Monday, June 30, 2008

Acupuncture For Surgical Pain

Reported June 30, 2008

Acupuncture for Surgical Pain

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DURHAM, N.C. (Ivanhoe Newswire) -- For centuries, acupuncture has been used for its pain-relieving benefits. Now, doctors are using the therapy in a setting where pain management is crucial -- during surgery.

Lauren Hennessey is being prepped for surgery. And along with drugs to numb the pain, she's getting acupuncture. Duke University anesthesiologist TJ Gan said acupuncture sparks the release of endorphins and other natural pain killers in the body, making pain medication work more effectively.

"We have found that by using acupuncture, you can potentially reduce the amount of painkillers that you otherwise would need to use during surgery,” Dr. Gan told Ivanhoe. “Some studies suggest that accupuncture can also reduce the amount of anesthetic that you need to provide for the patients."

And fewer drugs mean fewer side effects.

"I never vomited,” Hennessey said. “I was nauseous for very shortly and my pain was very minimal."

Dr. Gan said the pain relieving benefits of pre-operative acupuncture may last far longer than the effects of any drugs.

"There is evidence to suggest that if you control the pain well during surgery, not only does it benefit the patient immediately post-operatively, but there is also increasing evidence to suggest that this will prevent longer-term pain problems," Dr. Gan said.

But even with the growing body of evidence of its benefits, Dr. Gan said acupuncture should only be used as a complement to traditional anesthesia.

"For most of the conditions, I think we still need powerful drugs to control pain, but I think acupuncture would be a very useful addition to that regimen," Dr. Gan said.

Dr. Gan said he targets both universal and localized acupuncture points in patients, depending on the part of body that will be affected by the surgery. Acupuncture for surgery pain is also used at Yale, Stanford and Massachusetts General, among others.


Acupuncture for Surgical Pain -- Research Summary

BACKGROUND: The ancient Chinese art of acupuncture can be traced back to the Stone Age. Stone acupuncture needles from 3000 B.C. were discovered by archaeologists in Mongolia. The art has come a long way from there, but the principles remain the same. Based on the principles of yin and yang, the theory is that the thin needles (0.18 millimeters to 0.51 millimeters thick) create a balance between blood and energy to relieve pain. The technique has been theorized to treat a wide array of ailments, ranging from stress to indigestion to infertility, but there has been little evidence to support these claims, making it a controversial technique in the medical community, but recent clinical studies have produced results convincing some of the world's brightest minds to believe there may be some science behind the technique for certain conditions.

NEEDLES RELIEVING PAIN? During surgery, anesthesia and pain-killing medications are often used to make patients comfortable and make invasive surgery possible. After surgery, patients are often left with post-operative pain requiring additional medication. These drugs, ranging from narcotics to opioids, can cause unpleasant side effects like nausea, vomiting, constipation and hallucinations. A 2007 study out of Duke University Medical Center suggests acupuncture may reduce patients' post-operative pain, therefore reducing the amount of painkillers needed.

After analyzing 15 studies on acupuncture for surgical pain, Duke researchers found performing acupuncture before or during certain operations reported significantly less pain afterwards than patients who did not receive acupuncture. The patients also required less painkillers after surgery, thereby reducing related side effects. Acupuncture patients experienced 1.5 times lower rates of nausea, 1.6 times fewer reports of dizziness and 3.5 times fewer cases of urinary retention compared to the other patients, the study found; however, it was used as a compliment to traditional surgical anesthesia and painkillers -- not a replacement.

CONVINCING FOR SOME: While many will continue to discredit the controversial practice, T.J. Gan, M.D., vice chair of the department of anesthesiology at Duke University School of Medicine, is convinced it's right for some cases. "There has been a fair amount of evidence both in animals and humans that stimulating the acupuncture points can result in the release of body own pain killers systems such endorphins and enkephalins," Dr. Gan told Ivanhoe.

"The acupuncture needs to be inserted about half an hour to 45 minutes before surgery because it typically takes about five or 10 minutes for the body to start releasing some of these pain killing effects of the acupuncture," Dr. Gan explained. "We typically maintain the acupuncture throughout the surgery to the end of surgery. And during that period there is the release of body’s own endorphins."

Acupuncture programs are also in place at Yale, Stanford, Bringham and Women's and Massachusetts General Hospital, among others.


FOR MORE INFORMATION, PLEASE CONTACT:

Melissa Schwarting

Senior Media Relations Strategist

Duke University Medical Center

(919) 660-1303

melissa.schwarting@duke.edu


Alex's comment: It is much easier to treat pain before it starts than chase it afterwards. This is true with medication and as this article demonstrates with acupuncture too. For my patients that are going into surgery there are homeopathics that can be safely taken prior to surgery that are very beneficial in reducing or even eliminating the use of pain medications afterwards. Send me an email if you would like my pre and post surgery protocols.