Acupuncture in Perioperative Analgesia: Evidence and Practice

Recent meta-analyses of randomized controlled trials (RCT) on perioperative acupuncture (AC) suggest that AC might be a useful additional tool in treatment of postoperative pain (POP). In particular, AC was shown to reduce the intensity of POP and requirement of postoperative analgesics, thus leading to decreased rate of analgesia induced side effects and higher patients’ satisfaction with the treatment of POP.Despite solid background in scientific literature, AC is still scarcely used in everyday clinical practice of anesthesiology. Good effectiveness and safety of AC in perioperative conditions were demonstrated in a number of RCTs, the critical evaluation of its cost-effectiveness is still lacking.According to the principles of evidence-based medicine combined with our experience in research and in perioperative use of AC, we have implemented this method into clinical therapeutic pathways (Standard Operating Procedures) in perioperative setting. The highest clinical benefits experience the patients after caesarian section, where AC is used to treat acute postoperative pain as well as the patients with postdural puncture headache, where the use of conventional analgesic methods is ineffective or restricted (4,5).Several pilot and randomized controlled investigations are on the run with the purpose to implement AC in treatment of preoperative anxiety and postoperative pain, especially in patients scheduled for ambulatory gynecologic and orthopedic surgery.