Electroacupuncture for Acute Pancreatitis
Electroacupuncture for Acute Pancreatitis
This study aims to prove the efficacy of electroacupuncture (EA) for pain relief in patients
 with acute pancreatitis compared with conventional treatment. Patients diagnosed with acute
 pancreatitis will be enrolled after obtaining informed consents. They will be randomly
 assigned to EA 1, EA 2, or control group in a 1:1:1 ratio. All the enrolled patients will
 basically receive the conventional standard-of-care therapy for acute pancreatitis. Local
 electroacupuncture will be given in group EA 1, while local with distal electroacupuncture
 will be given in group EA 2, additionally. For the conventional therapy, first non-steroidal
 anti-inflammatory drugs will be administered; afterwards, if inadequately controlled,
 low-potency narcotic analgesics such as codeine and then high-potency narcotic analgesics
 such as morphine or meperidine will be given sequentially as required. The patients
 randomized to the EA 1 and 2 groups will undergo 1 session of electroacupuncture daily from
 day 1 until day 4, or until pain is resolved. The primary endpoint is the visual analogue
 scale (VAS) for pain on day 5. Secondary endpoints include daily VAS, requirement of
 analgesics, changes of inflammatory markers, and hospital days.
Acute pancreatitis (AP) causes significant abdominal pain, which can destroy patients'quality
 of life. Most patients have associated nausea and vomiting. Pain control for such patients is
 the mainstay of AP management. Opioids are safe and effective for pain control in patients
 with AP. Compared with other analgesic options, opioids may decrease the need for
 supplementary analgesia. However, frequent administration of opioid analgesics may result in
 opioid dependency. Unfortunately, any innovative treatment for the pain better than opioids
 has not been developed in the medical science so far. Therefore, the development of novel
 treatment for pain relief without triggering dependency is urgent. Acupuncture originated in
 China approximately 2000 years ago and is one of the oldest medical procedures in the world.
 Acupuncture continued to be developed and codified in texts over the subsequent centuries and
 gradually became one of the standard therapies used in China. Later, acupuncture was
 introduced to other countries including Asia, Europe, and Unites States. The most thoroughly
 studied application of acupuncture is for pain relief. In this sense, acupuncture in the
 oriental medicine could be an appropriate alternative for opioid analgesics, since it has
 been known as an effective treatment for pain relief without dependency. Electroacupuncture
 (EA) is a form of acupuncture where a small electric current is passed between pairs of
 acupuncture needles. Previous studies suggested that EA blocks pain by activating a variety
 of bioactive chemicals through peripheral, spinal, and supraspinal mechanisms. Therefore, we
 plan to prove the efficacy of EA for pain relief in patients with AP compared with
 conventional treatment.
Inclusion Criteria:

 -  Patients diagnosed with acute pancreatitis

 -  The definition of acute pancreatitis is based on the fulfillment of 2 out of 3 of the
 following criteria: clinical (upper abdominal pain), laboratory (serum amylase or
 lipase > 3 x upper limit of normal) and/or imaging (computed tomography, magnetic
 resonance imaging, ultrasonography) criteria.

 Exclusion Criteria:

 -  Those whose informed consent could not be obtained

 -  Patients with severe pancreatitis accompanying multiple organ failure