Ask an answerable question (PICO)：
Bliud up a clinical question: explore if auricular point acupressure can relieve shoulder and neck pain within the patients after cervical spine surgery. PICO-P: patients after cervical spine surgery, I: auricular point acupressure, C: rountine treatment, O: shoulder pain or neck pain.
The Method and Analysis of Literature Review：
The study keywords of PICO, included: P (Patients with cervical spine sugery), I (Auricular point acupressure), C (Routine treatment) and O (Neck pain or shoulder pain). The above keywords, synonyms and the Mesh terms were combined with “OR” and the P, I, O were combined with “AND” through Boolean logic, and they were searched with multiple combination on Cochrane library, PubMed, Embase and Chinese Electronic Periodical Services (CEPS) of Airiti Library before August 2021, without language limitation of the literatures.
Critical Appraisal：
A total of 79 literatures were obtained in the database. We excluded duplicates, non-RCT, non-SR, low-level evidence, and those research design or methods did not meet PICO. Finally, a randomized controlled trial study and a systematic review of the literature were selected. We evaluated the effectiveness, importance and applicability by CASP in 2020 version; and the classification of evidence level by the Oxford Evidence Classification Standard in 2011 version.
Clinical Application of Evidence：
Using the 7 steps of empirical knowledge translation to improve, implement and analyzing the results was applied in this article. The study was designed as a single group before-and-after study, during September 16 to November 15, 2020, in three neurosurgery wards of a medical center in northern Taiwan. Auricular point acupressure was used as an interventional measure for pain relief.
Evaluation of Effectiveness：
A total of 25 cases were admitted. Patients after cervical spine surgery received interventional measures of auricular point acupressure. The Numerical Rating Scale (NRS) was 7.04±1.70 points before intervention and dropped to 1.20±1.08 points after intervention, with a total decrease of 5.84 points. The results of the study show that the auricular point acupressure is effective in reducing the degree of shoulder and neck pain after cervical spine surgery.
Conclusions and Recommendations：
The auricular point acupressure is effective in relieving shoulder and neck pain, adverse reactions, patients' complaints, and clinical economic benefits after cervical spine surgery. Therefore, it is recommended that it might be fully implemented in patients with cervical spine surgery. Otherwise, we will provide clinical nurses with on-the-job education and training and reply to teaching through the seed teacher, so as to provide patients with professional and effective pain relief treatment.
