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Acupuncture is more effective at reducing nausea and vomiting with fewer adverse side effects after major breast surgery than the leading medication, according to a study reported in the September 22 issue of the journal Anesthesia and Analgesia.
Researchers at Duke University Medical Center also found that patients who underwent acupuncture reported decreased postoperative pain and increased satisfaction with their postoperative recovery.
About 70 percent of women who undergo major breast surgery requiring general anesthesia suffer from postoperative nausea and vomiting, according to Tong Joo Gan, MD, the Duke anesthesiologist who led the trial. These adverse side effects are important factors in determining how soon patients can return home after surgery.
"The patients in our randomized trial who received acupuncture enjoyed a more comfortable recovery from their surgery than those who received an antisickness medication," Gan said.
In the trial, Gan employed an electro-acupuncture device in which an electrode is attached at the appropriate pressure point. In this case, the point is known as P6 and is located below the wrist. Instead of actually breaking the skin with the traditional long slender needles, the electro-acupuncture device delivers a small electrical pulse through the skin.
"Electro-acupuncture enhances or heightens the effects of traditional acupuncture," Gan explained. "Also, in the busy and complicated setting of the operating room, the electro-acupuncture device is much more convenient to use."
The researchers enrolled 75 women who were to undergo major breast surgery (mastectomy, breast augmentation and breast reduction) requiring the use of general anesthesia. They were then randomized into three groups: one which received acupuncture, one which received the medication Zofran® (ondansetron) and a group that received neither.
The surgeries lasted anywhere from two to four hours, and the incidence of postoperative nausea and vomiting and pain were tracked at 30-minute intervals for the first two hours after surgery, and then again 24 hours later.
Two hours after surgery, 77 percent of the patients receiving acupuncture experienced no postoperative nausea and vomiting, nor did they require an antiemetic drug to reduce nausea and vomiting, compared to 64 percent for those who received ondansetron and 42 percent who received nothing. At 24 hours, the rates were 73 percent, 52 percent and 38 percent, respectively.
According to Chinese healing practices, there are about 360 specific points along 14 different lines, or meridians, that course throughout the body just under the skin.
While pressure on other acupuncture points – LI4 on the hand, SP6 on the leg and "back-shu" along the spine – are known to have pain-killing effects, this is the first to show that P6 also has analgesic effects to go along with its known antiemetic properties, Gan said.
While it is not completely known why or how acupuncture – whether electro-acupuncture or traditional – works, recent research seems to point its ability to stimulate the release of hormones or the body's own painkillers, known as endorphins, Gan said.
The researchers will conduct further studies comparing the various combinations of these frequencies, as well as comparing the combination of acupuncture with other antiemetic medications.
Source: Medical Week staff, week of September 25, 2004
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