Acupuncture therapy for postoperative pain

Jian Hao

1Tianjin Fourth Central Hospital,Tianjin 300140,China.

Standard sternotomy with median incision is widely used in cardiothoracic surgery for enough vision filed,short operation time, high safety and fast healing.However, high incidence of pain seriously affects the quality of life and surgical satisfaction of patients [1].Pain after thoracotomy may be related to intercostal nerve injury, nerve sensitization, local or central inflammation, tissue injury,myofascial pain syndrome,rib fracture, and psychogenic factors. Postoperative pain is mostly caused by skin stretching, tissue edema,muscle spasm. Acupuncture can dredge meridians,promote blood circulation and remove blood stasis, by which could achieve the purpose of relieving muscle spasm and relieving pain. It has obvious effects on acute pain during perioperative period[2,3].

To observe the effect of perioperative acupuncture on postoperative pain in patients undergoing standard sternotomy, Feixiang Ma [4] conducted a RCT research with 57 patients randomly divided into acupuncture group (30 cases) and control group (27 cases). The control group was treated with routine operationand nursing, and the acupuncture group was treated with acupuncture for 10 days on the basis of perioperative period.The pain levels of the two groups before and after operation were compared. The pain level of the acupuncture group was significantly lower than that of the control group on the 2nd, 10th, and 30th days after operation(P＜0.05),and the short-term pain levels in the two groups were statistically significant (P＜0.05). The research showed that, the perioperative acupuncture treatment has a significant analgesic effect on short-term pain for patients undergoing anterior thoracotomy.

In this study, Ashi acupoint, Zhongfu (LU 1), Qihu(ST 13) and other local acupoints, such as the second,fourth costal space beside the sternum were choice for acupuncture, as these acupoints are all prone to pain after thoracotomy.The perioperative local acupuncture treatment of pain prone areas can improve the pain threshold of these areas, so as to reduce the incidence and degree of postoperative pain. The effects of acupuncture on acute pain maybe for the following,acupuncture can promote substances exchange,balance physiological metabolism, improve blood circulation, loosen adhesion tissue, adjust nerve response, reduce soft tissue edema, improve nutrition in the diseased tissue area, and expand local blood vessels [5], and can increase the tissue pain threshold,thereby reducing nerve root pulling stimulation and reducing pain symptoms[3].

This research evaluates the effect of acupuncture on postoperative pain in patients undergoing standard sternotomy. Perioperative acupuncture treatment has a significant analgesic effect on short-term pain for patients undergoing anterior midline thoracotomy. The application of acupuncture in acute pain should be widely recommended.