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CRITICAL CARE AND TRAUMA

Prehospital Analgesia with Acupressure in Victims of Minor Trauma: A Prospective, Randomized, Double-Blinded Trial

Alexander Kober, MD^*, Thomas Scheck, MD^*, Manfred Greher, MD^*, Frank Lieba, BS, Roman Fleischhackl, BS^*, Sabine Fleischhackl, BS^*, Frederick Randunsky, BS, and Klaus Hoerauf, MD^*

*Department of Anesthesia and Intensive Care, University of Vienna; Vienna Red Cross, Van Swieten; and the Research Institute of the Vienna Red Cross, Vienna, Austria

Address correspondence and reprint requests to Klaus Hoerauf, MD, Department of Anesthesia and Intensive Care, University Hospital of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. Address e-mail to klaus.hoerauf{at}univie.ac.at

Untreated pain during the transportation of patients after minor trauma is a common problem in emergency medicine. Because paramedics usually are not allowed to perform invasive procedures or to give drugs for pain treatment, a noninvasive, nondrug-based method would be helpful. Acupressure is a traditional Chinese treatment for pain that is based on pain relief followed by a short mechanical stimulation of specific points. Consequently, we tested the hypothesis that effective pain therapy is possible by paramedics who are trained in acupressure. In a double-blinded trial we included 60 trauma patients. We randomly assigned them into three groups ("true points," "sham-points," and "no acupressure"). An independent observer, blinded to the treatment assignment, recorded vital variables and visual analog scales for pain and anxiety before and after treatment. At the end of transport, we asked for ratings of overall satisfaction. For statistical evaluation, one-way analysis of variance and the Scheffé F test were used. P < 0.05 was considered statistically significant. Morphometric and demographic data and potential confounding factors such as age, sex, pain, anxiety, blood pressure, and heart rate before treatment did not differ among the groups. At the end of transport we found significantly less pain, anxiety, and heart rate and a greater satisfaction in the "true points" groups (P < 0.01). Our results show that acupressure is an effective and simple-to-learn treatment of pain in emergency trauma care and leads to an improvement of the quality of care in emergency transport. We suggest that this technique is easy to learn and risk free and may improve paramedic-based rescue systems.

IMPLICATIONS: We tested, in a double-blinded manner, the hypothesis that acupressure could be an effective pain therapy in minor-trauma patients. Our results show that acupressure is an effective and simple-to-learn treatment of pain in emergency medical care and can improve the quality of care.

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