Background: Patients commonly develop postoperative pain after total knee arthroplasty. Acupuncture-related techniques and low-level laser therapy could be beneficial for pain management for older individuals.
Objective: To examine the effect of low-level laser acupuncture in reducing postoperative pain, pain-related interference in daily life, morphine consumption, and morphine-related side effects in older patients with knee osteoarthritis who underwent total knee arthroplasty.
Design, setting, participants and intervention: A single-blind randomized placebo-controlled trial was conducted. Patients (N = 82) were recruited and randomly assigned via a computer-generated list to the laser acupuncture group or a placebo group. The laser acupuncture group received low-level laser therapy at Sanyinjiao (SP6), Taixi (KI3), Kunlun (BL60), Fengshi (GB31), Futu (ST32) and Neiguan (PC6) after total knee arthroplasty, while the placebo acupuncture group received the same treatment procedure without laser energy output.
Main outcome measures: The primary outcome was postoperative pain intensity, and it was measured at baseline and hours 2, 6, 10, 24, 48 and 72 after total knee arthroplasty. The secondary outcomes, including relative pain, postoperative pain-related interference in daily life and morphine consumption, were measured at hours 24, 48 and 72 after total knee arthroplasty.
Results: Generalized estimating equations revealed significant between-group differences in pain intensity (P = 0.01), and trend differences in pain intensity for the laser acupuncture group starting at hours 10 to 72 (P < 0.05) and morphine consumption at hours 48 and 72 (P < 0.05). The changes in pain-related interference in daily life were significant (P < 0.05) at 72 h, with the exception of the parameters for worst pain, mood, and sleep. Nausea and vomiting side effects from morphine had significant between-group differences at hours 10 and 24 (P < 0.05).
Conclusion: Low-level laser acupuncture gradually reduced older patients’ postoperative pain intensity and morphine consumption within the first 72 h after their total knee arthroplasty for osteoarthritis. Low-level laser acupuncture may have benefits as an adjuvant pain management technique for clinical care.