Acupuntura no Tratamento da Dor em Pediatria: Revisão da Literatura

Introduction: Acupunture is a Traditional Chinese Medicine technique over 2500 years old. It is based on the principle that the energy travels through our bodies in special channels, called meridians. Traditionally it consists on the insertion of needles in specific anatomical spots (acupuncture points) with the purpose of a therapeutic effect. There is evidence on the efficacy and safety of acupuncture in the pain management of adults. Its use in children and adolescents is more complex, which justifies the scarcity of publications on this topic. Objective: To perform a systematic review of the literature on the possible benefits of acupuncture in the treatment of acute and chronic pain in the pediatric population. Methods: This systematic review was based on the PubMed database. The search was defined by the terms “pain”, “acupuncture” and “children”. Two hundred and fifty two papers were found and 10 fulfilled the inclusion criteria. Results: A meta-analysis was not possible due to the heterogeneity of interventions, age range and clinical conditions between the reviewed papers. We did an individual description of each paper following the chronological order of publication. Discussion and Conclusion: The papers reviewed were unanimous in showing efficacy and safety in the use of acupuncture, in the pediatric population, in the control of acute and chronic pain management. The studies concerning acute pain were 80% of the publications included in our review and the majority of those focused on postoperative pain. Acupuncture seems to be useful as adjunctive therapy in the perioperative period in the purpose of decreasing the administered doses of opioid analgesics and, consequently in reducing the incidence of their adverse effects. The role of acupuncture in pediatric chronic pain was, in our sample, addressed in only 2 prospective studies, both focusing on its efficacy in headache treatment. Despite the inherent limitations of each study all of them concluded that there is, with or without statistical significance, improvement in pain scores and higher satisfaction of children and their parents, withoutany complications and adverse effects.