Acupuncture for Postoperative Pain
Postoperative pain resulting from surgical trauma is a significant challenge. Thus, opioid analgesics are commonly used to treat this kind of pain; however, these drugs are associated with a number of undesirable side effects. Research indicates that certain modes of acupuncture improves postoperative pain after surgery and reduces opioid use. Hence, these findings support the use of acupuncture as an adjuvant therapy in treating postoperative pain.
Mechanistic Evidence of acupuncture in Postoperative Pain
- Electro-acupuncture stimulates the release of β-endorphin, encephalin, and endomorphin, which in turn activates the μ- and δ-opioid receptors, key receptor sites in the management of acute, chronic, and neuropathic pain [1].
- High-frequency stimulation (100-200 Hz) provides rapid-onset analgesia that does not appear to be blocked by naloxone (a μ-opioid antagonist), suggesting it may be mediated by norepinephrine, serotonin, and dynorphins [2].
- Low-frequency (2-4 Hz) and medium-frequency stimulation (15-30 Hz) appear to produce an analgesic effect that is reversed by naloxone, suggesting it is mediated by enkephalins and endorphins [2,3]. These frequencies also appear to produce analgesia that accumulates, lasting at least an hour after treatment [2].
Acupuncture is well known for inhibiting the inflammatory process. Thus, postoperative rehabilitation, with the beneficial effects of acupuncture, can easily help with inflammation, reducing swelling and aiding mobility after certain surgeries. Secondly, acupuncture promotes microcirculation in tiny vasculature that makes up the capillary bed and can stimulate your own bodies ability to reconnect the tiny blood vessels that have been compromised from the surgery.
Furthermore, acupuncture reduces adhesions and scar tissue formation which often occur after surgery.
References
- Lin J, Chen W. Acupuncture analgesia: a review of its mechanisms of actions. Am J Chin Med 2008;36:635–45.
- Chernyak G, Sessler D. Perioperative acupuncture and related techniques. Anesthesiology 2005;102:1031–78.
- Zhao Z. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol 2008;85:355–75.