Effects of Electroacupuncture on Intraoperative and Postoperative Analgesic Requirement

Abstract

Acupuncture has been shown to be effective in experimental and clinical acute pain settings. This study aims to evaluate the effect of preoperative electroacupuncture (EA) on intraoperative and postoperative analgesic (alfentanil and morphine) requirement in patients scheduled for gynaecologic lower abdominal surgery. Ninety patients were randomly assigned to one of three groups: Group I (control group) –received placebo EA for 45 minutes before induction of general anaesthesia (GA); Group II –preoperative EA instituted 45 minutes before induction of GA; Group III – 45 minutes of postoperative EA. The Bispectral Index monitor was used intraoperatively to monitor the hypnotic effect of anaesthetic drugs, and alfentanil was titrated to maintain the blood pressure and pulse rate within ±15% of basal values. Postoperative pain was managed by intravenous morphine via a patient-controlled analgesia (PCA) device. Patients in Group II (0.44 ± 0.15μg/kg/min) received less alfentanil than those in Group III (0.58 ± 0.22μg/kg/min) (p=0.024), but not significantly less than those in Group I (0.51 ± 0.21μg/kg/min) (p=0.472). Postoperative morphine consumption was numerically lower in Group II compared with the other groups; however, the difference was statistically significant only during the period of 6–12 hours between Group II [0.03 (0.05) mg/kg] and Group I [0.10 (0.11) mg/kg] (p=0.015), and Group II and Group III [0.08 (0.10) mg/kg] (p=0.010). The 24-hour cumulative morphine consumption for Group II (0.52 ± 0.19mg/kg) was less than that for either Group I (0.68 ± 0.38mg/kg) or Group III (0.58 ± 0.27mg/kg), but the difference did not reach significance. In conclusion, preoperative EA leads to a reduced intraoperative alfentanil consumption, though this effect may not be specific, and has a morphine sparing effect during the early postoperative period.

Postoperative and Preincisional Electrical Nerve Stimulation TENS Reduce Postoperative Opioid Requirement After Major Spinal Surgery

“…15 Beyond this, the effectiveness of preincisional electroacupuncture in reducing opioid requirements has been shown. 16,17 On the one hand, preincicsional TENS might produce differential effects on the production of pain-producing substances (eg, substance P, potassium, hydrogen ions, lactic acid, and bradykinin) immediately before skin incision. On the other hand, preincisional TENS influences the conductance of painful stimuli via k-receptors by producing ir-dynorphin A.…”

Randomised, Controlled Study of Preoperative Eletroacupuncture for Postoperative Pain Control after Cardiac Surgery

“…The use of EA in the preoperative of gynaecological surgery permitted the reduction in the consumption of opioids during and after surgery. 12 However, the use of preoperative EA is not a common practice as EA sessions are usually conducted immediately before surgery. That fact reduces its practical application because of other intensive demands of the surgical centre at that critical time and acupuncturists' reality (most acupuncturists do not work at hospitals and very few hospitals have a structured acupuncture department), which hinders the use of this technique immediately before surgical procedure.…”

Electroanalgesia for the postoperative control pain in dogs

“…Several studies have shown that patients receiving electrical stimulation applied at the traditional Chinese acupoints (electroacupuncture) prior to surgery have a lower level of pain, reduced opioid requirement, a lower incidence of post-nausea and vomiting, and lower sympatho-adrenal responses [2][3][4][5][6] . In addition, other studies have demonstrated that the electrical stimulation applied at the dermatomal levels corresponding to the skin incision also reduces pain and postoperative opioide analgesic requirement 7,8 .…”