ACUPUNCTURE AND POST-OPERATIVE PAIN


About post-operative pain
Pain after surgery is common, often severe and largely unnecessary. Effective relief of post-operative pain is vital, and not just for humanitarian reasons. Such pain probably prolongs hospital stay, as it can affect all organ systems, including: respiratory (e.g. reduced cough, sputum retention, hypoxaemia); cardiovascular (e.g. increased myocardial oxygen consumption, ischaemia); gastrointestinal (e.g. decreased gastric emptying, reduced gut motility, constipation); genitourinary (e.g. urinary retention); neuroendocrine (e.g. hyperglycaemia, protein catabolism, sodium retention); musculoskeletal (e.g. reduced mobility, pressure sores, increased risk of DVT); and psychological (e.g. anxiety, fatigue). There is now evidence that post-operative pain relief has significant physiological benefit (Charlton 1997). Not only can it result in earlier discharge from hospital, but it may also reduce the onset of chronic pain syndromes. Nevertheless, post-operative pain remains grossly under treated, with up to 70% of patients reporting moderate to severe pain following surgery

How acupuncture can help
Systematic reviews suggest that acupuncture and ear acupuncture are useful adjunctive treatments for post-operative pain management (Sun 2008; Usinchenko 2008). Several recent randomised controlled trials have found acupuncture and electroacupuncture to reduce post-operative pain, the use of patient-controlled analgesia (opioids), and post-operative nausea and vomiting (Salmeddini 2010; Larson 2010; Parthasarathy 2009; Wu 2009; Grube 2009; Wong 2006). In general, acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body’s homeostatic mechanisms, thus promoting physical and emotional well-being. Stimulation of certain acupuncture points has been shown to affect areas of the brain that are known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety
About traditional acupuncture
Acupuncture is a tried and tested system of traditional medicine, which has been used in China and other eastern cultures for at least 2thousand years to restore, promote and maintain good health. Its benefits are now widely acknowledged all over the world and in the past couple of decade traditional acupuncture has begun to feature more prominently in mainstream healthcare in the west. In conjunction with needling, the practitioner may use techniques such as moxibustion, cupping, massage or electro-acupuncture. They may also suggest dietary or lifestyle changes.
Traditional acupuncture takes a holistic approach to health and regards illness as a sign that the body is out of balance. The exact pattern and degree of imbalance is unique to each individual. The traditional acupuncturist’s skill lies in identifying the precise nature of the underlying disharmony and selecting the most effective treatment. The choice of acupuncture points will be specific to each patient’s needs. Traditional acupuncture can also be used as a preventive measure to strengthen the constitution and promote general well-being.
An increasing weight of evidence from Western scientific research (see overleaf) is demonstrating the effectiveness of acupuncture for treating a wide variety of conditions. From a biomedical viewpoint, acupuncture is believed to stimulate the nervous system, influencing the production of the body’s communication substances hormones and neurotransmitters. The resulting biochemical changes activate the body’s self regulating homeostatic systems, stimulating its natural healing abilities and promoting physical and emotional well –being

Robert Vandevelde

Past President AACMA
Investigation