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Perioperative acupuncture: why are we not using it?
  1. T I Usichenko1,
  2. K Streitberger2
  1. 1Department of Anaesthesiology and Intensive Care Medicine, University Medicine of Greifswald, Greifswald, Germany
  2. 2University Department of Anesthesiology and Pain Therapy, Inselspital, University Hospital of Bern, Switzerland
  1. Correspondence to Dr Taras Usichenko, Department of Anaesthesiology and Intensive Care Medicine, University Medicine of Greifswald, Fleischmannstr. 42-44, Greifswald 17475, Germany; taras{at}

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Acupuncture is mostly known to the general readership for its analgesic effects.1 Focusing on the treatment of acute postoperative pain, a meta-analysis of 15 randomised controlled trials (RCTs) comparing acupuncture with sham control in the management of postoperative pain showed that acupuncture decreased both pain intensity and opioid consumption up to 72 h after surgery.2 This opioid reduction effect was associated with a decreased incidence of opioid-related side effects such as nausea, dizziness, sedation, pruritus and urinary retention. More evidence is provided by two trials3 ,4 which suggest that the perioperative administration of acupuncture may be a useful adjunct for postoperative analgesia.

The study by Ntritsou et al3 confirms the conclusions of this meta-analysis and again demonstrates the benefits of postoperative acupuncture listed above. Besides the importance of confirming the evidence from previous studies, there are several interesting aspects in this investigation which are worthy of comment.

Ntritsou et al used a pragmatic approach, where acupuncture for postoperative pain relief was performed immediately at the end of surgery in the operating room. This postoperative approach means that acupuncture interferes much less with the running of the operation. The results confirm the previously described effect of acupuncture point stimulation on postoperative pain5 and suggest the same effectiveness as when the stimulation is started before surgery.6

Moreover, the choice of acupuncture points was more practical than in other investigations in which acupuncture point …

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