• Miaomiao Liu, Yingge Tong, Ling Chai, Siqing Chen, Zihao Xue, Yi Chen, and Xiaoyan Li.
• Medical College, Hangzhou Normal University, Hangzhou, Zhejiang, China; Shaoxing Vocational & Technical College, Shaoxing, China.
• Pain Manag Nurs. 2021 Jun 1; 22 (3): 268-280.

ObjectivesThis systematic review aimed to summarize and provide an update on clinical studies investigating the effects of auricular point acupressure (APA) on pain relief, in addition to the APA methods of delivery and operation.DesignA systematic review.Data SourcesA systematic review on literatures published on five English (PubMed, Web of Science, Embase, EBSCO, and Cochrane databases) and four major Chinese databases (China National Knowledge Infrastructure, Wan Fang Data, Chinese Scientific Journals Database [VIP], and SinoMed) was conducted.MethodWe screened nine electronic databases from the time of their respective establishment until December 20, 2019. Randomized controlled trials and studies that defined an APA intervention measure and evaluated pain intensity were considered. We individually categorized and analyzed 46 studies considering the following: (1) acute or chronic pain and (2) whether the outcomes positively or negatively support the effectiveness of APA on pain intensity. We also summarized the methods of delivery used (including the acupoint selection, stimulator selection, method of taping seeds on the ears, frequency of replacing seeds, suitability of acupressure intensity, acupressure frequency, and pressing time) and APA operator.ResultsRegardless of pain intensity, APA effectively treated most acute pain when combined with other interventions. Although it was used alone to treat low back pain and dysmenorrhea, other chronic diseases typically underwent a combination of APA with other interventions. The 43 positive studies revealed that acute pain required shorter APA intervention periods than chronic pain. Corresponding acupoints and nervous system acupoints were chosen. Vaccaria seeds, the single-ear method (including the alternate-ear method), and daily seed replacement were commonly adopted. Deqi was considered an effective signal for appropriate acupressure intensity. Additionally, the patients could effectively apply acupressure.ConclusionThis systematic review revealed important trends in APA treatments, which could be essential in determining treatment efficacy.Copyright © 2020 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

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