Intraoperative electro-auricular acupuncture may reduce pain after TKA
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Use of electro-auricular acupuncture intraoperatively may reduce postoperative pain among patients undergoing total knee arthroplasty, according to results presented at the Anesthesiology Annual Meeting.
Stephanie Cheng, MD, DABMA, and colleagues provided 41 patients undergoing primary TKA with an intraoperative, standardized opioid-sparing multimodal protocol and electro-auricular acupuncture.
“We were looking at the number of patients that were able to maintain a low-dose opioid regimen, which we defined as 112.5 oral morphine equivalents,” Cheng, lead author of the study and attending anesthesiologist at Hospital for Special Surgery, told Healio Orthopedics. “For comparison, [that is] 15 pills of oxycodone, which is typically what people get prescribed for pain control afterward, 15 pills of the 5 mg.”
Cheng noted additional outcomes included pain scores, adverse events and prior experience with acupuncture. Researchers allowed patients to receive 5 mg to 10 mg of oral oxycodone for additional pain control and patients were discharged with daily oral meloxicam, acetaminophen and a prescription for 42 5-mg oxycodone pills without refills.
Cheng noted 65% of patients maintained a low-dose opioid regimen compared with 9% of patients in historical data. Results showed all patients had discontinued their opioid medication by postoperative day 30, with three patients remaining opioid-free throughout the 30 days.
“Orthopedic surgery is moving more toward an ambulatory surgery model, and the ability to control pain and, in addition, things like nausea and dizziness can help with early discharge and getting patients expedited from the [post-anesthesia care unit] PACU on the same day of surgery,” Cheng said. “Integrating acupuncture and other complimentary medicine protocols into the surgical experience could impact that recovery of patients in such a positive way and our study particularly indicates that that is possible. Obviously, more research is needed in this area, but I think we have an encouraging start.”
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Cheng S, et al. Paper A2078. Presented at: The Anesthesiology Annual Meeting. Oct. 8-12, 2021; San Diego (hybrid meeting).
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