Acupuncture Cuts Need for Post-Op Painkillers
WEDNESDAY Oct. 17, 2007 -- Powerful opioids taken after surgery can have powerful side effects, but new research finds that using acupuncture before and during an operation cuts a patient's need for the painkillers.
"From a pain perspective, you can reduce the amount of morphine that the patient uses and improve the quality of analgesia and pain control," said lead researcher Dr. Tong J. Gan, a professor and vice chairman of anesthesiology at Duke University Medical Center, in Durham, N.C.
Gan was to present the findings Tuesday at the American Society for Anesthesiology conference in San Francisco.
Morphine is a type of opioid, a category of potent painkillers that often produce side effects such as nausea and vomiting.
In the new study, Gan's team analyzed data taken from 15 small randomized clinical trials looking at the use of acupuncture to reduce postoperative pain.
The analysis found that adjunctive acupuncture could reduce post-op itchiness by 30 percent, nausea by 50 percent and dizziness by 60 percent, he said. About eight out of 10 patients will experience those side effects from postoperative morphine, Gan said.
The studies also show that acupuncture could be of benefit following many types of surgeries, the researcher added. Chinese acupuncture was the style used in the studies he reviewed, but similar effects would occur with other styles and whether needles, electrical or manual acupuncture was used, Gan speculated.
Adjunctive acupuncture is "not widely used because people need to be educated," Gan said. To use it, surgeons need training but they don't "need to know every acupuncture point. Only a few are important points to relieve this discomfort."
Gan said he uses acupuncture in about 20 percent to 30 percent of the surgeries he's involved with. He said that few patients decline to use adjunctive acupuncture, and when they do it's usually because they have little knowledge of it.
Acupuncture "is becoming increasingly accepted by both physicians and patients," added Dr. David P. Martin, an anesthesiologist at the Mayo Clinic in Rochester, Minn. He said the technique can be helpful whether it is used to lower the level of morphine or other opioid painkiller, or whether it is used to relieve nausea. Often, he said, "people prefer to have pain to throwing up."
He questioned, however, how widely acupuncture could be used during operations because "acupuncture needles tend to get in the way" in crowded OR conditions.
Another expert said Gan's finding that adjunctive acupuncture can reduce urinary retention by 3.5 times is especially important.
"The risk reduction is huge," said Dr. Kenneth Levey, a clinical assistant professor of obstetrics and gynecology at New York University School of Medicine, New York City. Urinary retention is not only uncomfortable for the patient but the use of a catheter to relieve it increases the risk of infection, he said.
"For optimum pain control with minimum side effects, opioids plus acupuncture are the way to go and hopefully will become more widely accepted," Levey added.
There's more on acupuncture at the U.S. National Center for Complementary and Alternative Medicine.
Posted: October 2007
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