Electroacupuncture Alleviates Intraoperative Immunosuppression in Patients Undergoing Supratentorial Craniotomy

Abstract

Background Clinical experience suggests that anaesthesia using a combination of acupuncture and drugs can reduce the dosage of anaesthetics required for craniotomy, decreasing both the disturbance in physiological functions during the operation and postoperative complications and improving the rate of recovery. The aim of the present study was to investigate the impact of electroacupuncture (EA) on the dynamic equilibrium of the immune system and immune cell populations during the pericraniotomy period. Methods A total of 56 patients undergoing craniotomy were randomised into three groups: control (C, n=18), EA (A, n=19) and sham acupuncture (S, n=19) groups. Blood samples were collected before anaesthesia (T0) and 30 min, 2 h and 4 h after induction of anaesthesia (T1, T2 and T3, respectively,) to measure the levels of tumour necrosis factor α (TNFα), interleukin (IL)-8, IL-10, IgM, IgA, IgG and full blood count. Results There was no significant difference between the measurements in groups A and S during craniotomy. The levels of IgM and IgA decreased significantly in group C compared with groups A and S at T2 and T3 time points. The levels of total T cells and suppressor T cells in group C decreased significantly compared with groups A and S at T1 and T2, and the level of natural killer cells in group C decreased significantly compared with groups A and S at T1. No significant differences between groups were found in the levels of TNFα, IgG, IL-10, IL-8, leucocytes, neutrophils, monocytes, Th cells or B cells. Conclusions EA appears to reduce immunosuppression of both the humoral and cellular components during surgery.

Effects of flurbiprofen axetil on postoperative serum IL-2 and IL-6 levels in patients with colorectal cancer

“…Many studies have indicated that postoperative pain is one of the most important factors causing immunosuppression during the perioperative period (Li et al, 2013). Rational analgesics may effectively inhibit the stress induced by pain, reduce the incidence of complications, and promote the patient's recovery.…”

Sham Electroacupuncture Methods in Randomized Controlled Trials

“…Among them, 5 studies29549095107 were published between 1992 and 1999; 33 studies22242527303138454752535657586768717273747778818384929397104105106110111 were published between 2000 and 2010; the remaining 56 studies1819202123262832333435363739404142434446484950515559606162636465666970757679808285868788899194969899100101102103108109 were reported from 2010 to 2015 (Fig. 2).…”

“…2). Indications for EA included pain (32 studies)1819212426273133363740424547515256606667727682848890929697103110111, anesthesia (8 studies)46507374868994102, stroke (7 studies)2528293462105106, depression (6 studies)235359656880, obesity (4 studies)32495470, primary dysmenorrheal/menstrual pain (4 studies)619899101, substance abuse (heroin or smoking) (3 studies)6495107, osteoarthritis (2 studies)22104, migraine (2 studies)3978, nausea and vomiting (2 studies)3857, postoperative ileus (2 studies)3591, insomnia (2 studies)6381, benign prostate hyperplasia (2 studies)7987, diabetic mellitus related diseases (2 studies)83109, carpal tunnel syndrome (1 study)100, rheumatoid arthritis (1 study)93, whiplash-associated disorders (1 study)69, constipation (1 study)48, multiple sclerosis (1 study)41, tinnitus (1 study)20, auditory hallucination (1 study)30, attention deficit hyperactivity disorder (1 study)…”

“…EA treatment alone was adopted in 55 trials1920212223242526282930313435363738394243535558606166686971727577787980838485868788899091959899100101103104107108110111, while the interventions of the remaining 39 trials were a combination of EA and western conventional medicine (WCM). Four trials244754100 were designed as two groups of EA, and seven trials384361639899101 were conducted with two groups of sham EA.…”

Narrative Review of Perioperative Acupuncture for Clinicians

“…According to a study by Li et al [55], electroacupuncture applied during supratentorial craniotomy surgery to the points LI-4 (Hegu), TE-5 (Weiguan), BL-63 (Jinme), LR-3 (Taichong), ST-36 (Zusanli), GB-40 (Quixu), BL-10 (Tianzhu), GB-20 (Fengchi), BL-2 (Cuanzhu), and EX-HN4 (Yuyao) appears to reduce immunosuppression of humoral and cellular constituents in patients. Perioperative acupuncture has also been shown to decrease intraoperative anesthetic requirements, but outcomes illustrating clinical translation and significance are variable [56e59].…”