Acupuncture Integrated Into Anesthesia Pain Medicine James D. Colson, M.S., M.D. Clinical Assistant Professor University of Michigan Overview Complementary and alternative medicine (CAM) therapies have become more prominent in our healthcare system.
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Acupuncture Integrated Into Anesthesia Pain Medicine
James D. Colson, M.S., M.D.
Clinical Assistant Professor
University of Michigan
Yin and Yang exemplified as physiological processes Acupunctures Effectiveness
12 paired and 2 unpaired
Cho et al: fMRI Neurophysiological Evidence of Acupuncture Mechanisms. Medical Acupuncture 2002; 14:16-22.
Interventions: acupoints and a corresponding functional cortical area.
Outcome measure: Findings on fMRI imaging in the anterior cingulated cortex and thalamic areas.
Conclusions: Acupuncture appears to inactivate brain regions involved in the transmission and perceptions of pain.
Varied approaches to practice of Acupuncture
Meridians and points are universally accepted
Each approach differs in choice of points and method of stimulation
Goal: To restore the flow of qi
Acupuncture Methodology involved in the transmission and perceptions of pain.
Classical acupuncture is the traditional practice according to the principles of Taoism.
Acupuncture needling evokes a sensation termed “de qi”
Tonification for deficient energy requires
some form of needle stimulation:
Acupuncture, like any other invasive treatment, has its own specific set of contraindications, commonly observed side effects, as well as potential for serious adverse complications
In Western medical practice, acupuncture is most applicable in treating pain.
Kotani et al: Preoperative Intradermal Acupuncture Reduces Postoperative Pain, Nausea and Vomiting, Analgesic Requirement, and Sympathoadrenal Responses. Anesthesiology 2001; 95:349-356.
Interventions: Postoperative Pain, Nausea and Vomiting, Analgesic Requirement, and Sympathoadrenal Responses. Anesthesiology 2001; 95:349-356.
Outcome measures: Pain intensity; supplemental IV opioid requirement; side effect profile; and stress hormone responses, 4 days postoperatively.
Acupuncture for Postoperative Pain requirement; side effect profile; and stress hormone responses, 4 days postoperatively.
Conclusions: Acupuncture used preoperatively significantly decreased postoperative pain scores, reduced supplemental analgesic requirements up to 50%, lowered the incidence of postoperative nausea and vomiting 20 to 30%, and reduced stress hormone concentrations 30 to 50%, compared to controls.
Wang et al: Narcotic Sparing Effect of Acupuncture during Lithotripsy: A Double Blinded RCT. Anesthesiology 2004; 101:A31
Interventions: Lithotripsy: A Double Blinded RCT. Anesthesiology 2004; 101:A31
Outcome measures: Alfentanil usage; PACU discharge; physical recovery score.
Conclusions: Alfentanil usage in the acupuncture group was significantly lower. No differences in time to home discharge. Physical recovery scores showed a trend toward improvement with acupuncture.
Skilnand et al: Acupuncture in the management of pain in labor. Acta Obstet Gynecol Scand 2002; 81:943-948.
Interventions: labor. Acta Obstet Gynecol Scand 2002; 81:943-948.
Outcome measures: Pain assessed using a 10 cm VAS; need for analgesic medication.
10 analgesic medication.
2 hrs After
Acupuncture for Pain Relief in Labor
Visual Analog Pain Scores
■Real Acupuncture Group
● Sham Acupuncture Group
* P < 0.001
Acupuncture for Pain Relief in Labor analgesic medication.
Conclusions: Significantly lower pain scores and less need for analgesic interventions with acupuncture.