a higher score for postoperative pain
management quality in the press needle and medication group at LI4 Hegu, LR3 Taichong, ear
point MA TF-1 Shenmen, and MA AT-1 Thalamus compared to the sham press needle and medication
group, as assessed using the American Pain Society Patient Outcome Questionnaire Revised
questionnaire at 24 hours after open spine surgery
The outcome of this research is the intensity of pain scores measured using the visual analog
scale assessed prior to press needle acupuncture insertion, 24 hours post-operation, and 72
hours post-operation. Additionally, the quality of postoperative pain management is assessed
using the American Pain Society Patient Outcome Questionnaire Revised (APS-POQ-R) at 24 hours
post-operation.