The effect of high and low frequency electroacupuncture in pain after lower abdominal surgery Postoperative Pain Experience: Results from a National Survey Suggest Postoperative Pain Continues to Be Undermanaged Preoperative Intradermal Acupuncture Reduces Postoperative Pain, Nausea and Vomiting, Analgesic Requirement, and Sympathoadrenal Responses Efficacy of Chinese acupuncture on postoperative oral surgery pain. Effects of Electroacupuncture on Intraoperative and Postoperative Analgesic Requirement Auricular acupuncture for pain relief after ambulatory knee surgery: a randomized trial Effect of acupuncture on pain management in patients before and after lumbar disc protrusion surgery--a randomized control study. The Effect of Location of Transcutaneous Electrical Nerve Stimulation on Postoperative Opioid Analgesic Requirement: Acupoint Versus Nonacupoint Stimulation Evaluation of acupuncture for pain control after oral surgery: a placebo-controlled trial. The Analgesic Effects of Capsicum Plaster at the Zusanli Point After Abdominal Hysterectomy Auricular acupuncture for pain relief after total hip arthroplasty – a randomized controlled study Early postoperative stress: video-assisted wedge resection/lobectomy vs conventional axillary thoracotomy. Transcutaneous electrical nerve stimulation reduces the incidence of vomiting after hysterectomy. Analgesic effect of electroacupuncture in postthoracotomy pain: a prospective randomized trial. Pressure on acupoints decreases postoperative pain. Effect of transcutaneous electrical nerve stimulation for pain relief on patients undergoing hemorrhoidectomy Effect of the Intensity of Transcutaneous Acupoint Electrical Stimulation on the Postoperative Analgesic Requirement Acupuncture and transcutaneous stimulation analgesia in comparison with moderate‐dose fentanyl anaesthesia in major surgery
& NA ; In the present study , we examined the effects of preoperative electroacupuncture ( EA ) at classical bilateral acupuncture points ( Zusanli , also known as ST‐36 ) on postoperative pain and opioid‐related side effects . One hundred healthy consenting women undergoing lower abdominal surgery were r and omly assigned to four treatment regimens : Group I ( n=25 ) , control ; Group II ( n=25 ) , sham‐EA ( needle insertion without electrical stimulation ) ; Group III ( n=25 ) , low‐EA ( 2 Hz of electrical stimulation ) ; and Group IV ( n=25 ) , high‐EA ( 100 Hz of electrical stimulation ) . EA groups received needle insertion with or without electrical stimulation 20 min prior to anesthesia . All patients received patient‐controlled analgesia ( PCA ) of morphine postoperation . Postoperative pain was evaluated by recording ( 1 ) the time of the first required analgesic , ( 2 ) the number of PCA dem and s , ( 3 ) the total amount of morphine required by PCA , and ( 4 ) patients ' VAS pain score . We found that the time of first analgesic requested was 10 , 18 , 28 , and 28 min in the control , sham‐ , low‐ , and high‐EA groups , respectively . During the first 24 h , the total amount of morphine required was decreased by 21 , 43 and 61 % in the sham‐ , low‐ and high‐EA groups , respectively . The incidence of nausea and dizziness during the first 24 h after surgery was significantly reduced in both the low‐EA and high‐EA groups compared with the control and sham‐EA groups . We also found that sham‐EA exerts a beneficial effect with respect to its pain relieving quality but not the side effect profiles . Our findings demonstrates that preoperative treatment with low‐EA and high‐EA can reduce postoperative analgesic requirements and associated side effects in patients undergoing lower abdominal surgery Postoperative pain can have a significant effect on patient recovery . An underst and ing of patient attitudes and concerns about postoperative pain is important for identifying ways health care professionals can improve postoperative care . To assess patients ’ postoperative pain experience and the status of acute pain management , we conducted a national study by using telephone question naires . A r and om sample of 250 adults who had undergone surgical procedures recently in the United States was obtained from National Family Opinion . Patients were asked about the  severity of postsurgical pain , treatment , satisfaction with pain medication , patient education , and perceptions about postoperative pain and pain medications .  Approximately 80 % of patients experienced acute pain after surgery . Of these patients , 86 % had moderate , severe , or extreme pain , with more patients experiencing pain after discharge than before discharge . Experiencing postoperative pain was the most common concern ( 59 % ) of patients . Almost 25 % of patients who received pain medications experienced adverse effects ; however , almost 90 % of them were satisfied with their pain medications . Approximately two thirds of patients reported that a health care professional talked with them about their pain . Despite an increased focus on pain management programs and the development of new st and ards for pain management , many patients continue to experience intense pain after surgery . Additional efforts are required to improve patients ’ postoperative pain experience Background In a controlled and double-blind study , the authors tested the hypothesis that preoperative insertion of intradermal needles at acupoints 2.5 cm from the spinal vertebrae ( bladder meridian ) provide satisfactory postoperative analgesia . Methods The authors enrolled patients scheduled for elective upper and lower abdominal surgery . Before anesthesia , patients undergoing each type of surgery were r and omly assigned to one of two groups : acupuncture ( n = 50 and n = 39 for upper and lower abdominal surgery , respectively ) or control ( n = 48 and n = 38 for upper and lower abdominal surgery , respectively ) . In the acupuncture group , intradermal needles were inserted to the left and right of bladder meridian 18–24 and 20–26 in upper and lower abdominal surgery before induction of anesthesia , respectively . Postoperative analgesia was maintained with epidural morphine and bolus doses of intravenous morphine .  Consumption of intravenous morphine  was recorded . Incisional pain at rest and during coughing and deep visceral pain were recorded during recovery and for 4 days thereafter on a four-point verbal rating scale . We also evaluated time-dependent changes in plasma concentrations of cortisol and catecholamines . Results Starting from the recovery room , intradermal acupuncture increased the fraction of patients with good pain relief as compared with the control ( P < 0.05 ) . Consumption of supplemental intravenous morphine was reduced 50 % , and the incidence of postoperative nausea was reduced 20–30 % in the acupuncture patients who had undergone either upper or lower abdominal surgery ( P < 0.01 ) . Plasma cortisol and epinephrine concentrations were reduced 30–50 % in the acupuncture group during recovery and on the first postoperative day ( P < 0.01 ) . Conclusion Preoperative insertion of intradermal needles reduces postoperative pain , the analgesic requirement , and opioid-related side effects after both upper and lower abdominal surgery . Acupuncture analgesia also reduces the activation of the sympathoadrenal system that normally accompanies surgery One of the challenges of acupuncture research is design ing appropriate control groups . To address this problem , after surgical third molar extraction s 19 patients were r and omly assigned to an acupuncture group ( n = 11 ) or a placebo acupuncture group ( n = 8) . The length of time for reaching moderate pain and pain intensity after oral surgery were recorded by st and ard patient self-report . The results indicated that subjects treated with acupuncture reported longer pain-free duration times ( mean , 181 versus 71 minutes ; p < or = 0.046 ) and experienced less pain intensity than those who received placebo acupuncture . This study provides a model for an acupuncture control that could examine the placebo effect in clinical acupuncture research Acupuncture has been shown to be effective in experimental and clinical acute pain setting s. This study aims to evaluate the effect of preoperative electroacupuncture ( EA ) on intraoperative and postoperative analgesic ( alfentanil and morphine ) requirement in patients scheduled for gynaecologic lower abdominal surgery . Ninety patients were r and omly assigned to one of three groups : Group I ( control group ) –received placebo EA for 45 minutes before induction of general anaesthesia ( GA ) ; Group II –preoperative EA instituted 45 minutes before induction of GA ; Group III – 45 minutes of postoperative EA . The Bispectral Index monitor was used intraoperatively to monitor the hypnotic effect of anaesthetic drugs , and alfentanil was titrated to maintain the blood pressure and pulse rate within ±15 % of basal values . Postoperative pain was managed by intravenous morphine via a patient-controlled analgesia ( PCA ) device . Patients in Group II ( 0.44 ± 0.15μg/kg/min ) received less alfentanil than those in Group III ( 0.58 ± 0.22μg/kg/min ) ( p=0.024 ) , but not significantly less than those in Group I ( 0.51 ± 0.21μg/kg/min ) ( p=0.472 ) . Postoperative morphine consumption was numerically lower in Group II compared with the other groups ; however , the difference was statistically significant only during the period of 6–12 hours between Group II [ 0.03 ( 0.05 ) mg/kg ] and Group I [ 0.10 ( 0.11 ) mg/kg ] ( p=0.015 ) , and Group II and Group III [ 0.08 ( 0.10 ) mg/kg ] ( p=0.010 ) . The 24-hour cumulative morphine consumption for Group II ( 0.52 ± 0.19mg/kg ) was less than that for either Group I ( 0.68 ± 0.38mg/kg ) or Group III ( 0.58 ± 0.27mg/kg ) , but the difference did not reach significance . In conclusion , preoperative EA leads to a reduced intraoperative alfentanil consumption , though this effect may not be specific , and has a morphine sparing effect during the early postoperative period Background : Auricular acupuncture is a promising method for postoperative pain relief . However , there is no evidence for its use after ambulatory surgery . Our aim was to test whether auricular acupuncture is better than invasive needle control for complementary analgesia after ambulatory knee surgery . Methods : One hundred and twenty patients undergoing ambulatory arthroscopic knee surgery under st and ardized general anesthesia were r and omly assigned to receive auricular acupuncture or a control procedure . Fixed indwelling acupuncture needles were inserted before surgery and retained in situ until the following morning . Postoperative rescue analgesia was directed to achieve pain intensity less than 40 mm on a 100-mm visual analogue scale . The primary outcome measure was the postoperative requirement for ibuprofen between surgery and examination the following morning . Results : Intention-to-treat analysis showed that patients from the control group ( n = 59 ) required more ibuprofen than patients from the auricular acupuncture group ( n = 61 ) : median ( interquartile range ) 600 ( 200–800 ) v. 200 ( 0–600 ) mg ( p = 0.012 ) . Pain intensity on a visual analogue scale was similar in both groups at all time points registered . The majority of patients in both groups believed that they had received true acupuncture and wanted to repeat it in future . Interpretation : Auricular acupuncture reduced the requirement for ibuprofen after ambulatory knee surgery relative to an invasive needle control procedure Management of acute and chronic low back and leg pain often includes the use of acupuncture . The effectiveness of this form of therapy is dependent upon compliance , which in turn is dependent on availability , response , treatment of proper acupoints , and the placebo effect . We hypothesized that classical acupuncture would be more effective than placebo acupuncture .  One hundred and thirty-two patients with acute and chronic low back and leg pain were examined before and after surgery for lumbar disc protrusion . Diagnosis was based on CT and MRT findings . Patients received acupuncture drug-free throughout the study period . The visual analogue scale was used to assess pain intensity before and after ( i.e. 30 min . 60 min . 2 h and 6 h ) acupuncture . Classical acupuncture result ed in a significant reduction in pain that become increasingly stronger during the 6h study period . Placebo acupuncture lead to same early pain relief that did not reach statistic significant and then declined thereafter Transcutaneous electrical nerve stimulation ( TENS ) has been used as a complementary ( supplemental ) therapy to opioid analgesics for pain relief after surgery . Simultaneous stimulation at a classical Chinese acupoint site and periincisional dermatomes significantly decreases the postoperative analgesic requirement . This sham-controlled study was design ed to assess the relative effectiveness of acupoint versus nonacupoint stimulation on the postoperative hydromorphone ( HM ) requirement , the incidence of opioid-related side effects , and the overall recovery profile . One hundred women undergoing total abdominal hysterectomy or myomectomy procedures with a st and ardized general anesthesia were r and omly assigned to one of four postoperative analgesic treatment regimens ( n = 25 each ) : Group I = sham-TENS ( no electrical current ) at the Zusanli ( ST36 ) acupoints , Group II = nonacupoint-TENS at the shoulders , Group III = dermatomal-TENS at the level of the surgical incision , and Group IV = acupoint-TENS at the Zusanli acupoints . The frequency of TENS was set in the st and ard dense- and -disperse mode of 2/100 Hz . The intensity of stimulation was set at 0 mA for patients in Group I and at 9 - 12 mA for patients in Groups II , III , and IV . A patient-controlled analgesia ( PCA ) device programmed to deliver bolus doses of HM 0.2 - 0.4 mg IV on dem and with a minimal lockout interval of 10 min was used to quantify the postoperative opioid analgesic requirement . St and ard 100-mm visual analog scales were used to assess pain , as well as sedation , fatigue , and nausea , at specific intervals after surgery . The numbers of PCA dem and s and delivered bolus doses , requirements for supplemental medication , and any opioid-related side effects were recorded . In the first 24 h postoperatively , the opioid requirements in Groups III and IV were decreased by 37 % and 39 % , respectively , compared with the control ( sham ) group and 35 % and 38 % , respectively , compared with Group II . The duration of PCA usage and the incidences of nausea and dizziness were also significantly decreased in Groups III and IV compared with Groups I and II . We conclude that periincisional dermatomal and Zusanli acupoint stimulation were equally effective in decreasing the postoperative opioid analgesic requirement and in reducing opioid-related side effects . Both of these positions were more effective than the nonacupoint ( shoulder ) location . Implication s : The location of the stimulating electrodes seems to be an important determinant of the efficacy of transcutaneous electrical nerve stimulation in decreasing the need for opioid analgesics in the postoperative period . This study demonstrates that transcutaneous electrical nerve stimulation applied at the dermatomal level of the skin incision is as effective as Zusanli acupoint stimulation , and both were more effective than stimulation at a nonacupoint ( shoulder ) location . ( Anesth Analg 1998;87:1129 - 34 BACKGROUND Acupuncture is increasingly being used by the general population and investigated by conventional medicine ; however , studies of its effects on pain still lack adequate control procedures . OBJECTIVES To evaluate the ( 1 ) efficacy of Chinese acupuncture in treating postoperative oral surgery pain , ( 2 ) validity of a placebo-controlled procedure , and ( 3 ) effects of psychological factors on outcomes . DESIGN R and omized , double-blind , placebo-controlled trial . SETTING Dental School Outpatient Clinic , University of Maryl and at Baltimore . PARTICIPANTS Thirty-nine healthy subjects , aged 18 to 40 years , assigned to treatment ( n=19 ) and control ( n=20 ) groups . MAIN OUTCOME MEASURES Patients ' self-reports of time until moderate pain , time until medication use , total pain relief , pain half gone , and total pain medication consumption . RESULTS Mean pain-free postoperative time was significantly longer in the acupuncture group ( 172.9 minutes ) than in the placebo group ( 93.8 minutes ) ( P=.01 ) , as was time until moderate pain ( P=.008 ) . Mean number of minutes before requesting pain rescue medication was significantly longer in the treatment group ( 242.1 minutes ) than in the placebo group ( 166.2 minutes ) ( P=.01 ) , as was time until medication use ( P=.01 ) . Average pain medication consumption was significantly less in the treatment group ( 1.1 tablets ) than in the placebo group ( 1.65 tablets ) ( P=.05 ) . There were no significant between-groups differences on total-pain-relief scores or pain-half-gone scores ( P>.05 ) . Nearly half or more of all patients were uncertain of or incorrect about their group assignment . Outcomes were not associated with psychological factors in multivariate models . CONCLUSIONS Acupuncture is superior to the placebo in preventing postoperative dental pain ; noninsertion placebo procedure is valid as a control BACKGROUND : Acupuncture has been used to supplement opioid analgesics for postoperative pain control . We design ed this double-blind , sham-controlled study to assess the effectiveness of capsicum plaster ( PAS ) at Zusanli ( ST-36 ) acupoints on postoperative opioid analgesic requirement , side effects , and recovery profile . METHODS : Ninety women undergoing total abdominal hysterectomy were r and omly assigned to 3 treatment regimens ( n = 30 each ) : group Zusanli = PAS at Zusanli acupoints , group sham = PAS at the nonacupoints on the shoulders , and group control = placebo tape at Zusanli acupoints . The PAS was applied before induction of anesthesia and maintained for 8 h per day for 3 postoperative days . RESULTS : The total amount of morphine administered in the first 24 h after the operation was significantly decreased in group Zusanli ( 31.5 ± 6.8 mL ) compared with groups control ( 44.3 ± 10.1 mL ) and sham ( 44.6 ± 10.4 mL ) ( P < 0.01 ) . The incidence of postoperative side effects and the use of rescue antiemetics during the 72 h after surgery were significantly reduced in group Zusanli compared with other groups ( P < 0.01 ) . CONCLUSION : PAS at Zusanli points decreased the postoperative opioid requirement and opioid-related side effects of patients undergoing abdominal hysterectomy & NA ; Auricular acupuncture ( AA ) is known to be effective in treatment of various pain conditions , but still there have been no r and omized controlled studies of AA for treatment of acute postoperative pain  . Therefore we tested whether AA of specific points is superior to sham acupuncture for complementary analgesia after total hip arthroplasty in a patient – anesthesiologist – evaluator – analyst blinded study . The patients were r and omly allocated to receive true AA ( lung , shenmen , thalamus and hip points ) or sham procedure ( 4 non‐acupuncture points on the auricular helix ) . Permanent press AA needles were retained in situ 3 days after surgery . Postoperative pain was treated with intravenous piritramide ( opioid receptor agonist with analgesic potency of 0.7 compared with morphine ) using a patient‐controlled analgesia ( PCA ) pump . The time to the first analgesic request , the amount of postoperative piritramide via PCA and pain intensity on a 100‐mm visual analogue scale ( VAS‐100 ) were used to evaluate postoperative analgesia . Intraoperative anesthetic requirement , incidence of analgesia‐related side effects , inflammation parameters and success of patients ' blinding were also recorded . Fifty‐four patients ( 29 AA and 25 controls ) completed the study .  Piritramide requirement during 36 h after surgery in AA group was lower than in control : 37±18 vs. 54±21 mg ; mean±SD ; P=0.004 . Pain intensity on VAS‐100 and incidence of analgesia‐related side effects were similar in both groups . The differences between the groups as regard patients ' opinions concerning success of blinding were not significant . Findings from our study demonstrate that AA could be used to reduce postoperative analgesic requirement Postoperative pain is a major cause of ineffective breathing after lung surgery , predisposing patients to hypoxemia . Because potent analgesics like opioids depress ventilation and other analgesic techniques are time-consuming , efficient postoperative pain therapy is difficult . Therefore , a less painful surgical approach could be beneficial . Forty-seven patients with diagnosis of a pulmonary nodule were prospect ively studied . Patients were assigned to a video-assisted thoracic surgery ( VATS ) group ( n=22 ) or a group undergoing axillary thoracotomy ( n=25 ) . Visual analogue scale ( VAS ) scores , plasma glucose levels , plasma epinephrine and plasma norepinephrine levels , as well as arterial oxygen ( PaO2 ) and carbon dioxide ( PaCO2 ) tension were determined the day before surgery , and 3 , 15 , 24 , 48 , and 72 h after surgery . Postoperative piritramide ( a synthetic morphine compound ) dem and was recorded . VAS values were significantly lower ( p<0.05 ) during the whole observation period in the VATS group . Significantly higher epinephrine levels were observed 3 and 15 h after surgery ( 267.4 + /- 28 vs 111.8 + /- 13 ng/L ; p<0.01 ; and 176.6 + /- 46.5 vs 96 + /- 14.5 ng/L ; p<0.05 ) in the thoracotomy group , whereas there was no significant difference in norepinephrine ( correction of norephinephrine ) levels . Piritramide dem and was significantly ( p<0.05 ) reduced in the VATS group throughout the whole observation period . There was no difference in PaCO2 values but PaO2 Values were higher in the VATS group over 72 h , with maximum differences occurring at 15 h after operation : 60.9 + /- 1.9 vs 49.2 + /- 2.4 mm Hg ( p<0.01 ) . In conclusion , the videoendoscopic approach is associated with less postoperative pain and better oxygenation than traditional surgical approaches The possible postoperative antiemetic effect of transcutaneous electrical nerve stimulation ( TENS ) on the P6 point ( on the Pericardium Channel of H and -Jueyin ) was evaluated in 103 women undergoing hysterectomy .  TENS on the P6 point was applied 30 - 45 min before induction of anesthesia in 51 patients and continued for 6 h postoperatively . The control group , 52 patients , was treated exactly in the same way but with the electrical stimulator turned off . Incidence of vomiting was assessed blindly 2 h , 4 h , 6 h , and 8 h postoperatively . The incidence of vomiting postoperatively was significantly less in the TENS-treated group when compared with the control group ( between 0 h and 2 h : 23 % vs 43 % , P < 0.05 ; between 2 h and 4 h : 27 % vs 50 % , P < 0.025 ; and between 4 h and 6 h : 31 % vs 67 % , P < 0.001 , respectively ) . Six hours postoperatively TENS was discontinued , and 8 h postoperatively the two groups did not differ significantly for incidence of vomiting ( between 6 h and 8 h : 51 % vs 65 % ) . The authors conclude that TENS reduces the incidence of vomiting after hysterectomy BACKGROUND The role of electroacupuncture in  postthoracotomy pain control is uncertain . We conducted a pilot study to evaluate the role of electroacupuncture in the management of early postthoracotomy wound pain .  METHODS A total of 27 patients with operable non-small cell lung carcinoma who received thoracotomy were recruited and r and omized to receive either electroacupuncture or sham acupuncture in addition to routine oral analgesics and patient-controlled intravenous analgesia for postoperative pain control . All patients received acupuncture twice daily with visual analog pain score recorded for the first 7 postoperative days . Specific chest acupoints ( LI 4 , GB 34 , GB 36 , and TE 8) were targeted . Patient-controlled analgesia was used for the first 3 postoperative days in all patients , and the cumulative dosage used was recorded . RESULTS Two patients were excluded after r and omization because of complications unrelated to acupuncture . Interventions and data collection were completed for the remaining 25 patients ( 13 in the electroacupuncture group ; 12 in the sham acupuncture group ) . There was a trend for lower visual analog scale pain scores in the electro-acupuncture group between postoperative days 2 and 6 , although this did not reach statistical significance . The cumulative dose of patient-controlled analgesia morphine used on postoperative day 2 was significantly lower in the electroacupuncture group ( 7.5 + /- 5 mg versus 15.6 + /- 12 mg ; p < 0.05 ) . Such delay of onset of pain control may be related to the frequency of electroacupuncture used . CONCLUSIONS Electroacupuncture may reduce narcotic analgesic usage in the early postoperative period . A prospect i ve r and omized controlled trial using different electroacupuncture frequency is warranted to verify this benefit Our objective was to study the analgesic effect of acupoint pressure on postoperative pain in a controlled single-blind study . Forty patients undergoing knee arthroscopy in an ambulatory surgery unit in a university-affiliated hospital were r and omized to receive either an active stimulation ( AS ) or a placebo stimulation ( PS ) 30 min after awakening from anesthesia . We stimulated 15 classical acupoints in the AS group , on the side contralateral to surgery , with a firm pressure and a gliding movement across the acupoint . In the PS group , 15 nonacupoints were subjected to light pressure in the same areas as the acupoints in the AS group . We assessed pain using a 100-mm visual analog scale ( VAS ) before sensory stimulation , after 30 and 60 min , and after 24 h. We recorded heart rate , systolic arterial pressure , and skin temperature before stimulation and after 30 and 60 min . We assessed skin blood flow with laser Doppler before stimulation and after 1 and 30 min . Sixty minutes and 24 h after AS , VAS pain scores were lower than in the placebo group ( p < 0.05 and 0.0001 , respectively ) . There were no significant changes in the autonomic variables . The results indicate that pressure on acupoints can decrease postoperative pain PURPOSE : Posthemorrhoidectomy pain control remains a challenging problem . Transcutaneous electrical nerve stimulation is known to be effective in the treatment of many diseases . Our aim was to investigate the effect of transcutaneous electrical nerve stimulation on pain relief in patients undergoing hemorrhoidectomy .  METHODS : Sixty patients with symptomatic hemorrhoids were r and omly allocated into two groups , the acupoint group ( n=30 ) and the nonpoint control group ( n=30 ) . Transcutaneous electrical nerve stimulation was applied to those patients who received  hemorrhoidectomy  , and patient-controlled analgesia was achieved by injection of morphine through ambulatory infusion pumps . The dependent measures in this study were pain score from 0 ( no pain ) to 10 ( agonizing pain ) , analgesic doses administrated through patient-controlled analgesia , and postoperative complications . RESULTS : The subjective pain scores evaluated 8 , 12 , 16 , and 24 hours after hemorrhoidectomy in the control group and the acupoint group were 5.9±0.5 and 4.1±0.5 , 5.7±0.5 and 3.5±0.4 , 4.1±0.4 and 2.3±0.3 , and 3.2±0.4 and 1.9±0.2 , respectively ( two-way analysis of variance;P<0.05 ) . There was a significant difference between treatment groups in morphine use , with 11.6±2.2 mg in the control group and 6.2±1.3 mg in the acupoint group ( P<0.05 ) . The acupoint group tended to have less postoperative acute urinary retention ( Fisher 's exact probability test;P=0.145 ) and less need for analgesics than the control group ( P=0.112 , Fisher 's exact test ) . CONCLUSION : Transcutaneous electrical nerve stimulation is effective for pain relief in patients receiving hemorrhoidectomy . Its efficacy and safety could assist outpatient pain management after hemorrhoidectomy Given the inherent side effects associated with both opioid and nonopioid analgesic drugs , a nonpharmacologic therapy that could decrease the need for analgesic medication would be valuable . We design ed a shamcontrolled study to assess the effect of the intensity of transcutaneous acupoint electrical stimulation ( TAES ) on postoperative patient-controlled analgesia ( PCA ) requirement for hydromorphone ( HM ) , the incidence of opioid-related side effects , and the recovery profile after lower abdominal surgery . One hundred one healthy consenting women undergoing lower abdominal procedures with a st and ardized general anesthetic technique were r and omly assigned to one of four postoperative analgesic treatment regimens : Group I ( n = 26 ) PCA only ; Group II ( n = 25 ) , PCA + sham-TAES ( no electrical stimulation ) ; Group III ( n = 25 ) , PCA + low-TAES ( 4 - 5 mA of electrical stimulation ) ; Group IV ( n = 25 ) , PCA + high-TAES ( 9 - 12 mA of electrical stimulation ) . The PCA device was programmed to deliver HM , 0.2 - 0.4 mg intravenously boluses " on dem and , " with a minimum lockout interval of 10 min . The TAES skin electrodes were placed at the Hegu acupoint on the nondominant h and and on both sides of the surgical incision . The TAES frequency was set in the dense- and -disperse mode , alternating at 2 Hz and 100 Hz every 3 s , with stimulation of the h and and incision alternated every 6 s. The patients in Groups II-IV were instructed to use TAES every 2 h for 30 min while awake . After discontinuation of PCA , oral pain medications were administered on dem and . The postoperative PCA-HM requirement , pain scores , opioid-related side effects , and requirements for antiemetic and antipruritic medication were recorded . High-TAES decreased the HM requirement by 65 % and reduced the duration of PCA therapy , as well as the incidence of nausea , dizziness , and pruritus . Low-TAES produced a 34 % decrease in the HM requirement compared with only 23 % in the " sham " TAES group . We conclude that high-TAES produced a significant decrease in the PCA opioid requirement and opioid-related side effects after low intraabdominal surgery . ( Anesth Analg 1997;85:406 - 13 The efficacy of acupuncture and transcutaneous stimulation analgesia , supplemented by small doses of fentanyl ( mean 1.2 μg/kg , SD 1.7 ) was compared with moderate‐dose fentanyl anaesthesia ( mean 22.9 μg/kg , SD 2.8 ) in 29 patients who underwent surgery for retroperitoneal lymph node dissection . The present study describes the anaesthetic techniques and comparison of haemodynamics , dem and for analgesies after surgery , recovery and blood gases , restoration of urinary and bowel functions , convalescence in terms of self‐reliance and the postoperative course in respect of fatigue and morbidity . A more rapid return of consciousness , an absence of hypercapnia and a smaller decrease in pH were observed in patients who received acupuncture and transcutaneous stimulation ( p < 0.05 ) . No clinical ly relevant disadvantages attributable to the method were demonstrated
Postoperative pain management remains a significant challenge for all healthcare providers .
The objective of this systematic review was to quantitatively evaluate the efficacy of acupuncture and related techniques as adjunct analgesics for acute postoperative pain management .