Skip to main content
Download PDF

Narrative Review of Perioperative Acupuncture for Clinicians

Innovations in Acupuncture and Medicine volume 8, pages 264–269 (2015)Cite this article

Abstract

Acupuncture is one of the oldest forms of the natural healing arts. The exact mechanisms of action are unknown at this time; however, current theories to explain the benefits experienced after acupuncture include Traditional Chinese Medicine and Western medicine concepts. Acupuncture may improve the quality of perioperative care and reduce associated complications. Perioperative acupuncture is apparently effective in reducing preoperative anxiety, postoperative nausea and vomiting, and postoperative pain. The Pericardium-6 (P-6; Nei Guan), Yintang (Extra 1), and Shenmen acupuncture points are the most studied and effective acupuncture points in reducing preoperative anxiety, postoperative nausea and vomiting, and postoperative pain experiences. Intraoperatively administered acupuncture may reduce immunosuppression in patients and lessen intraoperative anesthetic requirements, although the clinical usefulness of acupuncture in the intraoperative period remains inconclusive. Perioperative acupuncture is a promising intervention, but additional studies are needed to further understand and define acupuncture’s role throughout the perioperative period and determine its clinical usefulness. The purpose of this article is to provide a brief clinical review concerning acupuncture and its application for common issues that occur in the perioperative period.

1. Introduction

Acupuncture is described as “a family of procedures involving the stimulation of anatomical points on the body using a variety of techniques” [1]. There are multiple forms of specific acupuncture practice such as needle acupuncture, acupuncture point injection, and auricular acupuncture. Acupuncture is a main pillar of Traditional Chinese Medicine, which also includes acupressure, moxibustion, cupping, and use of medicinal herbs. The most common types of acupuncture utilized in Western medical practice and research are needle acupuncture and auricular acupuncture. These techniques entail manually inserting small needles superficially into the skin at specific anatomical points throughout the body [1]. Once the needles are properly placed, they are commonly manipulated by hand or connected to electrical stimulation [1].

Acupuncture is one of the oldest forms of the natural healing arts. Its use may date to as early as the 4th or 3rd century BC [2]. In 1971, the practice of acupuncture and its benefits gained much attention in the United States after reporter James Reston developed acute appendicitis while covering President Nixon’s visit to China. It has been documented that acupuncture treatment was an integral component of his postoperative care [2,3]. Mr. Reston’s experience was described in an article publicized in the New York Times, which created a surge in American research interest that prompted Western scientists to study its potential contribution to Western medicine [2,3]. The introduction of advanced imaging modalities such as magnetic resonance imaging (MRI) and positron emission tomographic (PET) scanning in the following years further aided the interest and study of acupuncture [2,4–8]. At this time, a significant collection of scientific literature has been accumulated concerning the implications of acupuncture for the management of multiple ailments such as postoperative pain, nausea and vomiting, osteoarthritis pain, rheumatoid arthritis pain, low back pain, headaches, knee pain, depression, and anxiety. In addition, multiple studies have investigated the physiological mechanism of acupuncture. However, it remains to be completely understood.

Traditional Chinese Medicine theory recognizes the concept of qi, which is described as “life force” or “energy.” Traditional Chinese Medicine treatments attempt to identify energetic imbalances within a patient and subsequently restore the discovered disharmonies [9]. Traditional acupuncture treatments consist of stimulating specific points on any of 12 individual “meridians” that control the flow of qi throughout the body. Each meridian has a distinct number of points located along it, and it passes through or near a related organ for which the meridian is named [2]. There are 365 common points that inhabit the 12 meridians, with each point denoted by the meridian name followed by a specific number [e.g., Lung-7 (LU-7)] [2]. In addition to points within the meridian system, several points and systems exist on “extra” meridians and anatomical regions such as the ear (i.e., auricular acupuncture).

Western science has attempted to understand the physiological mechanisms to explain the benefits experienced after acupuncture treatment. Based upon the results of multiple scientific studies, various theories on the analgesic mechanism of action have been concluded. Such theories include the release of endogenous opioids such as beta-endorphins, stimulation of descending antinociceptive pathways, release of inhibitory neurotransmitters such as norepinephrine and serotonin, modulation of the hypothalamic-limbic system, activation of the pain neuromatrix, and a placebo effect [2,4,8,10,11]. However, the mechanisms of these actions are yet to be fully identified and understood.

2. Application of acupuncture in the perioperative period

Acupuncture appears to be a promising intervention for various uses throughout the stages of perioperative care. Acupuncture utilization can be assigned and grouped into three perioperative application periods: (1) preoperative preparation; (2) intraoperative; and (3) postoperative care [2] (Table 1).

3. Preoperative preparation period

The application of acupuncture during the preoperative period appears to effectively reduce preoperative anxiety, enhance analgesia, minimize postoperative pain, and diminish postoperative nausea and vomiting (PONV) [12–17]. These beneficial effects of preoperative acupuncture may be attributed to the sedative effects of treatment. Studies indicate that increased anxiety may be related to increased pain levels, particularly postoperative pain and subsequent analgesic consumption [2,18–21].

Table 1 Application of perioperative acupuncture.*
Full size table

According to recent studies, body and auricular acupuncture point treatments are both effective in modulating anxiety in preoperative patients. Multiple studies have indicated that acupuncture administered at the Yintang (Extra 1) point effectively decreases anxiety such as preoperative anxiety [22–26] (Fig. 1). In addition, stimulation of auricular acupuncture points such as the Relaxation point is effective in treating preoperative anxiety [27–29].

Figure 1
figure 1

Yintang (Extra 1) acupoint.

Full size image

Preoperative acupuncture treatment is a valuable intervention in reducing PONV. Acupuncture intervention for PONV yields a positive influence when administered administration in the pre- and postoperative periods. Other acupuncture points have been studied in this context, although the P-6 (Nei Guan) point is the most effective of the studied points [12,13,30–48].

4. Intraoperative period

The clinical usefulness of acupuncture in the intraoperative period remains inconclusive [49]. Some studies have shown that intraoperative acupuncture combined with orthodox anesthetic practices is safe, can reduce the required dose of opioids, and may yield a higher level of comfort during the postoperative period in comparison to the unaccompanied administration of anesthesia [50,51]. However, some studies have yielded dubious outcomes and further research is necessary [52–54].

Acupuncture may reduce immunosuppression in patients and decrease intraoperative anesthetic requirements [55–59]. 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 [56–59]. The body acupuncture point SP-6 (San Yin Chiao) and the auricular acupuncture points Lateral Control Point, Shenmen, Thalamus, Tranquilizer, and Master Cerebral Point decrease intraoperative anesthetic requirements [56,57,59] (Fig. 2).

Figure 2
figure 2

Shenmen auricular acupoint.

Full size image

5. Postoperative care period

Postoperative nausea and vomiting continues to be a very common challenge during the postoperative period. There is a variety of available prophylactic antiemetic interventions and the incidence of PONV has been significantly reduced in recent years; however, it has been reported that up to 70% of high-risk patients are still affected [2,60,61]. Acupuncture for the treatment of PONV is an effective intervention. The use of preoperatively administered acupuncture and/or postoperative administered acupuncture both effectively reduce PONV. Multiple acupuncture points have been investigated regarding their role in treating and preventing PONV; however, stimulation of the P-6 (Nei Guan) point appears to be the most effective method in reducing PONV with acupuncture intervention [12,13,30–48] (Fig. 3).

Figure 3
figure 3

P-6 (Nei Guan) acupoint.

Full size image

Postoperative pain is a regular concern in the perioperative period. Acupuncture may be an effective adjunctive intervention for postoperative pain by reducing the required doses of analgesics (primarily opioids) and subsequent complications. The use of acupuncture could be especially valuable for high-risk patients such as patients who have chronic obstructive pulmonary disorder or obstructive sleep apnea, which may be prone to complications (primarily respiratory depression) from analgesics [62]. Stimulation of multiple body acupuncture points appear to be capable of reducing postoperative pain. Based on a systematic review and meta-analysis of randomized controlled trials concerning auricular acupuncture for pain management, Asher et al [63] concluded that auricular acupuncture may be valuable in the treatment of a variety of types of pain, particularly postoperative pain [63]. Various studies have shown reduced postoperative pain after the stimulation of several acupuncture points such as the body acupuncture points P-6 (Nei Guan), GB-21 (Jinajing), LU-1 (Zhongfu), LI-11 (Quchi), LI-4 (Heu), TE-3 (Zhongzhu), TE-5 (Waiuan), and the auricular acupuncture points Shenmen, Heart, Lung, Tooth, Mouth, Uterus, Cushion, Thalamus, Hip, Knee, and Forehead [47,48,62–64]. The acupuncture points that have been most studied and have demonstrated the greatest influence on reducing postoperative pain are P-6 and Shenmen. Future studies are necessary to further develop an understanding of the clinical importance.

6. Discussion

Approximately 240 million surgical procedures are performed annually worldwide [65]. Severe pain after surgical procedures is a major factor causing patient dissatisfaction, delayed recovery, immobility, and prolonged hospital stay in the postoperative period and is associated with severe complications such as chronic pain. [66,67]. Gerbershagen et al [68] showed that severe pain is an issue after major surgery and after many minor surgeries. Optimal perioperative pain management is an ethical issue and a medical and economic concern [69]. Despite the implementation of guidelines on postoperative pain, many patients continue to experience severe postoperative pain [67,70,71]. A recent study demonstrates that a young age, preoperative chronic pain intensity, and female sex are associated with a higher postoperative pain intensity and that these associations are consistent for a large number of different types of surgery [69].

Acupuncture is one of the oldest forms of healing and its acceptance in Western medicine is rapidly increasing. Perioperative acupuncture appears to be effective in reducing preoperative anxiety, PONV, and postoperative pain. Preoperative stimulation of the Yintang (Extra 1) point and Relaxation point seem to positively influence preoperative anxiety. Stimulation of P-6 (Nei Guan) appears to be the most effective acupuncture method in reducing PONV. The clinical usefulness of acupuncture administered to LI-4, TE-5, BL-63, LR-3, ST-36, GB-40, BL-10, GB-20, BL-2, and EX-HN4 in the intraoperative period remains unclear; however, this treatment may improve immunosuppression in patients and decrease intraoperative anesthetic requirements, particularly with the stimulation of SP-6, (San Yin Chiao), Lateral Control Point, Shenmen, Thalamus, Tranquilizer, and Master Cerebral Point. Acupuncture administered in the postoperative period, particularly through stimulation of P-6 (Nei Guan) and Shenmen points, effectively reduce postoperative pain levels, and may be particularly beneficial for patients at a high risk of complications from analgesics. Acupuncture treatment in the perioperative period appears to be a promising intervention in positively influencing various perioperative issues. Patients with significant preoperative anxiety, who are at high risk for PONV, have a high tolerance of opioids, or are expected to have significant postoperative pain may receive the most benefit from perioperative acupuncture.

There is a significant lack of high-quality research with regards to perioperative acupuncture, particularly in the area of intraoperative acupuncture. Further studies are needed to assess the safety and efficacy of intraoperative acupuncture and to predict patient subgroups that are most likely to respond positively to perioperative acupuncture. In particular, the at-risk demographics, young age, high preoperative chronic pain intensity, and the female sex should be targeted in larger scale trials.

Disclosure statement

The authors declare that they have no conflicts of interest and no financial interests related to the material of this manuscript.

References

  1. National Center for Complementary and Alternative Medicine (NCCAM). Acupuncture: What You Need To Know. Available at: http://nccam.nih.gov/health/acupuncture/introduction.htm. [Date accessed: January 25, 2015].

    Google Scholar 

  2. Chernyak GV, Sessler DI. Perioperative acupuncture and related techniques. Anesthesiology. 2005;102:1031–1049. quiz 1077–8.

    Google Scholar 

  3. Reston J. Now, about my operation in Peking. New York: New York Times; 1971:A1–A6.

    Google Scholar 

  4. Biella G, Sotgiu ML, Pellegata G, Paulesu E, Castiglioni I, Fazio F. Acupuncture produces central activations in pain regions. Neuroimage. 2001;14:60–66.

    Google Scholar 

  5. Cho ZH, Oleson TD, Alimi D, Niemtzow RC. Acupuncture: the search for biologic evidence with functional magnetic resonance imaging and positron emission tomography techniques. J Altern Complement Med. 2002;8:399–401.

    Google Scholar 

  6. Kong J, Ma L, Gollub RL, Wei J, Yang X, Li D, et al. A pilot study of functional magnetic resonance imaging of the brain during manual and electroacupuncture stimulation of acupuncture point (LI-4 Hegu) in normal subjects reveals differential brain activation between methods. J Altern Complement Med. 2002;8:411–419.

    Google Scholar 

  7. Wu MT, Hsieh JC, Xiong J, Yang CF, Pan HB, Chen YC, et al. Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the braindpreliminary experience. Radiology. 1999;212:133–141.

    Google Scholar 

  8. Wu MT, Sheen JM, Chuang KH, Yang P, Chin SL, Tsai CY, et al. Neuronal specificity of acupuncture response: a fMRI study with electroacupuncture. Neuroimage. 2002;16:1028–1037.

    Google Scholar 

  9. Council of Colleges of Acupuncture and Oriental Medicine. Frequently Asked Questions. Available at: http://www.ccaom.org/faqs.asp. [Date accessed: January 25, 2015].

    Google Scholar 

  10. Pomeranz B, Stux G. Scientific Basis of Acupuncture. Berlin: Springer Verlag; 1989:1–199.

    Google Scholar 

  11. Karavis MY. The neurophysiology of acupuncture: a viewpoint. Acupunct Med. 1997;15:33–42.

    Google Scholar 

  12. Korinenko Y, Vincent A, Cutshall SM, Li Z, Sundt 3rd TM. Efficacy of acupuncture in prevention of postoperative nausea in cardiac surgery patients. Ann Thorac Surg. 2009;88:537–542.

    Google Scholar 

  13. Holmér Pettersson P, Wengström Y. Acupuncture prior to surgery to minimise postoperative nausea and vomiting: a systematic review. J Clin Nurs. 2012;21:1799–1805.

    Google Scholar 

  14. Acar HV, Cuvas‚ O, Ceyhan A, Dikmen B. Acupuncture on Yintang point decreases preoperative anxiety. J Altern Complement Med. 2013;19:420–424.

    Google Scholar 

  15. Lee A, Chan S. Acupuncture and anaesthesia. Best Pract Res Clin Anaesthesiol. 2006;20:303–314.

    Google Scholar 

  16. Wu S, Liang J, Zhu X, Liu X, Miao D. Comparing the treatment effectiveness of body acupuncture and auricular acupuncture in preoperative anxiety treatment. J Res Med Sci. 2011;16:39–42.

    Google Scholar 

  17. Coura LE, Manoel CH, Poffo R, Bedin A, Westphal GA. Randomised, controlled study of preoperative electroacupuncture for postoperative pain control after cardiac surgery. Acupunct Med. 2011;29:16–20.

    Google Scholar 

  18. Ulett GA, Han S, Han JS. Electroacupuncture: mechanisms and clinical application. Biol Psychiatry. 1998;44:129–138.

    Google Scholar 

  19. Ulett GA. Conditioned healing with electroacupuncture. Altern Ther Health Med. 1996;2:56–60.

    Google Scholar 

  20. Lim AT, Edis G, Kranz H, Mendelson G, Selwood T, Scott DF. Postoperative pain control: contribution of psychological factors and transcutaneous electrical stimulation. Pain. 1983;17:179–188.

    Google Scholar 

  21. Scott LE, Clum GA, Peoples JB. Preoperative predictors of postoperative pain. Pain. 1983;15:283–293.

    Google Scholar 

  22. Paraskeva A, Melemeni A, Petropoulos G, Siafaka I, Fassoulaki A. Needling of the extra 1 point decreases BIS values and preoperative anxiety. Am J Chin Med. 2004;32:789–794.

    Google Scholar 

  23. Wang SM, Gaal D, Maranets I, Caldwell-Andrews A, Kain ZN. Acupressure and preoperative parental anxiety: a pilot study. Anesth Analg. 2005;101:666–669.

    Google Scholar 

  24. Agarwal A, Ranjan R, Dhiraaj S, Lakra A, Kumar M, Singh U. Acupressure for prevention of pre-operative anxiety: a prospective, randomised, placebo controlled study. Anaesthesia. 2005;60:978–981.

    Google Scholar 

  25. Fassoulaki A, Paraskeva A, Patris K, Pourgiezi T, Kostopanagiotou G. Pressure applied on the extra 1 acupuncture point reduces bispectral index values and stress in volunteers. Anesth Analg. 2003;96:885–890.

    Google Scholar 

  26. Wang SM, Escalera S, Lin EC, Maranets I, Kain ZN. Extra-1 acupressure for children undergoing anesthesia. Anesth Analg. 2008;107:811–816.

    Google Scholar 

  27. Wang SM, Kain ZN. Auricular acupuncture: a potential treatment for anxiety. Anesth Analg. 2001;92:548–553.

    Google Scholar 

  28. Kober A, Scheck T, Schubert B, Strasser H, Gustorff B, Bertalanffy P, et al. Auricular acupressure as a treatment for anxiety in prehospital transport settings. Anesthesiology. 2003;98:1328–1332.

    Google Scholar 

  29. Wang SM, Peloquin C, Kain ZN. The use of auricular acupuncture to reduce preoperative anxiety. Anesth Analg. 2001;93:1178–1180.

    Google Scholar 

  30. National Institutes of Health. NIH Panel Issues Consensus Statement on Acupuncture; 5 Nov 1998. Available at http://www.nih.gov/news/pr/nov97/od-05.htm [Date accessed: January 25, 2015].

    Google Scholar 

  31. Arnberger M, Stadelmann K, Alischer P, Ponert R, Melber A, Greif R. Monitoring of neuromuscular blockade at the P6 acupuncture point reduces the incidence of postoperative nausea and vomiting. Anesthesiology. 2007; 107:903–908.

    Google Scholar 

  32. Kim YH, Kim KS, Lee HJ, Shim JC, Yoon SW. The efficacy of several neuromuscular monitoring modes at the P6 acupuncture point in preventing postoperative nausea and vomiting. Anesth Analg. 2011;112:819–823.

    Google Scholar 

  33. Frey UH, Funk M, Lohlein C, Peters J. Effect of P6 acustimulation on postoperative nausea and vomiting in patients undergoing a laparoscopic cholecystectomy. Acta Anaesthesiol Scand. 2009;53:1341–1347.

    Google Scholar 

  34. Liu YY, Duan SE, Cai MX, Zou P, Lai Y, Li YL. Evaluation of transcutaneous electroacupoint stimulation with the train-of-four mode for preventing nausea and vomiting after laparoscopic cholecystectomy. Chin J Integr Med. 2008;14:94–97.

    Google Scholar 

  35. Lee S, Lee MS, Choi DH, Lee SK. Electroacupuncture on PC6 prevents opioid-induced nausea and vomiting after laparoscopic surgery. Chin J Integr Med. 2013;19:277–281.

    Google Scholar 

  36. Noroozinia H, Mahoori A, Hasani E, Gerami-Fahim M, Sepehrvand N. The effect of acupressure on nausea and vomiting after cesarean section under spinal anesthesia. Acta Med Iran. 2013;51:163–167.

    Google Scholar 

  37. Lee A, Fan LT. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD003281.

    Google Scholar 

  38. Ezzo J, Streitberger K, Schneider A. Cochrane systematic reviews examine P6 acupuncture-point stimulation for nausea and vomiting. J Altern Complement Med. 2006;12:489–495.

    Google Scholar 

  39. Dundee JW, Chestnutt WN, Ghaly RG, Lynas AG. Traditional Chinese acupuncture: a potentially useful antiemetic? Br Med J. 1986;293:583–584.

    Google Scholar 

  40. Al-Sadi M, Newman B, Julious SA. Acupuncture in the prevention of postoperative nausea and vomiting. Anaesthesia. 1997;52:658–661.

    Google Scholar 

  41. Wang SM, Kain ZN. P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting in children. Anesthesiology. 2002;97:359–366.

    Google Scholar 

  42. Barsoum G, Perry EP, Fraser IA. Postoperative nausea is relieved by acupressure. J R Soc Med. 1990;83:86–89.

    Google Scholar 

  43. Zarate E, Mingus M, White PF, Chiu JW, Scuderi P, Loskota W, et al. The use of transcutaneous acupoint electrical stimulation for preventing nausea and vomiting after laparoscopic surgery. Anesth Analg. 2001;92:629–635.

    Google Scholar 

  44. Rusy LM, Hoffman GM, Weisman SJ. Electroacupuncture prophylaxis of postoperative nausea and vomiting following pediatric tonsillectomy with or without adenoidectomy. Anesthesiology. 2002;96:300–305.

    Google Scholar 

  45. White PF, Issioui T, Hu J, Jones SB, Coleman JE, Waddle JP, et al. Comparative efficacy of acustimulation (ReliefBand) versus ondansetron (Zofran) in combination with droperidol for preventing nausea and vomiting. Anesthesiology. 2002;97:1075–1081.

    Google Scholar 

  46. Lee A, Done ML. The use of nonpharmacologic techniques to prevent postoperative nausea and vomiting: a meta-analysis. Anesth Analg. 1999;88:1362–1369.

    Google Scholar 

  47. Xu M, Zhou SJ, Jiang CC, Wu Y, Shi WL, Gu HH, et al. The effects of P6 electrical acustimulation on postoperative nausea and vomiting in patients after infratentorial craniotomy. J Neurosurg Anesthesiol. 2012;24:312–316.

    Google Scholar 

  48. Liodden I, Howley M, Grimsgaard AS, Fønnebø VM, Borud EK, Alraek T, et al. Perioperative acupuncture and postoperative acupressure can prevent postoperative vomiting following paediatric tonsillectomy or adenoidectomy: a pragmatic randomised controlled trial. Acupunct Med. 2011;29:9–15.

    Google Scholar 

  49. Wang SM, Kain ZN, White PF. Acupuncture analgesia: II. Clinical considerations. Anesth Analg. 2008;106:611–621.

    Google Scholar 

  50. Kotani N, Hashimoto H, Sato Y, Sessler DI, Yoshioka H, Kitayama M, et al. Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses. Anesthesiology. 2001;95:349–356.

    Google Scholar 

  51. Kho HG, van Egmond J, Zhuang CF, Lin GF, Zhang GL. Acupuncture anaesthesia. Observations on its use for removal of thyroid adenomata and influence on recovery and morbidity in a Chinese hospital. Anaesthesia. 1990;45:480–485.

    Google Scholar 

  52. Wetzel B, Pavlovic D, Kuse R, Gibb A, Merk H, Lehmann C, et al. The effect of auricular acupuncture on fentanyl requirement during hip arthroplasty: a randomized controlled trial. Clin J Pain. 2011;27:262–267.

    Google Scholar 

  53. Usichenko TI, Dinse M, Lysenyuk VP, Wendt M, Pavlovic D, Lehmann C. Auricular acupuncture reduces intraoperative fentanyl requirement during hip arthroplastyda randomized double-blinded study. Acupunct Electrother Res. 2006;31(3–4):213–221.

    Google Scholar 

  54. Sim CK, Xu PC, Pua HL, Zhang G, Lee TL. Effects of electroacupuncture on intraoperative and postoperative analgesic requirement. Acupunct Med. 2002;20(2–3):56–65.

    Google Scholar 

  55. Li G, Li S, An L, Wang B. Electroacupuncture alleviates intraoperative immunosuppression in patients undergoing supratentorial craniotomy. Acupunct Med. 2013;31:51–56.

    Google Scholar 

  56. Tseng CK, Tay AA, Pace NL, Westenskow DR, Wong KC. Electro-acupuncture modification of halothane anaesthesia in the dog. Can Anaesth Soc J. 1981;28:125–128.

    Google Scholar 

  57. Greif R, Laciny S, Mokhtarani M, Doufas AG, Bakhshandeh M, Dorfer L, et al. Transcutaneous electrical stimulation of an auricular acupuncture point decreases anesthetic requirement. Anesthesiology. 2002;96:306–312.

    Google Scholar 

  58. Morioka N, Akca O, Doufas AG, Chernyak G, Sessler DI. Electro-acupuncture at the Zusanli, Yanglingquan, and Kunlun points does not reduce anesthetic requirement. Anesth Analg. 2002;95:98–102.

    Google Scholar 

  59. Taguchi A, Sharma N, Ali SZ, Dave B, Sessler DI, Kurz A. The effect of auricular acupuncture on anaesthesia with desflurane. Anaesthesia. 2002;57:1159–1163.

    Google Scholar 

  60. Gan TJ, Meyer T, Apfel CC, Chung F, Davis PJ, Eubanks S, et al. Consensus guidelines for managing postoperative nausea and vomiting. Anesth Analg. 2003;97:62–71.

    Google Scholar 

  61. Bolton CM, Myles PS, Nolan T, Sterne JA. Prophylaxis of postoperative vomiting in children undergoing tonsillectomy: a systematic review and meta-analysis. Br J Anaesth. 2006;97:593–604.

    Google Scholar 

  62. Taghavi R, Tabasi KT, Mogharabian N, Asadpour A, Golchian A, Mohamadi S, et al. The effect of acupuncture on relieving pain after inguinal surgeries. Korean J Pain. 2013;26:46–50.

    Google Scholar 

  63. Asher GN, Jonas DE, Coeytaux RR, Reilly AC, Loh YL, Motsinger-Reif AA, et al. Auriculotherapy for pain management: a systematic review and meta-analysis of randomized controlled trials. J Altern Complement Med. 2010;16:1097–1108.

    Google Scholar 

  64. Ward U, Nilsson UG. Acupuncture for postoperative pain in day surgery patients undergoing arthroscopic shoulder surgery. Clin Nurs Res. 2013;22:130–136.

    Google Scholar 

  65. Weiser TG, Regenbogen SE, Thompson KD, Haynes AB, Lipsitz SR, Berry WR, et al. An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet. 2008;372:139–144.

    Google Scholar 

  66. Katz J, Seltzer Z. Transition from acute to chronic postsurgical pain: risk factors and protective factors. Expert Rev Neurother. 2009;9:724–744.

    Google Scholar 

  67. Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367:1618–1625.

    Google Scholar 

  68. Gerbershagen HJ, Aducktahil S, van Wijck AJ, Pelen LM, Kalkman CJ, Meissner W. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology. 2013;118:934–944.

    Google Scholar 

  69. Gerbershagen HJ, Pogatzki-Zahn E, Aducktahil S, Peelen LM, Kappen TH, van Wijck AJ, et al. Procedure-specific risk factor analysis for the development of severe postoperative pain. Anesthesiology. 2014;120:1237–1245.

    Google Scholar 

  70. Fletcher D, Fermanian C, Mardaye A, Aegerter P. A patient-based national survey on postoperative pain management in France reveals significant achievements and persistent challenges. Pain. 2008;137:441–451.

    Google Scholar 

  71. Maier C, Nestler N, Richter H, Hardinghaus W, Pogatzki-Zahn E, Zenz M, et al. The quality of pain management in German hospitals. Dtsch Arztebl Int. 2010;107:607–614.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. AZ Pain Doctors, Private Practice, 725 S. Dobson Rd, Ste 100, Chandler, AZ 85224, USA

    Jordan A. Gliedt, Clinton J. Daniels & Adam Wuollet

Authors
  1. Jordan A. Gliedt
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Clinton J. Daniels
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Adam Wuollet
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Jordan A. Gliedt.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gliedt, J.A., Daniels, C.J. & Wuollet, A. Narrative Review of Perioperative Acupuncture for Clinicians. Innov. Acupunct. Med. 8, 264–269 (2015). https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.jams.2014.12.004

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.jams.2014.12.004

Keywords

Innovations in Acupuncture and Medicine

ISSN: 3059-4049

Contact us