Perioperative medicine evolved from clinical anaesthesia
and is about the medical care of patients starting from the time of
contemplation of surgery through the operative period to full recovery, but not
counting the operation or procedure itself. Perioperative medicine is a large
and constantly developing area encompassing involvement in many different
clinical areas.
The use of acupuncture in perioperative medicine dated
back to 31/08/1958 when a tonsillectomy was completed under acupuncture without
using any other anaesthetics in Shanghai, China. From that time acupuncture has
been used in surgery to enhance the effect of anaesthetic medicine and promote
recovery after operation. Recently Dr. Xiong and colleagues in China provided
an update on the benefits of acupuncture in perioperative medicine in a review
article published in the British Journal of Anaesthesia.
It is well known that acupuncture stimulation at some
specific acupoints exerts analgesic effect which has been used to reduce the
consumption of anaesthetics and analgesics, such as opioids. This is importance
because higher doses of drugs are generally associated with high risk of
morbidity, longer duration of recovery and higher cost.
Use of acupuncture reduces many anaesthetic-related adverse
effects such as nausea, vomiting, haemodynamic instability and
intubation-related complication. Many studies showed that acupuncture therapy
can rebalance haemostasis and alleviate stress response by modulating
sympathetic nerve function.
Acupuncture enhances post-operative analgesia. Many
studies reported that acupuncture prolonged anaesthetic effect and
significantly reduced the use of pain killers following surgery. Further acupuncture
exerts organ-protective effect after surgery. Acupuncture exerts modulatory
effect on heart, increasing cardiac output, stroke volume, and decreasing total
peripheral resistance and central venous pressure. Acupuncture improves
postoperative pulmonary function, and protects brain against brain oedema, and
increases blood circulation to other important organs such as liver and kidney.
The authors suggest that better selection of acupoint,
advanced techniques used to stimulate acupoints and good timing of acupoint
stimulation will maximise the benefits of acupuncture in perioperative
medicine.
Reference:
Lu et al., Perioperative
acupuncture modulation: more than anaesthesia. British Journal of
Anaesthesia115 (2): 183–93 (2015). http://bja.oxfordjournals.org/content/115/2/183.short
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