Background: Press needle (PN) acupuncture is a non-pharmacological alternative that may reduce pain and analgesic use. This study aimed to evaluate the efficacy of PN acupuncture in managing postoperative pain in pediatric patients admitted to the Pediatric Intensive Care Unit (PICU). Methods: A randomized controlled trial was conducted at the Mother and Child Health Center, Dr. Cipto Mangunkusumo National Central Public Hospital, Jakarta, Indonesia. Seventy postoperative children aged 1–18 years admitted to the PICU were enrolled and randomly assigned to two groups. The intervention group received PN acupuncture at bilateral MA-TF1 Shenmen, thalamus points, LI4-Hegu, and LR3-Taichong with superficial insertion depth; the control group received sham acupuncture. Pain scores and analgesics use were recorded at 0, 1, 6, 24, 48, and 72 h, with adjustments to type and dose based on World Health Organization (WHO) pain ladder. This study was funded by Universitas Indonesia through the PUTI Grant (Contract No. NKB-70/UN2.RST/HKP.05.00/2024). Results: Baseline characteristics were comparable between groups. Pain scores decreased significantly over time in both groups, with a greater reduction in the intervention group (mean difference at 72 h: 0.43; 95% CI: 0.20–0.66; p < 0.0000). Although not statistically significant, there was a trend toward lower analgesic use, particularly paracetamol and ketorolac, in the intervention group. No adverse events were reported. Conclusions: PN acupuncture was well-tolerated and showed potential efficacy in reducing pain and analgesic use in pediatric postoperative patients. (Clinical-Trials.gov under the code NCT06390007).
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