Although it is one of the oldest medical procedures in the world, acupuncture has not been a long-utilized tool in traditional Western medicine. As more data is published about the benefits of this practice, physicians are integrating the use of acupuncture into their therapy arsenals. Acupuncture has many clinical applications. In this article, we will discuss how acupuncture can be used to improve the surgical experience for patients.
The Basics
Traditionally, acupuncturists use very fine, metal needles to stimulate external points that correspond to internal organs. The needle placement causes a physiologic response explained by traditional Chinese theories. According to these theories, there are 14 main channels that run throughout the body and these channels are associated with specific organs. 365 points are recognized along these channels.
In the United States, each state determines the requirements for acupuncture licensure. For more information about certification, you can visit http://www.nccaom.org.
At my hospital, a small group of anesthesiologists are trained in the practice of acupuncture. They are running a pilot program and have found that the service is very welcomed by our patients. We focus on three main symptoms that are common complaints at the time of surgery: anxiety, nausea, and pain.
Picture posted with patient permission
Anxiety
Having surgery is nerve wracking! Sometimes, getting “prepped” for surgery can make a patient feel like a Formula One racecar. After admission to the preoperative area, an entire pit crew comes at the patient with wires, IVs, blood pressure cuffs, heart monitors, leg squeezers and more. It is no wonder people can feel anxious and the anxiety often ramps up as they get closer to the operating room. To calm the patient, the anesthesiologist usually administers IV medications such as versed.
Using acupuncture for perioperative anxiety has proven to be a great adjunct to conventional methods. Preoperatively, acupuncture can be used to relieve stress. One study found that placing acupuncture needles at points in the ear significantly lowered anxiety starting 30 minutes after placement and lasting up to 48 hours. The needles can be placed preoperatively and kept in the ear for the entire duration of the procedure for maximal effect.
Nausea
It’s a fact; women are more likely to have postoperative nausea and vomiting (PONV) than men. Depending on risk factors, women can have a 20-78% chance of PONV. Anesthesiologists use medications and specific strategies to reduce the risk of PONV. The use of acupressure for control of PONV is one of the most popular uses of acupressure.
The most studied pressure point for postoperative nausea and vomiting is the P6 pressure point. You may have seen wristbands in the pharmacy for nausea relief. These bands put pressure on P6. P6 is located three fingerbreadths below the wrist on the inner forearm between the two tendons. In addition to P6, the points in the ear as well as the feet and hands help with PONV prevention.
Pain
Postoperative pain control can be challenging for patients and doctors. As a surgeon, I want to make sure my patients are as comfortable after surgery as possible. No one should be in pain after surgery but up to 75% of people report moderate to severe pain after a major procedure. Opioids are the mainstay of treatment for pain after surgery. Not only are opioids addictive, but they also slow down bowel function, cause nausea and vomiting, and increase sedation.
Acupuncture is used to relieve pain and can help with perioperative pain control. One meta-analysis (a study reviewing a whole bunch of smaller studies) found that acupuncture resulted in decreased pain on postoperative day one and decreased opioid use. Multiple other studies have been published on the various acupoints that can help with perioperative pain control. Below are some examples of points used for used to control pain.
One of the beautiful elements of Eastern medicine is the value placed on the whole patient. Often, treatment of the whole body is needed to address one symptom. The use of acupuncture relies on the harmony between the external and internal body. The perioperative period is just one example of how acupuncture can be incorporated into Western medical practice.
So, if your surgeon asks if you would like some acupuncture on the day of surgery, it can’t hurt to say yes. What’s a couple more needles?! You may even like it!
I am a board certified Gynecologic Oncologist seeing patients in Portland, Oregon.
I was raised in Los Angeles and completed my medical training at Los Angeles County Medical Center.
Primarily, I am a surgeon who sees patients with gynecologic malignancies and precancerous conditions, however, I also counsel patients who are genetically predisposed to cancer development. I practice evidence-based medicine and take a holistic approach to patient care. I enjoy collaborating with other health specialists and incorporating alternative medicine including acupuncture, naturopathic, and Ayurvedic medicine. My research has been published in numerous peer reviewed medical journals. Portland Monthly has named me as a “Top Doc” annually since my arrival in Portland.