An interventional study of Acupuncture needles in Knee Arthropathy, Hip Arthropathy and Anxiety, sponsored by Hartford Hospital. Completed at 1 site in United States. Open to participants aged 18 Years to 85 Years. Per ClinicalTrials.gov, last updated 2025-03-26.
Sponsored by Hartford Hospital · Not applicable, Interventional, and Supportive care
Open-label, randomized controlled trial to determine the effect of preoperative acupuncture on preoperative anxiety and postoperative pain for high-anxiety patients undergoing total hip or knee arthroplasty. The hypothesis is that preoperative acupuncture will reduce preoperative anxiety, reduce postoperative pain, reduce postoperative nausea and vomiting, reduce opioid consumption, and improve patient satisfaction.
Acupuncture has been extensively practiced and studied worldwide, particularly as a part of Eastern medicine, but it is a relatively uncommon therapy offered in Western medical institutions, such as those in the United States. Considering the commonly cited benefits of acupuncture, such as reduced anxiety and pain, hospitals throughout the United States have the opportunity to implement acupuncture as a cost-effective and safe technique for improving surgical outcomes.
Acupuncture administered in the preoperative period can be particularly effective for reducing preoperative anxiety, postoperative pain, postoperative opioid consumption, and postoperative nausea and vomiting. Consequently, preoperative acupuncture can improve patient satisfaction and decrease hospital costs. However, due to a lack of implementation and experience, further research is needed to establish the safety and efficacy of preoperative acupuncture in United States medical practices.
At the Bone-and-Joint Institute at Hartford Hospital, where this study is proposed, a quality study on total knee or hip arthroplasty patients found that 21% of its monthly patients were "high-anxiety" according to the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Thus, there is a significant population of patients who would benefit from a procedure to reduce preoperative anxiety at our facility.
This proposal is for a prospective, open-label, randomized controlled trial to determine the effect of preoperative acupuncture on preoperative anxiety and postoperative pain for high-anxiety patients undergoing total hip or knee arthroplasty. The hypothesis is that preoperative acupuncture will reduce preoperative anxiety and postoperative pain as well as reduce postoperative nausea and vomiting and opioid consumption and improve patient satisfaction. The study population is to include adult patients undergoing lower extremity total joint arthroplasty, including hip and knee joints, at the Bone-and-Joint Institute at Hartford Hospital.
712 studies on the registry are indexed under Joint Diseases; 127 are open to participants now.
This study's enrollment of 60 is close to the median of 60 across 470 interventional studies indexed under Joint Diseases.
Browse Joint Diseases studies →Hartford Hospital is the lead sponsor of 101 studies on the registry; 19 are open to participants now.
Of its 12 completed or terminated interventional studies of FDA-regulated products, 5 (42%) have results posted.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Preoperative acupuncture
Device: Acupuncture needles
No acupuncture
The acupuncture intervention includes a combination of auricular and body acupuncture. The auricular points used are Shen men, Zero point, Tranquilizer point, and Master cerebral. The body points used are the wrist PC6.
Also known as: DBC™ Detox-5 Acupuncture Needles (SKU: DTX.20X13) and ure needles o 1) SEIRIN J-Type Acupuncture Needles (SKU: SJ.18X30)
Perioperative Anxiety
Determine the effect of preoperative acupuncture on preoperative anxiety in the acupuncture group using VAS (Visual Analog Scale) which is a 10 centimeters line in length, from 0-100, with 0 at the left extreme being "not at all anxious" and 100 at the right extreme being "very anxious". Participants put a cross on the line to indicate how they felt at the time point used. A higher score means worse as it means high anxiety.
Time frame: Prior to acupuncture and 30 minutes after acupuncture
Postoperative Pain in the First 3 Postoperative Hours
Determine the effect of preoperative acupuncture on postoperative pain in both groups, using the self-reported NPS (Numeric Pain Scale) which is a scale of 0-10 where 0 is "no pain" and 10 is "severe pain". Using the mean pain score to compare the mean of the total pain in the first 3 postoperative hours between groups.
Time frame: Total mean pain in the first 3 postoperative hours
Patient Satisfaction With Acupuncture Procedure
Patients' satisfaction with acupuncture intervention was assessed in the acupuncture group only using the satisfaction scale of (1-5), where 1 is Extremely satisfied, 2 is Very satisfied, 3 is Somewhat satisfied, 4 is Not very satisfied, and 5 is Not at all satisfied. Each frequency represented the percentage of patients who were satisfied (given a score of 1 or 2 out of 5) with their acupuncture treatment. This assessment was done within a week after discharge, via a phone call.
Time frame: Within 1 week after hospital discharge
Preoperative Pain
Determine the effect of preoperative acupuncture on preoperative pain in the acupuncture group using the self-reported NPS (Numeric Pain Scale) which is a scale of 0-10 where 0 is "no pain" and 10 is "severe pain". Using the mean pain score to compare pre-acupuncture pain to post-acupuncture pain score in the acupuncture group only.
Time frame: Prior to acupuncture and 30 minutes after acupuncture
Opioid Consumption
Postoperative opioid consumption to be converted into morphine milliequivalents (MMEs) and compared between the two groups for up to 24 hours post surgery.
Time frame: During hospitalization, up to 24 hours post surgery
Midazolam Use as Anxiolytic Medications
The dose of Midazolam as an anxiolytic medication that was given at any time throughout hospitalization up to 24 postoperative hours.
Time frame: During hospitalization, up to 24 hours post surgery
Patient Satisfaction Scale With Overall Care
Patients' satisfaction with overall care management was compared using the patient satisfaction scale of (1-10), where 1 is extremely unsatisfied and 10 is extremely satisfied with overall care. Each frequency represents the percentage of patients in each group who have been either satisfied or extremely satisfied (given a score of 9 or 10 out of 10). This assessment was done within a week after discharge, via a phone call.
Time frame: Within 1 week after hospital discharge
Occurrence of Nausea and Vomiting at First Postoperative Hour
Compare the occurrence of postoperative nausea and vomiting using the Simplified Postoperative Nausea and Vomiting Impact Scale which consists of two questions, with a possible response total score of 0-6. Response score totals of 0-2 require no intervention. Response score totals of 3-4 may necessitate antiemetic medication. Response score totals of 5-6 are considered clinically important nausea requiring medication intervention, as this would constitute patients with excessive vomiting. This scale was used to report the occurrence of nausea (yes/no), with "yes" defined as any number above 0 in the scale, while "no" defined as 0.
Time frame: At 1 postoperative hour
Antiemetic Medications
The frequency of any antiemetic medication given at any time throughout hospitalization up to 24 postoperative hours
Time frame: During hospitalization, up to 24 hours post surgery
Hospital Length of Stay
Using the hospital admission and discharge dates \& times; this will be compared between the two groups.
Time frame: From the date and time of admission to the date and time of discharge, assessed as 24-48 hours
Postoperative Pain Upon Arrival to the PACU
Determine the effect of preoperative acupuncture on postoperative pain in both groups, using the self-reported NPS (Numeric Pain Scale) which is a scale of 0-10 where 0 is "no pain" and 10 is "severe pain". Using the mean pain score to compare the mean pain scores between groups upon arrival to the PACU.
Time frame: Postoperative pain at time of PACU arrival
Postoperative Pain at 1 Postoperative Hour
Determine the effect of preoperative acupuncture on postoperative pain in both groups, using the self-reported NPS (Numeric Pain Scale) which is a scale of 0-10 where 0 is "no pain" and 10 is "severe pain". Using the mean pain score to compare the mean of pain scores at the first postoperative hour between groups.
Time frame: At the first postoperative hour
Postoperative Pain After 3 Postoperative Hours
Determine the effect of preoperative acupuncture on postoperative pain in both groups, using the self-reported NPS (Numeric Pain Scale) which is a scale of 0-10 where 0 is "no pain" and 10 is "severe pain". Using the mean pain score to compare the mean pain scores after three postoperative hours between groups.
Time frame: After three postoperative hours
Number of Participants That Received Midazolam Dose >2mg
The number of participants who received a dose of midazolam exceeding 2 mg indicated a high level of perioperative anxiety that necessitated pharmacological intervention. The decision to use a dose higher than 2 mg was based on the standard practice of administering 2 mg of midazolam for preoperative regional nerve blocks; any dosage surpassing this amount was specifically intended for anxiety management.
Time frame: During hospitalization up to 24 postoperative hours
Patient's Satisfaction With Pain Management
Patients' satisfaction with their postoperative pain management was compared between groups using the satisfaction scale of (1-10), where 1 is extremely unsatisfied and 10 is extremely satisfied. Each frequency represented the percentage of patients in each group who were satisfied (given a score of 9 or 10 out of 10)This assessment was done within a week after discharge, via a phone call.
Time frame: Within 1 week after hospital discharge
Patient's Satisfaction With Anxiety Management
Patients' satisfaction with their perioperative anxiety management was compared between groups using the satisfaction scale of (1-10), where 1 is extremely unsatisfied and 10 is extremely satisfied. Each frequency represented the percentage of patients in each group who were satisfied (given a score of 9 or 10 out of 10). This assessment was done within a week after discharge, via a phone call.
Time frame: Within 1 week after hospital discharge
Acupuncture Patients Who Were Likely to Consider Acupuncture for Future Surgeries
Patients with acupuncture intervention were assessed for how likely to consider acupuncture for future surgeries using a scale of (1-4), where 1 is Very likely, 2 is Likely, 3 is Maybe, and 4 is Never. Each frequency represented the percentage of patients who were more likely (given a score of 1 or 2 out of 4) to receive acupuncture treatment in a future surgery. This assessment was done within a week after discharge, via a phone call.
Time frame: Within 1 week after hospital discharge
Occurrence of Nausea and Vomiting After 3 Postoperative Hours
Compare the occurrence of postoperative nausea and vomiting using the Simplified Postoperative Nausea and Vomiting Impact Scale which consists of two questions, with a possible response total score of 0-6. Response score totals of 0-2 require no intervention. Response score totals of 3-4 may necessitate antiemetic medication. Response score totals of 5-6 are considered clinically important nausea requiring medication intervention, as this would constitute patients with excessive vomiting. This scale was used to report the occurrence of nausea (yes/no), with "yes" defined as any number above 0 in the scale, while "no" defined as 0.
Time frame: After 3 postoperative hours
Postoperative Pain in the First 3 Postoperative Hours (Group X Time)
Determine the effect of preoperative acupuncture on postoperative pain in both groups, using the self-reported NPS (Numeric Pain Scale) which is a scale of 0-10 where 0 is "no pain" and 10 is "severe pain". To compare mean pain scores between groups, considering all 3 individual time points (at arrival to Post-Anesthesia Care Unit, 1st Postoperative hour, and 3rd Postoperative hour)
Time frame: Mean pain scores at arrival to Post-Anesthesia Care Unit, 1st Postoperative hour, and 3rd Postoperative hour
Participants were recruited based on their high anxiety score (according to the validated Amsterdam Preoperative Anxiety and Information Scale (APAIS-A-T\>10) who are scheduled for elective total knee or hip arthroplasty surgery at Bone and Joint Center from March 2022 to April 2023. The first patient was enrolled in March 21, 2022 and the last patient was enrolled in April 3, 2023.
| Milestone | Acupuncture | Control |
|---|---|---|
| Started | 30 | 30 |
| Completed | 30 | 29 |
| Not completed | 0 | 1 |
| Withdrew: Preoperative surveys missed | 0 | 1 |
Determine the effect of preoperative acupuncture on preoperative anxiety in the acupuncture group using VAS (Visual Analog Scale) which is a 10 centimeters line in length, from 0-100, with 0 at the left extreme being "not at all anxious" and 100 at the right extreme being "very anxious". Participants put a cross on the line to indicate how they felt at the time point used. A higher score means worse as it means high anxiety.
| score on a scale | Preoperative Pre-acupuncture | Preoperative Post-acupuncture |
|---|---|---|
| Perioperative Anxiety | 60.73 ± 21.28 | 28.90 ± 21.54 |
Determine the effect of preoperative acupuncture on postoperative pain in both groups, using the self-reported NPS (Numeric Pain Scale) which is a scale of 0-10 where 0 is "no pain" and 10 is "severe pain". Using the mean pain score to compare the mean of the total pain in the first 3 postoperative hours between groups.
| score on a scale | Acupuncture | Control |
|---|---|---|
| Postoperative Pain in the First 3 Postoperative Hours | 1.93 ± 1.63 | 2.79 ± 2.83 |
Patients' satisfaction with acupuncture intervention was assessed in the acupuncture group only using the satisfaction scale of (1-5), where 1 is Extremely satisfied, 2 is Very satisfied, 3 is Somewhat satisfied, 4 is Not very satisfied, and 5 is Not at all satisfied. Each frequency represented the percentage of patients who were satisfied (given a score of 1 or 2 out of 5) with their acupuncture treatment. This assessment was done within a week after discharge, via a phone call.
| Participants | Acupuncture Group |
|---|---|
| Patient Satisfaction With Acupuncture Procedure | 22 |
Determine the effect of preoperative acupuncture on preoperative pain in the acupuncture group using the self-reported NPS (Numeric Pain Scale) which is a scale of 0-10 where 0 is "no pain" and 10 is "severe pain". Using the mean pain score to compare pre-acupuncture pain to post-acupuncture pain score in the acupuncture group only.
| score on a scale | Preoperative Pre-acupuncture | Preoperative Post-acupuncture |
|---|---|---|
| Preoperative Pain | 4.97 ± 3.01 | 2.90 ± 6.62 |
Postoperative opioid consumption to be converted into morphine milliequivalents (MMEs) and compared between the two groups for up to 24 hours post surgery.
| Morphine MilliEquivalent | Acupuncture | Control |
|---|---|---|
| Opioid Consumption | 45.51 ± 30.02 | 52.46 ± 30.92 |
The dose of Midazolam as an anxiolytic medication that was given at any time throughout hospitalization up to 24 postoperative hours.
| milligrams | Acupuncture | Control |
|---|---|---|
| Midazolam Use as Anxiolytic Medications | 3.96 ± 1.73 | 4.21 ± 1.80 |
Patients' satisfaction with overall care management was compared using the patient satisfaction scale of (1-10), where 1 is extremely unsatisfied and 10 is extremely satisfied with overall care. Each frequency represents the percentage of patients in each group who have been either satisfied or extremely satisfied (given a score of 9 or 10 out of 10). This assessment was done within a week after discharge, via a phone call.
| Participants | Acupuncture | Control |
|---|---|---|
| Patient Satisfaction Scale With Overall Care | 21 | 24 |
Compare the occurrence of postoperative nausea and vomiting using the Simplified Postoperative Nausea and Vomiting Impact Scale which consists of two questions, with a possible response total score of 0-6. Response score totals of 0-2 require no intervention. Response score totals of 3-4 may necessitate antiemetic medication. Response score totals of 5-6 are considered clinically important nausea requiring medication intervention, as this would constitute patients with excessive vomiting. This scale was used to report the occurrence of nausea (yes/no), with "yes" defined as any number above 0 in the scale, while "no" defined as 0.
| Participants | Acupuncture | Control |
|---|---|---|
| Yes | 0 | 4 |
| No | 30 | 26 |
The frequency of any antiemetic medication given at any time throughout hospitalization up to 24 postoperative hours
| number of doses | Acupuncture | Control |
|---|---|---|
| Antiemetic Medications | 0.0 (0.0 to 1.0) | 0.0 (0.0 to 1.0) |
Using the hospital admission and discharge dates \& times; this will be compared between the two groups.
| hours | Acupuncture | Control |
|---|---|---|
| Hospital Length of Stay | 29.5 (27.8 to 31.3) | 29.0 (27.0 to 30.0) |
Determine the effect of preoperative acupuncture on postoperative pain in both groups, using the self-reported NPS (Numeric Pain Scale) which is a scale of 0-10 where 0 is "no pain" and 10 is "severe pain". Using the mean pain score to compare the mean pain scores between groups upon arrival to the PACU.
| score on a scale | Acupuncture | Control |
|---|---|---|
| Postoperative Pain Upon Arrival to the PACU | 0.47 ± 1.36 | 1.38 ± 2.83 |
Determine the effect of preoperative acupuncture on postoperative pain in both groups, using the self-reported NPS (Numeric Pain Scale) which is a scale of 0-10 where 0 is "no pain" and 10 is "severe pain". Using the mean pain score to compare the mean of pain scores at the first postoperative hour between groups.
| score on a scale | Acupuncture | Control |
|---|---|---|
| Postoperative Pain at 1 Postoperative Hour | 1.67 ± 2.22 | 2.45 ± 3.15 |
Determine the effect of preoperative acupuncture on postoperative pain in both groups, using the self-reported NPS (Numeric Pain Scale) which is a scale of 0-10 where 0 is "no pain" and 10 is "severe pain". Using the mean pain score to compare the mean pain scores after three postoperative hours between groups.
| score on a scale | Acupuncture | Control |
|---|---|---|
| Postoperative Pain After 3 Postoperative Hours | 3.67 ± 3.03 | 4.55 ± 3.29 |
The number of participants who received a dose of midazolam exceeding 2 mg indicated a high level of perioperative anxiety that necessitated pharmacological intervention. The decision to use a dose higher than 2 mg was based on the standard practice of administering 2 mg of midazolam for preoperative regional nerve blocks; any dosage surpassing this amount was specifically intended for anxiety management.
| Participants | Acupuncture | Control |
|---|---|---|
| Number of Participants That Received Midazolam Dose >2mg | 19 | 22 |
Patients' satisfaction with their postoperative pain management was compared between groups using the satisfaction scale of (1-10), where 1 is extremely unsatisfied and 10 is extremely satisfied. Each frequency represented the percentage of patients in each group who were satisfied (given a score of 9 or 10 out of 10)This assessment was done within a week after discharge, via a phone call.
| Participants | Acupuncture | Control |
|---|---|---|
| Patient's Satisfaction With Pain Management | 19 | 20 |
Patients' satisfaction with their perioperative anxiety management was compared between groups using the satisfaction scale of (1-10), where 1 is extremely unsatisfied and 10 is extremely satisfied. Each frequency represented the percentage of patients in each group who were satisfied (given a score of 9 or 10 out of 10). This assessment was done within a week after discharge, via a phone call.
| Participants | Acupuncture | Control |
|---|---|---|
| Patient's Satisfaction With Anxiety Management | 21 | 19 |
Patients with acupuncture intervention were assessed for how likely to consider acupuncture for future surgeries using a scale of (1-4), where 1 is Very likely, 2 is Likely, 3 is Maybe, and 4 is Never. Each frequency represented the percentage of patients who were more likely (given a score of 1 or 2 out of 4) to receive acupuncture treatment in a future surgery. This assessment was done within a week after discharge, via a phone call.
| Participants | Acupuncture Group |
|---|---|
| Acupuncture Patients Who Were Likely to Consider Acupuncture for Future Surgeries | 25 |
Compare the occurrence of postoperative nausea and vomiting using the Simplified Postoperative Nausea and Vomiting Impact Scale which consists of two questions, with a possible response total score of 0-6. Response score totals of 0-2 require no intervention. Response score totals of 3-4 may necessitate antiemetic medication. Response score totals of 5-6 are considered clinically important nausea requiring medication intervention, as this would constitute patients with excessive vomiting. This scale was used to report the occurrence of nausea (yes/no), with "yes" defined as any number above 0 in the scale, while "no" defined as 0.
| Participants | Acupuncture | Control |
|---|---|---|
| Yes | 5 | 5 |
| No | 25 | 25 |
Determine the effect of preoperative acupuncture on postoperative pain in both groups, using the self-reported NPS (Numeric Pain Scale) which is a scale of 0-10 where 0 is "no pain" and 10 is "severe pain". To compare mean pain scores between groups, considering all 3 individual time points (at arrival to Post-Anesthesia Care Unit, 1st Postoperative hour, and 3rd Postoperative hour)
| score on a scale | Acupuncture | Control |
|---|---|---|
| at arrival to PACU | 0.47 ± 1.36 | 1.38 ± 2.83 |
| 1hr post-operation | 1.67 ± 2.22 | 2.45 ± 3.15 |
| 3hr post-operation | 3.67 ± 3.03 | 4.55 ± 3.29 |
Collected over Adverse events were collected up to 30 postoperative days. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Acupuncture Group | 0/30 (0%) | 0/30 (0%) | 13/30 (43.3%) |
| Control Group | 0/30 (0%) | 0/30 (0%) | 0/30 (0%) |
| Event | Acupuncture Group | Control Group |
|---|---|---|
| Local bleedingSurgical and medical procedures | 9/30 | 0/30 |
| Residual painSurgical and medical procedures | 3/30 | 0/30 |
| DiscomfortSurgical and medical procedures | 1/30 | 0/30 |
| Age, Continuous(Years) | Acupuncture | Control | Total |
|---|---|---|---|
| Mean | 69.60 ± 9.71 | 67.63 ± 7.71 | 68.62 ± 8.75 |
| Sex: Female, Male(Participants) | Acupuncture | Control | Total |
|---|---|---|---|
| Female | 22 | 25 | 47 |
| Male | 8 | 5 | 13 |
| Ethnicity (NIH/OMB)(Participants) | Acupuncture | Control | Total |
|---|---|---|---|
| Hispanic or Latino | 4 | 1 | 5 |
| Not Hispanic or Latino | 26 | 29 | 55 |
| Unknown or Not Reported | 0 | 0 | 0 |
| Race (NIH/OMB)(Participants) | Acupuncture | Control | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 0 | 0 | 0 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 0 | 4 | 4 |
| White | 26 | 24 | 50 |
| More than one race | 0 | 0 | 0 |
| Unknown or Not Reported | 4 | 2 | 6 |
| Body Mass Index (BMI)(kg/m2) | Acupuncture | Control | Total |
|---|---|---|---|
| Mean | 32.16 ± 5.31 | 30.44 ± 5.51 | 31.30 ± 5.44 |
| Charlson Comorbidity Index (CCI)(units on a scale) | Acupuncture | Control | Total |
|---|---|---|---|
| Median | 1.0 (0.0 to 2.0) | 0.0 (0.0 to 2.0) | 0.0 (0.0 to 2.0) |
| History of mental illness(Participants) | Acupuncture | Control | Total |
|---|---|---|---|
| History of mental illnesses | 15 | 12 | 27 |
| Anxiety | 13 | 10 | 23 |
| Bipolar disorder | 0 | 1 | 1 |
| Depression | 8 | 6 | 14 |
| History of acupuncture(Participants) | Acupuncture | Control | Total |
|---|---|---|---|
| Yes | 12 | 7 | 19 |
| No | 18 | 23 | 41 |
3 further baseline measures are reported on the registry.
Documents are hosted by the registry — open the source record to download them.
Plan to share: No
This study is completed, as verified in Mar 2025. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Hartford Hospital