Acupuncture Cuts Postoperative Pain after Neck Surgery

neiguan shousanli

Acupuncture is effective for pain relief after surgery of the cervical spine. Researchers find electroacupuncture applied to acupoints Hegu (LI4) and Neiguan (PC6) safe and effective for achieving significant pain relief. Surgery on the anterior cervical spine is a complex procedure. Analgesics including fentanyl and sufentanil may be used to alleviate postoperative pain. However, due to concerns regarding respiratory depression, they are often prescribed at low dosages leading to only a partial painkilling effect. The results of the perioperative research finds acupuncture effective for pain relief and for stabilizing hemodynamics during surgery. 

Acupuncture point Hegu is traditionally used by licensed acupuncturists to relieve pain and dredge the acupuncture meridians. Neiguan is used by licensed acupuncturists to calm the shen (spirit), which has a tranquillising effect. Neiguan is also used to regulate the heartbeat, alleviate nausea, and to reduce pain. Together, these acupoints may be used to relieve pain in patients undergoing cervical spine surgery. Using electroacupuncture at the acupoint sites has the advantage of providing continuous acupoint stimulation, effectively relieving pain and reducing the required dosage of opioid analgesics. Moreover, it is a straightforward procedure to administer with minimal risk of adverse effects.

Foshan Chinese Medicine Hospital researchers (Zhou et al.) find that electroacupuncture significantly reduces the dosage of remifentanil and propofol required during surgical anaesthesia. The researchers determined that electroacupuncture produces additional benefits during surgery, heart rate and mean arterial blood pressure are more stable when electroacupuncture is applied. Postoperatively, patients in the electroacupuncture study group regained consciousness more quickly and had a shorter extubation (endotracheal tube removal) period compared with the control group that did not receive acupuncture.

Visual analogue scale (VAS) and Ramsay evaluations were used to measure pain and sedation. The evaluations were taken immediately after extubation and again at 2, 4, 8, 12 and 24 hours after extubation. The results showed significant positive patient outcomes for patients receiving electroacupuncture. For example, at 4 hours after extubation, the electroacupuncture group achieved better sedation and pain relief than the control group.

In the control group, 6 patients experienced nausea, vomiting, constipation and other adverse effects while only 1 patient in the electroacupuncture group experienced these issues. Electroacupuncture was applied perioperatively. The frequency of patient controlled analgesic administration was recorded for 24 hours after surgery. The control group self-administered analgesics a total of 116 times while the electroacupuncture group self-administered only 21 times. The researchers note that electroacupuncture stimulation reduced the overall need for pharmaceutical analgesics. The results indicate that electroacupuncture significantly reduces pain following surgery.

Zhou W, Chen YX & Ou JY. (2014). Electroacupuncture on Hegu Point and Neiguan Point to Treat Acute Pain after Surgery on Anterior Cervical Spine. World Journal of TCM. 9(4).