Department of Obstetrics and Gynaecology, Westfries Gasthuis, P.O. Box 600, 1620 AR Hoorn, The Netherlands
Email: renckens{at}xs4all.nl
Sir,
In their paper on the analgesic effects of electro-acupuncture (EA) during oocyte retrieval, Humaidan and Stener-Victorin drew a number of positive conclusions on this method, which is now the analgesia of choice in 50% of the patients in the Fertility Clinic in Skive, Denmark. I think that their conclusions can be modified considerably and will argue that conventional methods of pain relief during oocyte retrieval are still preferable. Regarding the adequacy of the EA analgesia, we learned that although the authors apparently have been able to convince their patients of the reliability and efficacy of EA, in the EA group the experienced pain was more severe than in the group receiving conventional analgesia (and 9% needed supplementation with an opiate). Of course many patients being confronted with enthusiastic and dedicated nurses and physicians, strongly convinced that EA produces adequate analgesia, will be prepared to tell them that the pain was bearable. This does not mean that they would not have preferred the conventional medical analgesia, had they been able to compare or choose. The main advantages that should compensate for the less effective analgesia of EA are a shorter hospitalization time and lower costs. These advantages are, however, of the type statistically significant, but clinically irrelevant: per patient, the EA was 1.34 Euro cheaper and the EA patients left the clinic some 8 min earlier. That was all.
I will refrain from commenting on the difference in acupuncture points presently en vogue in Denmark and Sweden, but the fact that both practices were successful does strengthen my conviction that EA has nothing to do with atavistic absurdities such as meridians and acupuncture points. Its effects can be adequately explained by the resulting distraction of attention and by the weakly analgesic effect of counter-irritation.
References
Humaidan P and Stener-Victorin E (2004) Pain relief during oocyte retrieval with a short duration electro-acupuncture techniquean alternative to conventional analgesic methods. Hum Reprod 19, 13671372.