The effect of high and low frequency electroacupuncture in pain after lower abdominal surgery Transcutaneous electrical nerve stimulation (TENS) for pain control after vaginal delivery and cesarean section Effect of Perioperative Electroacupuncture as An Adjunctive Therapy on Postoperative Analgesia with Tramadol and Ketamine in Prostatectomy: A Randomised Sham-Controlled Single-Blind Trial Needle-Free Electroacupuncture for Postoperative Pain Management Adjunct High Frequency Transcutaneous Electric Stimulation (TENS) for Postoperative Pain Management during Weaning from Epidural Analgesia Following Colon Surgery: Results from a Controlled Pilot Study. Postoperative pain management: study of patients' level of pain and satisfaction with health care providers' responsiveness to their reports of pain. Minute sphere acupressure does not reduce postoperative pain or morphine consumption. High frequency TENS as a complement for pain relief in postoperative transition from epidural to general analgesia after pancreatic resection. Preoperative Intradermal Acupuncture Reduces Postoperative Pain, Nausea and Vomiting, Analgesic Requirement, and Sympathoadrenal Responses Effect of acupressure of Ex-Le7 point on pain, nausea and vomiting after appendectomy: A randomized trial Effects of Electroacupuncture on Intraoperative and Postoperative Analgesic Requirement Effectiveness of transcutaneous electrical nerve stimulation on postoperative pain with movement. Transcutaneous electrical stimulation for postoperative pain. Postoperative pain control: Contribution of psychological factors and transcutaneous electrical stimulation [Effects of transcutaneous electrical stimulation of auricular Shenmen point on postoperative nausea and vomiting and patient-controlled epidural analgesia in cesarean section]. A Randomized Controlled Trial of Auricular Transcutaneous Electrical Nerve Stimulation for Managing Posthysterectomy Pain Survey of Adverse Events following Acupuncture (Safa): A Prospective Study of 32,000 Consultations The Effect of Location of Transcutaneous Electrical Nerve Stimulation on Postoperative Opioid Analgesic Requirement: Acupoint Versus Nonacupoint Stimulation The Analgesic Effects of Capsicum Plaster at the Zusanli Point After Abdominal Hysterectomy Effect of the frequency of transcutaneous electrical nerve stimulation on the postoperative opioid analgesic requirement and recovery profile. [Effect of electroacupuncture combined epidural anesthesia on plasma concentration of IL-1beta in patients undergoing gynecological surgery]. Thromboembolism after Total Hip Replacement: Role of Epidural and General Anesthesia [Effect of combined electroacupuncture and epidural anesthesia in gynecological operation evaluated by bispectral index]. Postoperative pain relief by transcutaneous electrical nerve stimulation (TENS). The York acupuncture safety study: prospective survey of 34 000 treatments by traditional acupuncturists Hi-TENS combined with PCA-morphine as post caesarean pain relief. Complications Occurring in the Postanesthesia Care Unit: A Survey Alfentanil Dose-Response Relationships for Relief of Postoperative Pain Correlation of Postoperative Pain to Quality of Recovery in the Immediate Postoperative Period A clinical assessment of electroanalgesia following abdominal operations. Acupressure improves the postoperative comfort of gastric cancer patients: A randomised controlled trial. Use of Transcutaneous Electrical Nerve Stimulation For Postoperative Pain Effect of the Intensity of Transcutaneous Acupoint Electrical Stimulation on the Postoperative Analgesic Requirement The effects of transcutaneous electrical nerve Stimulation on post-cesarean pain Effects of acupuncture on post-cesarean section pain. [Effect of previous analgesia of scalp acupuncture on post-operative epidural morphine analgesia in the patient of intestinal cancer].
& 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 Abstract Objective : The present study aims to determine the efficiency and reliability of transcutaneous electrical nerve stimulation ( TENS ) in the management of  pain related with uterine contractions after vaginal delivery and the pain related with both abdominal incision uterine contractions after cesarean section . Methods : A hundred healthy women who underwent cesarean section under general anesthesia were r and omly assigned to the placebo group ( Group 1 ) or the TENS group ( Group 2 ) , while 100 women who delivered by vaginal route without episiotomy were r and omized into the placebo group ( Group 3 ) or the TENS group ( Group 4 ) . Results : The patients in Group 2 had statistically lower visual analog scale ( VAS ) and verbal numerical scale ( VNS ) scores than the patients in Group 1 ( p < 0.001 for both ) . The patients in Group 4 had statistically lower VAS and VNS scores than the patients in Group 3 ( p = 0.022 and p = 0.005 , respectively ) . The analgesic requirement at the eighth hour of cesarean section was significantly lower in the patients who were treated with TENS ( p = 0.006 ) . The need for analgesics at the eighth hour of vaginal delivery was statistically similar in the patients who were treated with TENS and the patients who received placebo ( p = 0.830 ) . Conclusion : TENS is an effective , reliable , practical and easily available modality of treatment for postpartum pain Objectives To study the analgesic effect of electroacupuncture ( EA ) as perioperative adjunctive therapy added to a systemic analgesic strategy ( including tramadol and ketamine ) for postoperative pain , opioid-related side effects and patient satisfaction . Methods In a sham-controlled participant- and observer-blinded trial , 75 patients undergoing radical prostatectomy were r and omly assigned to two groups : ( 1 ) EA ( n=37 ; tramadol+ketamine+EA ) and ( 2 ) control ( n=38 ; tramadol+ketamine ) . EA ( 100 Hz frequency ) was applied at LI4 bilaterally during the closure of the abdominal walls and EA ( 4 Hz ) was applied at ST36 and LI4 bilaterally immediately after extubation . The control group had sham acupuncture without penetration or stimulation . The following outcomes were evaluated : postoperative pain using the Numerical Rating Scale ( NRS ) and McGill Scale ( SF_MPQ ) , mechanical pain thresholds using algometer application close to the wound , cortisol measurements , rescue analgesia , Spielberger State Trait Anxiety Inventory ( STAI Y-6 item ) , patient satisfaction and opioid side effects . Results Pain scores on the NRS and SF_MPQ were significantly lower and electronic pressure algometer measurements were significantly higher in the EA group than in the control group ( p<0.001 ) at all assessment s. In the EA group a significant decrease in rescue analgesia was observed at 45 min ( p<0.001 ) and a significant decrease in cortisol levels was also observed ( p<0.05 ) . Patients expressed satisfaction with the analgesia , especially in the EA group ( p<0.01 ) . Significant delays in the start of bowel movements were observed in the control group at 45 min ( p<0.001 ) and 2 h ( p<0.05 ) . Conclusions Adding EA perioperatively should be considered an option as part of a multimodal analgesic strategy This study examined the effects of needle-free electroacupuncture , at ST36 on postoperative pain following hysterectomy . Based on a double-blind , sham and different intervention controlled clinical experimental design , 47 women were r and omly allocated to four different groups . Except for those in the control group ( Group 1 , n = 13 ) , a course of treatment was given of either sham ( Group 2 , n = 12 ) , high-frequency stimulation ( Group 3 , n = 12 ) , or low-frequency stimulation ( Group 4 , n = 10 ) . All groups were assessed during the postoperative period for 24 hours . The Visual Analogue Scale was used to determine the amount of perceived pain felt by each subject . Differences were found between the means postoperatively at three , four , eight , 16 and 24 hours . Post hoc comparison tests indicated that Group 4 was significantly different from Groups 1 , 2 , and 3 at 24 hours . A one-way ANOVA analysis for total patient-controlled analgesia dem and and doses indicated significant differences between the groups F(3 , 42 ) = 3.59 , P < .05 . Post hoc analysis confirmed the differences between Groups 1 ( M = 84.54 ) and 4 ( M = 41.60 ) . Treatment outcomes of this therapy showed a positive effect for the management of postoperative pain The potential benefit of nonpharmacological adjunctive therapy is not well-studied following major abdominal surgery . The aim of the present study was to investigate transcutaneous electrical nerve stimulation ( TENS ) as a complementary nonpharmacological analgesia intervention during weaning from epidural analgesia ( EDA ) after open lower abdominal surgery . Patients were r and omized to TENS and sham TENS during weaning from EDA . The effects on pain at rest , following short walk , and after deep breath were assessed by visual analog scale ( VAS ) grading . Number of patients assessed was lower than calculated because of change in clinical routine . Pain scores overall were low . A trend of lower pain scores was observed in the active TENS group of patients ; a statistical significance between the groups was found for the pain lying prone in bed ( p < .05 ) . This controlled pilot study indicates benefits of TENS use in postoperative pain management during weaning from EDA after open colon surgery . Further studies are warranted in order to verify the potential beneficial effects from TENS during weaning from EDA after open , lower abdominal surgery The present prospect i ve survey was conducted in a 1200-bed hospital to examine postoperative patients ' current pain intensity , most intense pain experienced , satisfaction with postoperative pain management , and differences regarding pain and satisfaction levels .  All adult patients admitted to a hospital in Hong Kong for surgery , except those receiving local anesthesia , were eligible to enter this study . The patient outcome question naire developed by the American Pain Society was used to solicit data about patients ' pain and satisfaction with pain relief . The subjects were 294 postoperative patients . Approximately 85 % complained about varying degrees of pain during the 24 h prior to the assessment of their pain . When interviewed , most patients complained of mild to moderate pain ( median = 2 on a 10-point scale ) , while the median for ' worst pain intensity ' was 5 . Approximately 80 % of the subjects indicated that both the nurses and physicians reminded them to report pain when it occurred . Only 143 ( 48.6 % ) agreed that the nurses and physicians sufficiently emphasized the importance of pain relief . Those who received acute pain services , provided by anesthetists , reported lower levels of current pain intensity . Over 65 % of the subjects were satisfied with all levels of health care providers , regarding their postoperative pain management Minute sphere acupressure has been used for more than 2000 yr and remains popular in Japan . The points most relevant to abdominal surgery are those associated with meridian flows crossing or originating in the abdomen . We tested the hypothesis that minute sphere therapy reduces pain and analgesic requirements after open abdominal surgery . Participating patients were given st and ardized desflurane and fentanyl anesthetic .  On completion of surgery , they were r and omly assigned to untreated control or minute sphere acupressure at the Neiguan , Zusanli , Sanyinjiao , and Gongsun points . Each site was covered with bulky gauze dressings so that patients could not determine their assignments . Postoperative pain was treated with IV morphine via a patient-controlled analgesia pump . Our primary a priori end-points were pain and opioid consumption on the first postoperative morning . Data are reported as median ( 25th percentile , 75th percentile ) . Fifty-three patients ( 30 controls and 23 minute spheres ) completed the study .  Morphine requirements ( 47 mg [ 27 , 58 ] vs 41 mg [ 25 , 69 ] ) and pain scores ( 29.5 mm [ 16 , 59 ] vs 40 mm [ 22 , 58 ] ) were similar in the control and acupressure groups . These data provide an 80 % power for detecting a 50 % difference in morphine consumption at an alpha of 0.05 . Minute sphere treatment at the Neiguan , Zusanli , Sanyinjiao , and Gongsun points thus failed to provide analgesia after abdominal surgery . Minute sphere therapy is a form of acupuncture . We tested whether minute spheres placed on three acupressure points relevant to abdominal surgery reduced pain and morphine requirements after abdominal surgery . Treatment and control patients received a similar covering . Neither pain nor morphine requirements were different between the groups AIM This study investigated the effect of high frequency transcutaneous electric nerve stimulation ( TENS ) as a pain relieving complementary therapy at the transition from epidural ( EDA ) to general analgesia after pancreatic surgery by horizontal , abdominal incision . METHOD Fifty-five consecutive patients undergoing pancreatic resection were enrolled in the study and r and omly assigned to active or sham TENS treatment .  Twenty subjects were included in the analysis . Pain , quality of recovery and additional analgesia consumption were measured during the 24 h of transition from EDA to general analgesia . RESULTS Additional analgesic consumption and pain estimations at 24 h after EDA termination differed between the two groups , but was not statistically significant . CONCLUSION This study did not find support to reject use of high frequency TENS as complement during transition from EDA to general analgesia after major abdominal surgery with horizontal incision 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 Background : The Le7 acupoint had been known as an acupoint for reducing pain of appendicitis . However , no study on the effect of its acupressure on post-appendectomy pain is available . The objective of this study was to evaluate the effects of acupressure of Le7 acupoint on pain , nausea , and vomiting after appendectomy . Material s and Methods : A single-blind r and omized controlled trial was conducted on 70 post-appendectomy patients in a general surgical ward . Patients with inclusion criteria were selected consecutively and were r and omly assigned into two groups . The intervention group received acupressure to the Le7 acupoint and the second group was the control group . The severity of post-operative pain , nausea , and vomiting measured hourly till the seventh post-operative hour . T-test was used to compare the mean of pain and nausea severity of two groups . Paired t-test was used to compare the mean of pain intensity of each group before and total mean of pain at post-intervention hours . Chi-squared test and Fisher exact test were used for nominal data . Results : The mean of pain intensity in the intervention group was 5.10 ± 3.52 before intervention and decreased to 3.53 ± 0.75 in the post-operative hours ( P = 0.018 ) . The mean of pain intensity in the control group was 4.45 ± 3.16 before intervention and changed to 4.01 ± 0.92 in the post-operative hours ( P = 0.32 ) . However , the mean of pain intensity in the intervention group was less than the control group till 6th h after the surgery . No significant differences were observed between the two groups in terms of nausea and vomiting ( P = 0.74 ) . Conclusion : Acupressure on Le7 acupoint was effective on post-appendectomy pain but did not affect nausea and vomiting . Further investigations are suggested with starting acupressure at the onset of pain or nausea and vomiting 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 This study tested the effectiveness of episodic transcutaneous electrical nerve stimulation ( TENS ) as a supplement to pharmacologic analgesia on pain with movement and at rest after abdominal surgery and evaluated whether its use during walking and vital capacity maneuvers enhances performance of these activities . TENS , with a modulated frequency , intensity as high as the subject could tolerate , and electrodes placed on either side and parallel to the incision , was compared to placebo TENS and pharmacologic analgesia alone ( control ) by using a crossover design . Self-report of pain intensity , walking function , and vital capacity were assessed on 33 subjects .  TENS result ed in significantly less pain than the control during both walking ( P < .5 ) and vital capacity activities ( P < .1 ) and significantly less pain than placebo TENS during vital capacity ( P < .01 ) . TENS also produced significantly better gait speeds than the control ( P < .05 ) and greater gait distances ( P < .01 ) than the control and placebo TENS .  Vital capacity and pain intensity at rest were not significantly different among the 3 treatments . These results suggest TENS reduces pain intensity during walking and deep breathing and increases walking function postoperatively when used as a supplement to pharmacologic analgesia . The lack of effect on pain at rest supports the hypothesis that TENS works through reducing hyperalgesia A prospect i ve r and omised trial was conducted to assess transcutaneous electrical stimulation in the management of  postoperative pain and its effect on postoperative pulmonary function and respiratory complications .  Consecutive patients undergoing abdominal surgery were allocated to receive transcutaneous electrical stimulation or ' sham ' therapy . There was no significant difference in the amount of postoperative pain as measured by linear analogue pain scales or morphine requirements . Arterial oxygen and carbon dioxide tensions were similar in both groups . There was no difference in the incidence of postoperative chest infection . These results do not support the use of transcutaneous electrical stimulation following abdominal surgery Abstract The influence of transcutaneous electrical stimulation ( TES ) and psychological factors in determining the intensity of  acute postoperative pain was examined in a prospect i ve , double‐blind controlled trial completed by 30 patients having elective surgery . Psychometric tests were administered prior to surgery . Postoperative pain was assessed by cumulative morphine requirement ( M48 ) administered intramuscularly , and the mean score of a visual analogue scale of pain ( VAS ) , in the first 48 h following surgery . M48 was significantly correlated with the VAS score ( r = 0.62 , P < 0.001 ) , and with the psychometric test scores for trait‐anxiety ( r = 0.70 , P < 0.001 ) and neuroticism ( r = 0.67 , P < 0.001 ) . Though patients treated with TES required 25 % less morphine than those treated with placebo , the difference was not significant using monovariate analysis and applying unpaired two‐tailed Student 's t‐test ( P > 0.2 ) . When the contribution of neuroticism to the variance of M48 was adjusted using multiple regression analysis , the effect of TES became significant at the 0.05 level . Covariance analysis showed that TES contributed some 19 % to the explained variance of M48 while neuroticism contributed about 80 % , and there was no interaction between these two factors . These findings allow a degree of prediction of the individual patient 's postoperative pain and narcotic requirement , and point to a strong correlation between postoperative pain perception and personality OBJECTIVE To investigate the effects of transcutaneous electrical stimulation of auricular Shenmen point on postoperative nausea and vomiting and patient-controlled epidural analgesia in cesarean section . METHODS After IRB approval and informed consent , one hundred and eighty singleton primiparas undergoing elective cesarean section , in Qingdao Municipal Hospital , and Qingdao Hiser Medical Center , from November 2011 to March 2012 , were r and omly assigned to three groups : transcutaneous electrical stimulation of auricular Shenmen point group ( group A , n = 60 ) , transcutaneous electrical stimulation of auricular Eye point group ( group B , n = 60 ) and control group ( group C , n = 60 ) . Women of group A received transcutaneous electrical stimulation of auricular Shenmen point ( frequency 1.5 HZ ) at the time of preoperation , 4 , 10 and 22 hours of postoperation for 30 minutes . The strength was controlled by themselves . Women of group B received stimulation of auricular Eye point as group A. Women of group C received pressurization and connected line were the same with group A , but without electrical stimulation . The following indexes was observed : the incidence of postoperative nausea and vomiting ( PONV ) for 48 hours ; the rate of metoclopramide ; the visual analogue scale ( VAS ) score of rest pain , uterine contration pain and dynamic pain at the time of postoperation for 6 , 12 , 24 and 48 hours ( T(1)-T(4 ) ) ; the total number and effective compressions number of patient-controlled epidural analgesia(PCEA);the dose of analgesia mixture ; the anal exhaust time ; the volume of postoperative bleeding for 6 hours of postoperation and the other side effects . RESULTS Compared with group B and group C , the incidence of PONV , the rate of metoclopramide , the VAS score at the time T(1)-T(4 ) , the total number and effective compressions number of PCEA , the ratio of the total number with effective compressions number and the dose of analgesia mixture were decreased in group A ( P < 0.05 ) , but no difference compared group B with group C ( P > 0.05 ) . The anal exhaust time and the volume of postoperative bleeding for 6 hours of postoperation were no difference in the three groups ( P > 0.05 ) . No other side effects were observed . CONCLUSION Transcutaneous electrical stimulation of auricular Shenmen point can reduce the incidence of PONV and improves analgesia effect of PCEA in postoperation of cesarean section Background . A patient- and assessor-blinded r and omized controlled trial was conducted to examine the effectiveness of auricular transcutaneous electrical nerve stimulation ( TENS ) in relieving  posthysterectomy pain .  Method . Forty-eight women who had undergone a total abdominal hysterectomy were r and omly assigned into three groups ( n = 16 each ) to receive either ( i ) auricular TENS to therapeutic points ( the true TENS group ) , ( ii ) auricular TENS to inappropriate points ( the sham TENS group ) , or ( iii ) 20 minutes of bed rest with no stimulation ( the control group ) . The intervention was delivered about 24 hours after the operation . A visual analogue scale was used to assess pain while resting ( VAS-rest ) and upon huffing ( VAS-huff ) and coughing ( VAS-cough ) , and the peak expiratory flow rate ( PEFR ) was assessed before and at 0 , 15 , and 30 minutes after the intervention . Result . As compared to the baseline , only the true TENS group reported a significant reduction in VAS-rest ( P = .001 ) , VAS-huff ( P = .004 ) , and VAS-cough ( P = .001 ) , while no significant reduction in any of the VAS scores was seen in the sham TENS group ( all P > .05 ) . In contrast , a small rising trend was observed in the VAS-rest and VAS-huff scores of the control group , while the VAS-cough score remained largely unchanged during the period of the study . A between-group comparison revealed that all three VAS scores of the true TENS group were significantly lower than those of the control group at 15 and 30 minutes after the intervention ( all P < .02 ) . No significant between-group difference was observed in PEFR at any point in time . Conclusion . A single session of auricular TENS applied at specific therapeutic points significantly reduced resting ( VAS-rest ) and movement-evoked pain ( VAS-huff , VAS-cough ) , and the effects lasted for at least 30 minutes after the stimulation . The analgesic effects of auricular TENS appeared to be point specific and could not be attributed to the placebo effect alone . However , auricular TENS did not produce any significant improvement in the performance of PEFR Acupuncture is increasingly used , so it is important to establish whether its benefits outweigh its risks . Numerous case reports of adverse events show that acupuncture is not free of risk , but accurate data from prospect i ve investigations is scarce . A prospect i ve survey was undertaken using intensive event monitoring . Forms were developed for reporting minor events each month and significant events as they occurred . The sample size was calculated to identify any adverse events that occurred more frequently than once in 10,000 consultations . Acupuncturists were recruited from two professional organisations in the UK . Seventy-eight acupuncturists , all doctors or physiotherapists , reported a total of 2178 events occurring in 31,822 consultations , an incidence of 684 per 10,000 consultations . The most common minor adverse events were bleeding , needling pain , and aggravation of symptoms ; aggravation was followed by resolution of symptoms in 70 % of cases . There were 43 significant minor adverse events reported , a rate of 14 per 10,000 , of which 13 ( 30 % ) interfered with daily activities . One patient suffered a seizure ( probably reflex anoxic ) during acupuncture , but no adverse event was classified as serious . Avoidable events included forgotten patients , needles left in patients , cellulitis and moxa burns . In conclusion , the incidence of adverse events following acupuncture performed by doctors and physiotherapists can be classified as minimal ; some avoidable events do occur . Acupuncture seems , in skilled h and s , one of the safer forms of medical intervention 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 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 BACKGROUND Transcutaneous electrical nerve stimulation ( TENS ) at either an acupoint or dermatome corresponding to the surgical incision produces comparable decreases in postoperative opioid requirements and opioid-related side effects . However , the effect of the frequency of the electrical stimulus on the postoperative analgesic response to TENS therapy has not been studied . METHODS One hundred women undergoing major gynecological procedures with a st and ardized general anesthetic technique were enrolled in the study . Patients were r and omly assigned to four groups : group I , patient-controlled analgesia ( PCA ) plus sham TENS ( no stimulation ) ; group II , PCA plus low-frequency ( 2-Hz ) TENS ; group m , PCA plus high-frequency ( 100-Hz ) TENS ; group IV , PCA plus mixed-frequency ( 2- and 100-Hz ) TENS . The PCA device was programmed to deliver 2 - 3 mg intravenous boluses of morphine with a lockout interval of 10 min . The TENS device was used every 2 h during the day . St and ard 100-mm visual analog scales were used to assess pain , sedation , fatigue , and nausea at specific intervals after surgery . RESULTS Mixed frequency ( 2 and 100 Hz ) of stimulation decreased morphine requirements by 53 % compared with the sham group ; low ( 2-Hz ) and high ( 100-Hz ) frequencies produced 32 % and 35 % decreases , respectively . All three " active " TENS groups reduced the duration of PCA therapy , as well as the incidence of nausea , dizziness , and itching . CONCLUSIONS TENS decreased postoperative opioid analgesic requirements and opioid-related side effects when utilized as an adjunct to PCA after lower abdominal surgery . Use of TENS at mixed ( 2- and 100-Hz ) frequencies of stimulation produced a slightly greater opioid-sparing effect than either low ( 2-Hz ) or high ( 100 Hz ) frequencies alone OBJECTIVE To study the effect of electroacupuncture ( EA ) combined epidural anesthesia on plasma concentration of IL-1beta in patients undergoing gynecological surgery . METHODS Forty patients who were scheduled to receive gynecological operation under epidural anesthesia were r and omly assigned to the epidural anesthesia group ( Group A , 20 cases ) and the epidural combined EA group ( Group B , 20 cases ) . All patients in the two groups received epidural anesthesia . Continuous EA at Zusanli ( ST36 ) and Sanyinjiao ( SP6 ) with the frequency of 30 -100 Hz was applied in those in Group B. The peri-operative hemodynamic changes , visual analog scale ( VAS ) , and the plasma concentration of IL-1 3 were observed . RESULTS There was no statistical difference in peri-operative hemodynamic changes between the two groups ( P > 0.05 ) . Compared with Group A , the VAS was lower in Group B at post-operative 8 , 24 , and 48 h , respectively ( P < 0.05 ) , and the plasma concentration of IL-1beta was also lower in Group B at post-operative 4 h , 24 h , and 3 days ( P < 0 . 05 ) . CONCLUSION Acupuncture could ease postoperative pain and reduce the plasma concentration of IL-1beta The effects of continuous epidural anesthesia and of general anesthesia on the incidence of thromboembolism following total hip replacement were studied . Sixty patients were r and omly allotted to one of two groups receiving either epidural or general anesthesia . Epidural anesthesia ( N = 30 ) consisted of 0.5 % bupivacaine with epinephrine intraoperatively ; for pain relief in the postoperative period ( 24 h ) , 0.25 % bupivacaine with epinephrine was given every 3 h. General anesthesia ( N = 30 ) consisted of controlled ventilation with N2O-O2 and intravenous fentanyl and pancuronium bromide ; postoperatively , narcotic analgesics were given intramuscularly on dem and for pain relief . Significantly lower frequencies were found following epidural anesthesia than after general anesthesia in deep venous thrombosis involving the popliteal and femoral veins ( 13 % and 67 % , respectively ) , deep venous thrombosis involving both calf and thigh veins ( 40 % and 77 % ) , and pulmonary embolism ( 10 % and 33 % ) . Possible explanations for these differences include increased circulation in the lower extremities , less tendency for intravascular clotting to occur , and more efficient fibrinolysis in association with continuous epidural anesthesia . The decrease in blood loss associated with epidural anesthesia with lower transfusion requirements also might play a role . Epidural analgesia prolonged into the postoperative period , in addition to other appropriate thromboprophylactic measures , should be of value in patients undergoing operations associated with a high risk of thromboembolic complications OBJECTIVE To evaluate the effect of combined electroacupuncture ( EA ) and epidural anesthesia in gynecological operation by bispectral index ( BIS ) . METHODS Sixty patients of ASA grade I-II , 20 - 60 years old , being scheduled to receive gynecological operation with epidural anesthesia were r and omly assigned to 3 groups equally . Group A was anesthetized with epidural infusion of midazolam in dosage of 0.04 mg/kg , Group B with continuous EA in 30 - 100 Hz on Zusanli ( ST36 ) and Sanyinjiao ( SP6 ) acupoints , and Group C with both epidural infusion and EA same as those applied in Groups A and B. BIS , blood pressure ( BP ) , heart rate ( HR ) , and blood oxygen saturation ( SPO2 ) were monitored during peri-operative stage , and the post-operation visual analogue scores ( VAS ) was measured as well . RESULTS BIS decreased after operation in all groups ( P < 0.05 ) , the highest value was shown in Group B ( P < 0.05 ) and the lowest was seen in group C at time of skin incising ; while at time of gauze plugging , it was higher in Group B than in other two groups ( P < 0.05 ) . Besides , VAS in Group A at 8 h and 24 h after operation was higher than that in the other two groups respectively ( P < 0.05 ) . CONCLUSION BIS can be taken as an index for objective ly evaluating the effect of combined EA and epidural anesthesia in gynecological operation . EA anesthesia has certain analgesic and sedative effects , could effectively release postoperative pain In prospect i ve , r and om assignment of 2 groups of 15 patients , relief of postoperative pain with narcotic medications was evaluated and compared with transcutaneous electrical nerve stimulation ( TENS ) for 2 days immediately following surgery . Presence of ileus and hospital stay were identical in both groups . Patients on TENS demonstrated a marked significant decrease in the amount of narcotics administered . There was favorable nursing , physician and patient acceptance to these devices . Further clinical evaluation is , therefore , in progress Recent reports have highlighted the importance of having good evidence on the safety of acupuncture . 1 2 Sound evidence on the risks associated with acupuncture is , however , scarce.3 Our primary aim , therefore , was to describe the type and frequency of adverse events after acupuncture . A secondary aim was to examine mild transient reactions associated with  acupuncture  , some of which may indicate a positive response to treatment . The study involved a prospect i ve postal audit of treatments undertaken during a four week period in 2000 . All 1848 professional acupuncturists who were members of the British Acupuncture Council and were practising in the United Kingdom were invited to record details of adverse events and mild transient reactions after treatment . St and ardised self report forms were used . Participating practitioners also provided information on themselves , including age , sex , length of training , and years of practice . To have a OBJECTIVES to examine effectiveness and overall opiate consumption between high-sensory transcutaneous electrical nerve stimulation ( Hi-TENS ) combined with patient-controlled analgesia with morphine and patient-controlled analgesia with morphine alone  following elective ( e.g. scheduled ) caesarean birth . DESIGN r and omised , controlled study . SETTING a county hospital in south-west Sweden . PARTICIPANTS 42 multiparous women . MEASUREMENTS AND FINDINGS participants were r and omly assigned and connected to patient-controlled analgesia with morphine alone or in combination with Hi-TENS apparatus .  Levels of morphine  consumed were calculated every third hour during the first 24 hours post partum . Pain and sedation were assessed by visual analogue scale at one , three , six , nine , 12 and 24 hours post partum . Total consumption of morphine differed significantly between the groups : morphine with TENS was 16.2 ± 12.6 mg and morphine alone was 33.1 ± 20.9 mg ( p = 0.007 ) . Assessment of pain relief showed no significant difference . Sedation differed significantly between the groups ( p = 0.045 ) , especially between three and 12 hours post partum ( p = 0.011 ) . KEY CONCLUSIONS AND IMPLICATION S FOR PRACTICE pain relief from a combination of Hi-TENS and patient-controlled analgesia with morphine was as effective as patient-controlled analgesia with morphine alone , produced less sedation and reduced morphine use by approximately 50 % . Women undergoing a caesarean section should be given the opportunity to make an informed choice about post operative pain relief before surgery . A presumed benefit of this treatment combination is that the mother is more alert and better able to interact with her newborn during the first hours after birth without drowsiness due to large doses of opiates To identify and quantitate complications occurring in the postanesthesia care unit ( PACU ) , a prospect i ve study evaluated 18,473 consecutive patients entering a PACU at a university teaching hospital . Using a st and ardized collection form , the incidence of intra-operative and PACU complications was determined . The combined PACU and intraoperative complication rate was 26.7 % . Data showed a PACU complication rate of 23.7 % , with an overall intraoperative complication rate of 5.1 % . Nausea and vomiting ( 9.8 % ) , the need for upper airway support ( 6.9 % ) , and hypotension requiring treatment ( 2.7 % ) were the most frequently encountered PACU complications . Patients in whom PACU complications developed were analyzed by ASA physical status . Of all patients experiencing nausea and vomiting ( n = 1571 ) , the highest percentage were ASA physical status II patients ( n = 831 ) . Likewise , in the group of 1450 patients who demonstrated a need for upper airway support , 792 were ASA physical status II . In patients experiencing a major cardiovascular complication , for example , variables associated with a greater risk of developing any PACU complications were ASA physical status ( status II ) , duration of anesthesia ( 2–4 h ) , anesthetic technique , emergency procedures , and certain types of surgical procedures ( orthopedic or abdominal ) . For patients admitted with a temperature of < 35 ° C the duration of the PACU stay was 152 ± 46 min compared with 116 ± 65 min for patients with a temperature ≥36 ° C ( P < 0.01 ) . In conclusion , events occurring during the PACU period continue to be a source of patient morbidity The aim of this study was to characterize within-patient alfentanil dose-response curves for the relief of spontaneous postoperative pain and to test the closeness of relationships 1 ) between pain intensity and alfentanil analgesic requirements , and 2 ) between alfentanil requirements for analgesic and nonanalgesic ( sedative and miotic ) effects . The effects of alfentanil were studied in 23 patients after elective abdominal surgery . During a 40- to 60-min testing session , the patient received two intravenous ( IV ) injections of saline ( placebo ) and up to six 3-micro gram/kg increments of alfentanil at 5-min intervals . The patient rated the pain intensity with a visual analog scale , and in a subgroup of 15 patients the blinded observer rated patients ' sedation and measured pupil diameter . Spontaneous postoperative pain was completely relieved in all patients with cumulative doses of alfentanil ranging from 6 to 18 micro gram/kg . The within-patient alfentanil dose-analgesic response curves were primarily quantal in nature : a precipitous decrease in pain intensity ( representing > or = to 2/3 of the total effect ) after the injection of only one of the increments of alfentanil was observed in 15 of 23 patients . When the analgesic effect of alfentanil was presented as the collective response of a group of individuals , the quantal nature of the response was concealed by the wide interindividual variability of the response . No statistically significant relationship was noted between predrug pain intensity and the cumulative dose of alfentanil necessary to produce pain relief . A strong correlation was found between interpatient variabilities in the analgesic and sedative effects of alfentanil ( r = 0.75 , P < 0.002 ) . At the same time , the relationship between alfentanil requirements for pain relief and that for pupil constriction did not demonstrate any significant correlation . The results suggest that , in a population of patients with postoperative pain , the intensity of spontaneous pain can not be the primary factor determining the dose of alfentanil necessary for its relief . ( Anesth Analg 1996;83:387 - 93 Background and Objectives : It is unclear whether the severity of postoperative pain may affect patients ' quality of recovery in the immediate postoperative period ( within 2 weeks of surgery ) . Methods : This was a prospect i ve , observational study in patients undergoing elective radical retropubic prostatectomy .  All patients received a st and ardized intraoperative general or spinal anesthetic followed by intravenous patient-controlled analgesia .  Visual analog scores for pain at rest , pain with activity , and nausea along with the QoR , an instrument vali date d to assess quality of recovery in the postoperative period , and Brief Fatigue Inventory were assessed on postoperative days 1 to 3 , 7 , and 30 . The Epworth Sleepiness Scale was assessed on postoperative days 7 and 30 . Results : We found that the severity of pain both at rest and with activity correlated with a decrease in quality of recovery as assessed by the QoR. Conclusions : Our findings suggest that an increase in postoperative pain is correlated with a decrease in a patient 's quality of recovery in the immediate postoperative period A prospect i ve r and omized controlled trial was performed to assess the value of transcutaneous electrical stimulation as an analgesic technique for  postoperative pain . Forty patients who underwent cholecystectomy were studied . Patients in group A ( control group ) complained of more severe wound pain than either patients in group B ( wound stimulation ) or group C ( remote stimulation ) . However , the treated groups showed no evidence of a significant reduction in opiate dem and or of improved ventilatory function OBJECTIVE This pilot study evaluated whether acupressure affected the postoperative comfort of gastric cancer patients following a subtotal gastrectomy . METHODS A r and omised controlled trial was conducted . Sixty patients were recruited from 141-bed general surgery ward at a 3000-bed medical centre in Northern Taiwan . Participants were r and omly assigned to either a control group receiving regular postoperative care or to the experimental group receiving additional acupressure at acupoints of Neiquan ( P6 ) and Zusanli ( ST36 ) for 3 consecutive days . RESULTS The similarities between two groups were in postoperative pain and the onset of postoperative nausea and vomiting ( PONV ) at the baseline . Following acupressure , significant differences were found in postoperative pain ( P=.03 ) and time of first flatus ( P=.04 ) ; but not PONV ( P=.49 ) , nor the time of first defecation ( P=.34 ) . CONCLUSIONS Acupressure is a simple , noninvasive , safe , and economical procedure for improving the comfort of patients who undergo surgery for gastric cancer .  Acupressure at the P6 and ST36 acupoints can improve postoperative comfort by alleviating pain and decreasing the time until first flatus . However , additional research is necessary to eluci date how acupressure can improve postoperative outcomes This study examined the effects of transcutaneous electrical neroe stimulation ( TENS ) on  incisional pain caused by the procedure of cleaning and packing an abdominal surgical wound . Seventy-five subjects ( mean age 56.9 years ) were r and omly assigned to one of three intervention groups : TENS , placebo-TENS , or no-treatment control . The appropriate experimental treatment was administered during the routine dressing change which took place two mornings after surgery . Using an 11-point , visual analogue pain scale , subjects described pain experienced during the dressing change . Subjects who received TENS reported a significantly lower level of pain after dressing change than did those subjects who received either placebo-TENS or no-treatment . Drug administration variables did not contribute significantly to level of reported pain 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 & NA ; The purpose of this study was to examine the effect of continuous transcutaneous electrical nerve stimulation ( TENS ) near the incision site on  post‐cesarean pain  and on analgesic intake during the early postoperative period . This investigation utilised a 2‐group ( TENS‐treated and placebo TENS‐treated ) , single‐blind experimental design . Eighteen multiparous women , each having undergone an elective cesarean delivery , participated in the study . Nine patients received TENS and nine placebo stimulation . The treatment was continuous through to the third day following the day of surgery . The McGill Pain Question naire was used to estimate the three most frequent types of post‐cesarean‐associated pain , and records of the patients ' analgesic intake were obtained from hospital charts . The results suggest that TENS was significantly more effective than placebo TENS in reducing cutaneous , movement‐associated incisional pain . However , pain result ing from internal structures i.e. , deep pain , afterbirth pain ( due to uterine contractions ) , and the somatic pain associated with decreased peristalsis ( gas pains ) were not amenable to TENS . No significant differences in analgesic intake were observed . The possible reasons for these findings are discussed BACKGROUND Post-operation pain is a very subjective phenomenon . The aim of this study was to find out the effects of acupuncture or electro-acupuncture on  post-cesarean pain .  METHODS Sixty women , who had had spinal anesthesia during cesarean section at the Department of Obstetrics of China Medical University Hospital , were r and omly assigned to the control group , the acupuncture group , and the electro-acupuncture group . After the operation , we applied subjects with acupuncture or electro-acupuncture on the bilateral acupuncture point , San Yin Jiao ( Sp6 ) , and the patient controlled analgesia ( PCA ) . The first time of requesting morphine , the frequency of PCA dem and s in 24 hours , and the doses of PCA used were recorded double blindly . In addition , monitoring the subjects ' vital signs , the opioid-related side effects , and the pain scores was done . RESULTS The results showed that the acupuncture group and the electro-acupuncture group could delay the time of requesting morphine up to 10 - 11 minutes when compared with the control group . The total dose of PCA  used within the first 24 hours was 30 % - 35 % less in the acupuncture group and the electro-acupuncture group when compared with the control group , which was indicated in statistical significance . However , there was no significant difference between the acupuncture group and the electro-acupuncture group . The electro-acupuncture group 's and the acupuncture group 's pain scores were lower than the control group 's within the first 2 hours . Both were statistically significant . However , two hours later , there were no significant differences of the visual analogue scale ( VAS ) scores between either of the treatment groups and the control group . Finally , the incidence of opioid-related side effects , such as dizziness , was less in the acupuncture group and electro-acupuncture group than in the control group . CONCLUSIONS This study shows that the application of acupuncture and electro-acupuncture could definitely delay the time of requesting pain relief medication after cesarean section and decrease the PCA doses used within the first 24 hours OBJECTIVE To probe the effect of previous analgesia of scalp acupuncture . METHODS Sixty cases of radical operation of intestinal cancer were r and omly divided into 2 groups : a scalp acupuncture plus epidural analgesia ( scalp acupuncture group ) and an epidural analgesia group , 30 cases in each group . The scalp acupuncture group received scalp acupuncture from 20 min before operation to the end of the operation , and epidural analgesia at the end of the operation . The epidural analgesia group only received epidural analgesia at the end of the operation . Recovery of VAS scores , BCS scores and gastrointestinal function after operation were investigated to probe into effects of scalp acupuncture on epidural morphine analgesia after operation in the patient of intestinal cancer . RESULTS The VAS scores at 6 h , 12 h , 24 h and 48 h in the scalp acupuncture group were lower than the epidural analgesia group , with significant differences at 6 h and 12 h between the two groups ( P < 0.05 ) . BCS scores at the 4 time points in the scalp acupuncture group were lower than the epidural analgesia group with significant differences between the two groups ( all P < 0.05 ) . The scalp acupuncture group in recovery of bowel sound , exsufflation from the anus in the scalp acupuncture group was faster than the epidural analgesia group ( P < 0.01 ) . CONCLUSION Scalp acupuncture has a certain previous analgesic effect , reducing discomfort of the patient after operation and promoting the recovery of gastrointestinal functions
Background Acute postoperative pain remains a major clinical problem that affects patient recovery .
Distal acupoint and peri-incisional stimulation are both used for relieving acute postoperative pain in hospital .
Our objective was to assess and compare the effects of distal and peri-incisional stimulation on postoperative pain in open abdominal surgery .