Acupuncture - postoperative and posttraumatic treatment
Dept. of Anesthesia, General Hospital Vienna, Austria
Within the last 30 years acupuncture has become an increasing acceptance within a western school medicine and a great popularity among the patients first of all as a therapeutic option in the treatment of different chronic diseases. Moreover in the last several years acupuncture also gains a value in the treatment of acute events such as trauma and perioperative period. The best investigated and proved efficacy of acupuncture has been found for postoperative nausea and vomiting especially in the eye surgery. The acupuncture seems to be as effective as a specific antiemetic medication as well in the prevention as in the therapy of postoperative nausea and vomiting without side effects. Also a very good efficacy of acupuncture has been shown for the analgesic action as a part of analgesia treatment of several painful conditions due to operation or trauma.
The electroacupuncture treatment provides the significant reduction of the postoperative opioid requirement and seems to be an alternative method for treating headache after spinal anaesthesia in caesarean section. Acupuncture has been also reported to be superior to the placebo in preventing postoperative dental pain. Acupuncture can also reduce the postoperative pain after total knee replacement by more than 20%. Although acupuncture is less effective than narcotic analgesics, it helps to alleviate the severity of such postoperative complications as the postoperative urinary retention, impairment of the function of the bronchi, intestinal paresis, vomiting, nausea or pain in 40-80% of cases.
It has been also found that electroacupuncture significantly attenuates the catecholamine responses in comparison to placebo treatment during the postoperative recovery period. Also the effect of stimulation of the ear-acupuncture point P 29 on the blood pressure can be used in perioperative period. It has been demonstrated, that bilateral stimulation of the P 29 mitigates hypotensive effects after induction of anaesthesia. This simple technique is void of any threatening side effects and may be beneficial in preventing post induction hypotension in patients at risk. Taking all these facts together, one should conclude that the use of acupuncture as a part of the comprehensive treatment concept (in combination with the drug therapy) in the management of postoperative and posttraumatic pain seems to be desirable.