Children have long been prescribed codeine for pain relief after having surgery to remove their tonsils. However, in February 2013, the Food & Drug Administration (FDA) banned the use of codeine in this setting because of a recently recognized risk of complications.
Dr. James Ochi, a San Diego pediatric ear, nose and throat (ENT) surgeon who has been in private practice for more than 20 years, conducted a study using acupuncture instead of codeine for pain relief for his tonsillectomy patients. The study was published in the International Journal of Pediatric Otorhinolaryngology, a medical journal exclusively devoted to the subspecialty of pediatric otolaryngology.
"I've been using medical acupuncture for years to help my patients suffer less pain after surgery. Now that it is unsafe to use codeine for these kids, I wanted to see if acupuncture without the use of narcotics was helpful for my patients," said Dr. Ochi. "Acupuncture in general has been shown to be effective in reducing pain, is safe and can be done quickly at minimal cost." Dr. Ochi performed all tonsillectomies at Rady Children's Hospital-San Diego and the acupuncture treatments at the El Centro Regional Medical Center Outpatient Clinic in El Centro, CA and his office in Encinitas, CA.
In this novel study, 31 patients ranging from 2 to 17 years old received acupuncture after tonsillectomy. Prior to acupuncture treatment, patients or their parents reported a mean pain level of 5.52 out of 10. After about 15 minutes of acupuncture the pain level dropped to 1.92, a statistically significant difference. Furthermore, parents on average estimated the duration of benefit from the acupuncture to last about 2½ days. No adverse effects were reported as a result of the drug-free treatments.
Since the FDA ban on the use of codeine, patients must rely on over-the-counter drugs such as Tylenol and ibuprofen, which also have risks and adverse effects especially in young patients and may not be effective. Narcotics have long been the mainstay of therapy for children suffering pain after having their tonsils removed. Since it is no longer safe to prescribe opioids, it is paramount to find ways of helping these young patients in an effective and safe manner.
"No matter who performs the surgery or how it's done, children often experience pain for ten days after tonsillectomy, even longer for adults," said Dr. Ochi. "It's extremely gratifying to see a safe and drug free treatment such as acupuncture reduce the pain and discomfort in children after surgery."
While this is a unique study, Harvard Medical School recently showed acupuncture reduced pain and agitation in children undergoing ear surgery.
- James W. Ochi. Acupuncture instead of codeine for tonsillectomy pain in children. International Journal of Pediatric Otorhinolaryngology, 2013; 77 (12): 2058 DOI: 10.1016/j.ijporl.2013.10.008
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