Effect of electroacupuncture on opioid consumption in patients with chronic musculoskeletal pain: protocol of a randomised controlled trial

This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The electronic version of this article is the complete one and can be found online at: http://www.trialsjournal.com/content/13/1/169BACKGROUND Chronic musculoskeletal pain is common and has been increasingly managed by opioid medications, of which the long-term efficacy is unknown. Furthermore, there is evidence that long-term use of opioids is associated with reduced pain control, declining physical function and quality of life, and could hinder the goals of integrated pain management. Electroacupuncture (EA) has been shown to be effective in reducing postoperative opioid consumption. Limited evidence suggests that acupuncture could assist patients with chronic pain to reduce their requirements for opioids. The proposed research aims to assess if EA is an effective adjunct therapy to standard pain and medication management in reducing opioids use by patients with chronic musculoskeletal pain. METHODS In this multicentre, randomised, sham-acupuncture controlled, three-arm clinical trial, 316 patients regularly taking opioids for pain control and meeting the defined selection criteria will be recruited from pain management centres and clinics of primary care providers in Victoria, Australia. After a four-week run-in period, the participants are randomly assigned to one of three treatment groups to receive EA, sham EA or no-EA with a ratio of 2:1:1. All participants receive routine pain medication management delivered and supervised by the trial medical doctors. Twelve sessions of semi-structured EA or sham EA treatment are delivered over 10 weeks. Upon completion of the acupuncture treatment period, there is a 12-week follow-up. In total, participants are involved in the trial for 26 weeks. Outcome measures of opioid and non-opioid medication consumption, pain scores and opioid-related adverse events are documented throughout the study. Quality of life, depression, function, and attitude to pain medications are also assessed. DISCUSSION This randomised controlled trial will determine whether EA is of significant clinical value in assisting the management of debilitating chronic pain by reducing opioids consumption and their associated adverse events, as well as improving the quality of life for those with chronic pain. Such an outcome will provide the rationale for including EA into multidisciplinary programmes for effective management of chronic musculoskeletal pain. TRIAL REGISTRATION Australian New Zealand Clinical Trial Registry (ACTRN12609000676213) http://www.anzctr.org.au/trial_view.aspx?ID=308008Charlie CL Xue, Robert D Helme, Stephen Gibson, Malcolm Hogg, Carolyn Arnold, Andrew A Somogyi, Cliff Da Costa, Yanyi Wang, Shao-chen Lu and Zhen Zhen

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

An Examination of Pain Perception and Cerebral Event-Related Potentials following Carbon Dioxide Laser Stimulation in Patients with Alzheimer’s Disease and Age-Matched Control Volunteers

BACKGROUND: Pain perception is known to depend on integrated cognitive processing. Alzheimer's disease affects 5% to 10% of older adults, but the impact of this disease on pain sensitivity and report has yet to be fully investigated

Husserl's Theory of a Priori Knowledge: A Response to the Failure of Contemporary Rationalism

I argue that recent rationalists' accounts of a priori knowledge suffer from two substantial weaknesses: an inadequate phenomenology of a priori insight , and the error of psychologism. I show that Husserl's theory of a priori knowledge presents a defensible and viable alternative for the contemporary rationalist, an alternative that addresses both the ontology and phenomenology of rational intuition, as well as such contemporary concerns as the possibility and character of a priori error, the empirical defeasibility of a priori claims, the relation of mind to necessity, and the role of conception and imagination in a priori knowledge. Consequently, I conclude that Husserl's theory provides the needed response to the 20 th century critique of rationalism, and its attendant a priorism, as mysterious and obscur