Table 3.

Nonpharmacologic therapy including acupuncture for acute pain in the ICU

Authors, Year	Modality/ Kind of Study, Number	Setting and Types of Pain	Outcomes/Comparators	Results	Recommendation
Sandvik et al. 2020 [55]	Review of 12 studies Hypnosis, massage, distraction, relaxation, spiritual care, harp music, music therapy, listening to natural sounds, passive exercise, acupuncture (n = 576), ice packs, and emotional support.	ICU Pain provoking tissue damage, disease, surgery/medical and nursing procedures	Measures: VAS (7); NRS (2); Edmonton Symptom Assessment (1); observational pain scale and BPS (2). Various designs: quasi-experiments with control groups (6); a tx with matched controls (1); case-controlled study with pre- and post-tests (1); an intervention without control using pre- and post-tests (1); qualitative descriptive (2); crossover design with randomization (1)	Reduced pain intensity from hypnosis, acupuncture, and natural sounds	Overall SOE not assessed. Suggest use of comprehensive multimodal interventions to investigate effects of nonpharmacologic tx protocols on pain, intensity, pain proportion, and impact on opioid consumption and sedation requirements.

BPS = Brief Pain Scale; NRS = numerical rating scale; SOE = strength of evidence; tx= treatment; VAS = visual analog scale.