Acupuncture at the P6 Acupoint to Prevent Postoperative Pain after Craniotomy: A Randomized, Placebo-Controlled Study

Abstract

Objective. Acute pain management after craniotomy can be challenging. Previous studies have shown inadequate pain control following the procedure. Oral medication can sometimes be delayed by postoperative nausea, and use of anesthetics may impair the assessment of brain function. We conducted this prospective study to evaluate the effect of acupuncture at the P6 acupoint on postoperative pain, nausea, and vomiting in patients undergoing craniotomy. Methods. The authors conducted a randomized, placebo-controlled trial among 120 patients scheduled for craniotomy under general anesthesia. 120 patients were randomly assigned into an acupuncture group or a sham acupuncture group. All patients received standardized anesthesia and analgesia treatment. Acupuncture was executed in the recovery room after surgery. For the acupuncture group, the P6 points on each wrist were punctured perpendicularly to a depth of 20 mm. Needles were retained for 30 min and stimulated every 10 min to maintain the De-Qi sensation. For the sham acupuncture group, sham points on each wrist were punctured perpendicularly to a depth of 5 mm. Needles were retained for 30 min with no stimulation during the duration. The postoperative pain scores, PONV, and dose of tramadol were assessed 24 h, 48 h, and 72 h after surgery. Results. A total of 117 patients completed the study. There was no statistically significant difference in baseline data between the two groups ( P > 0.05 ). The VAS pain score of the acupuncture group was lower than that of the sham acupuncture group, and this difference was statistically significant ( P = 0.002 ). There was no difference in pain scores between the two groups during 0–24 h and 48–72 h ( P > 0.05 ). The incidence of vomiting in the acupuncture group was lower than that in the sham acupuncture group during the 0–24 h period (13.8% vs. 28.8%, P = 0.048 ). There was no difference in vomiting, however, during the 24–72 h period ( P > 0.05 ). No significant differences were found in the degree of nausea and the dose of tramadol between the two groups at either time point in the acupuncture group and sham acupuncture group. Conclusion. The use of acupuncture at the P6 acupoint in neurosurgery patients did result in significantly lower pain scores and reduction in the incidence of vomiting after craniotomy. There were no significant side effects. Acupuncture at the P6 acupoint was well tolerated and safe in this patient population.

Effective Oriental Magic for Analgesia: Acupuncture

“…( 6) How to avoid bias produced by acupuncture specificity remains to be addressed, and the criteria for acupuncture quantification are unclear. (7) rough the literature measurement tool, we can clarify the current research trend and the cross-research between disciplines and even countries, which is significantly beneficial to the research progress of acupuncture treatment of pain, but there are still deficiencies. e literature selected in this paper is in English, while other languages are not included, which may lead to bias in some aspects.…”

“…So far, the most effective drugs to relieve pain are opioids, and the most widely used drugs are nonsteroidal anti-inflammatory drugs (NSAIDs); at the same time, addiction, drowsiness, and other side effects could not be ignored [ 5 , 6 ]. Abuse of painkillers may cause serious damage to brain function [ 7 ]. The severe opioid crisis is a tough issue that deserves more attention.…”

Additional Benefit of Intraoperative Electroacupuncture in Improving Tolerance of Deep Brain Stimulation Surgical Procedure in Parkinsonian Patients

“…Stimulation intensity was adapted to the patient’s perception, at the limit of the pain threshold, and, if possible, provoking a motor reaction. These are the generally accepted parameters for optimal analgesia [ 42 , 43 ].…”

“…The choice of the acupuncture points was based on the fact that these points belong to a common set of analgesic acupuncture points, notably used in surgery, and frequently cited in publications in this context [ 25 , 26 , 27 , 42 , 43 ]. In addition to analgesia, their other potential actions are effects on the autonomic nervous system, in particular nausea and vomiting (Neiguan P 6), headaches (Hegu LI 4, Taichong LV 3), or sleep (Sanyinjiao SP 6).…”

Electroacupuncture at ST36 (Zusanli) Prevents T-Cell Lymphopenia and Improves Survival in Septic Mice

“… 22 Acupuncture at P6 ( Neiguan ) acupoint significantly reduced the Visual Analog Scale pain score within 24–48 h in patients after craniotomy, reduced the incidence of vomiting within 24 h (the incidence rate in the acupuncture group is only 1/2 of that of the sham acupuncture group), and effectively prevented postoperative pain. 23 The study found that EA pretreatment at bilateral ST36 ( Zusanli ) acupoints significantly improved the intestinal function (the injury score of the EA pretreatment group is only 1/2 of that of the sepsis group) and survival rate (EA+Sepsis vs Sepsis: 75% vs 25%) in septic rats. 24 A randomized controlled trial showed that conventional therapies combined with EA at ST36 and ST37 ( Shangjuxu ) acupoints significantly reduced plasma level of TNF-α (from baseline 94.33±29.87 pg/mL to 19.68±11.70 pg/mL) and traditional Chinese medicine quantitative scores of intestinal dysfunction (from baseline 9.8±2.7 to 6.9±2.5) on day 7 in septic patients, and the effect of EA treatment group was better than that of conventional treatment alone.…”