Acupuncture Reduces Pain, Need for Opioids after Surgery

Oct 17, 2007

Using acupuncture before and during surgery significantly reduces the level of pain and the amount of potent painkillers needed by patients after the surgery is over, according to Duke University Medical Center anesthesiologists who combined data from 15 small randomized acupuncture clinical trials.

"While the amount of opioids needed for patients who received acupuncture was much lower than those who did not have acupuncture, the most important outcome for the patient is the reduction of the side effects associated with opioids," said Tong Joo (T.J.) Gan, M.D., a Duke anesthesiologist who presented the results of the analysis at the annual scientific conference of the American Society for Anesthesiology in San Francisco. "These side effects can negatively impact a patient's recovery from surgery and lengthen the time spent in the hospital."

Based on the results of this analysis, Gan recommends that acupuncture should be considered a viable option for pain control in surgery patients.

Patients who received acupuncture had significantly lower risk of developing most common side effects associated with opioid drugs compared with control: 1.5 times lower rates of nausea, 1.3 times fewer incidences of severe itching, 1.6 times fewer reports of dizziness and 3.5 times fewer cases of urinary retention.

Opioids are a class of medications that act on the body much like morphine. While they are effective in controlling pain, the side effects of the drugs often influence a patient's recovery from, and satisfaction with, their surgery, Gan said.

The results of this study add to the growing body of evidence that acupuncture can play an effective role in improving the quality of the surgical experience, Gan added. Numerous studies, some conducted by Gan, have demonstrated that acupuncture can also be more effective than current medications in lessening the occurrence of post operative nausea and vomiting, the most common side effect experienced by patients after surgery.

"Acupuncture is slowly becoming more accepted by American physicians, but it is still underutilized," Gan said. "Studies like this, which show that there is a benefit to using it, should help give physicians sitting on the fence the data they need to integrate acupuncture into their routine care of surgery patients."

Acupuncture has the added benefits of being inexpensive, with virtually no side effects, when done by properly trained personnel, Gan added.

The Chinese have been using acupuncture for more than 5,000 years for the treatment of a variety of ailments, including headaches, gastrointestinal disorders and arthritis. According to Chinese healing practices, there are about 360 specific points along 14 different lines, or meridians, that course throughout the body just under the skin.

"The Chinese believe that our vital energy, known as chi, flows throughout the body along these meridians," Gan explained. "While healthiness is a state where the chi is in balance, unhealthiness or disease state arises from either too much or too little chi, or a blockage in the flow of the chi."

Different bodily locations or organs have their own distinct acupuncture points that are the targets for the acupuncturist. For example, a point just below the wrist is the common target for women undergoing breast procedures to prevent nausea and vomiting, another point at the back of the hand is effective in reducing pain.

While it is not completely known why or how acupuncture works, recent research seems to point to its ability to stimulate the release of hormones or the body's own painkillers, known as endorphins, Gan said. He is now conducting studies to determine the exact mechanism behind acupuncture's effects.

Other members of the research team included Yanxia Sun, John Dubose and Ashraf Habib. The meta-analysis was supported by Duke's Department of Anesthesiology.

Source: Duke University Medical Center

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