Acupuncture May Lessen Post-Op Pain, Nausea

Study Shows Ancient Chinese Practice Is as Effective as Drugs After Breast Surgery

From the WebMD Archives

Sept. 22, 2004 -- A high-tech, acupuncture-like therapy appears to be as effective as the leading medication in treating nausea and vomiting following major breast surgery.

What's more, researchers also discovered that stimulating the specific acupuncture point employed significantly eased post-operative pain, something previously speculated but not studied in Western medicine, according to experts.

"We really weren't surprised by the post-operative nausea and vomiting relief we saw, because the specific acupuncture point we used -- known as P6 and located near the wrist -- is known to be the primary acupuncture point for relieving nausea and vomiting," says T.J. Gan, MD, anesthesiologist and director of clinical research at Duke University Medical Center, who led the study.

Previous studies have shown that placing acupuncture needles on P6, one of as many as 2,000 different acupuncture points on the body, helps prevent and relieve nausea and vomiting. In fact, P6's acupuncture properties are the principle behind wearing commercially available wristbands to prevent and relieve seasickness, says Gan.

Less Pain and No Needles

"What surprised us were the pain-relieving properties we saw. There are several acupuncture points that have been shown to be good for pain relief, but until now, P6 was not one of them widely considered or even used," he tells WebMD. "So in essence, with P6 you may be able to kill two birds with one stone."

Rather than traditional acupuncture needles, a method used for some 5,000 years and among the world's most practiced therapies, Gan used a tiny device in which an electrode like that in standard EKG tests is attached to the specific acupuncture point. He was testing whether its electrical charge would provide the same type of antinausea effect achieved with acupuncture needles.

In his study, published in the October issue of Anesthesia and Analgesia, Gan tracked 75 cancer patients recovering from major breast surgery.

One group of women received electrostimulation after surgery; another received Zofran, a widely used drug to prevent nausea and vomiting caused by cancer chemotherapy, radiation, anesthesia, and surgery; and a third group received neither type of treatment.

Two hours after surgery, 77% of the women receiving electrostimulation experienced no post-operative nausea or vomiting (PONV), and required no antisickness drugs. That compared with only 64% getting Zofran and 42% of those who relieved neither treatment.

At 24 hours following surgery, there was still no PONV in 73% among those getting electroacupuncture, compared with 52% of those getting the Zofran and 38% receiving neither treatment.

In questioning the patients, Gan's team also learned that those who were treated with electrode stimulation on P6 reported significantly less overall pain and a higher satisfaction level following surgery than the others.

The Point of Acupuncture

Acupuncture involves placing thin needles into the skin at specific points believed to connect with 12 main and eight secondary pathways called meridians. Piercing into these meridians, or periodically twisting the needle, is said to stimulate the flow of energy (or qi, pronounced "chee") to better regulate spiritual, emotional, mental, and physical balance influenced by the opposing forces of yin and yang (negative and positive energy). Sometimes, tiny electrodes are attached to the needles to better stimulate qi with a tiny jolt of electricity, a more invasive version of what Gan's team did.

Technically, this electrostimulation is not acupuncture, because no needles were used to pierce the skin, says Barrie R. Cassileth, PhD, author of the widely respected Alternative Medicine Handbook: The Complete Reference Guide to Alternative and Complementary Therapies and chief of integrative medicine at Memorial Sloan Kettering Cancer Center in New York, which runs an acupuncture research center.

"What this study has done is do away with the needle and just stimulate the acupuncture point in a randomized clinical trial; that's an advantage to people who may be fearful of needles, and important to medical research," says Cassileth, who was not involved in Gan's research. "What this paper does is increase our confidence on the feasibility and efficacy of using acupuncture-like techniques in treatment for a variety of symptoms."

In addition to nausea and some types of pain, including headaches and menstrual cramps, acupuncture has been shown in various studies to help treat asthma, carpal tunnel syndrome, and addiction to tobacco, drugs, and alcohol.

Having Breast Surgery? Take Note

While Gan's study only included breast cancer patients, he notes that some 70% of women who get any type of breast surgery requiring general anesthesia suffer from PONV -- a much higher rate than other types of surgery. Statistically, women are three times more likely than men to have PONV after major surgery, but the reasons aren't clear.

"The anesthesia is one component, but there seems to be something unique about breast procedures -- whether done for breast cancer or cosmetic enhancement -- that makes them very high risk for post-operative nausea and vomiting," Gan tells WebMD. "It hasn't been well studied, but may be due to nerve connections in the breast. The Chinese believe there is a direct connection of these nerves from the breast to the brain.

"Since women getting breast procedures are at such high risk of PONV and often suffer post-operative pain, my recommendation is that they consider acupuncture or a similar therapy to reduce some of these side effects," he says.

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SOURCES: Gan, T.Anesthesia and Analgesia, October 2004; vol 99. T.J. Gan, MD, professor of anesthesiology; director, clinical research, Duke University Medical Center, Durham, N.C. Barrie R. Cassileth, PhD, chief, integrative medicine services, Memorial Sloan-Kettering Cancer Center, New York; author, Alternative Medicine Handbook: The Complete Reference Guide to Alternative and Complementary Therapies. National Center for Complementary and Alternative Medicine web site.
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