Acupuncture reduces pain and opioid usage for total knee replacement surgery patients
Patients who have acupuncture during total knee replacement surgery report less pain and need far fewer opioids to manage their discomfort, according to a study being presented at the ANESTHESIOLOGY® 2021 annual meeting. Results of the study showed that 65% of patients who received acupuncture during surgery achieved a low-dose or opioid-free postoperative experience, compared to 9% of patients outside of the study.
“Total knee replacements are one of the most common operative procedures in the United States and often very painful, so there’s a great need to explore non-opioid pain relief techniques for this type of surgery,” said Stephanie Cheng, M.D., DABMA, lead author of the study and assistant attending anesthesiologist at the Hospital for Special Surgery and assistant professor of clinical anesthesiology at Weill Cornell Medicine, both located in New York City. “Acupuncture is extremely safe and can help reduce pain with few unwanted side effects, but it has not been well researched as part of surgical anesthesia.”
The study included 41 patients undergoing primary total knee replacement at the Hospital for Special Surgery. All patients received the institution’s standard opioid-sparing multimodal analgesic protocol, with the addition of electroacupuncture – a modified form of traditional acupuncture that applies a small electric current to thin needles that are inserted at known acupuncture points on the body. The acupuncture was administered during surgery by Dr. Cheng, who is board certified in medical acupuncture, to eight specific points in the ear to provide targeted pain relief in the knee.
With the addition of acupuncture, the majority of patients had a significant reduction in postoperative opioid use, compared to historical controls. Sixty-five percent of patients maintained a low-dose opioid regimen (15 oxycodone pills or less) from induction of anesthesia to 30 days after surgery, while 7% of patients remain completely opioid-free. Historically, only 9% of patients outside of the study maintained a low-dose or opioid-free regimen post-surgery. All patients studied discontinued opioid use after 30 days following surgery.
“Our study shows that if a trained medical acupuncturist is available to perform acupuncture in the operating room, it can help patients with postoperative pain recovery,” said Dr. Cheng. “Most studies fail to incorporate nontraditional techniques, such as acupuncture, to help decrease the dependance on opioid medications for postoperative pain control.”
In the context of the opioid epidemic, achieving low-dose perioperative opioid consumption is critical to reducing the risk of long-term opioid use in patients. With acupuncture being commonly used outside of the hospital as an effective therapy for pain management and treatment for a range of health issues and symptoms, it’s time to consider its benefits inside the hospital as well, Dr. Cheng said. “Additional research is needed to further define acupuncture’s effects and encourage its use in all aspects of disease treatment.”
ABOUT THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 54,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.
For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/madeforthismoment. Join the ANESTHESIOLOGY® 2021 social conversation today. Like ASA on Facebook, follow ASALifeline on Twitter and use the hashtag #ANES21.
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the 12th consecutive year), No. 4 in rheumatology by U.S. News & World Report (2021-2022), and the best pediatric orthopedic hospital in NY, NJ and CT by U.S. News & World Report “Best Children’s Hospitals” list (2021-2022). HSS is ranked world #1 in orthopedics by Newsweek (2021-2022). Founded in 1863, the Hospital has the lowest complication and readmission rates in the nation for orthopedics, and among the lowest infection rates. HSS was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center five consecutive times. The global standard total knee replacement was developed at HSS in 1969. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State, as well as in Florida. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Global Innovation Institute was formed in 2016 to realize the potential of new drugs, therapeutics and devices. The HSS Education Institute is a trusted leader in advancing musculoskeletal knowledge and research for physicians, nurses, allied health professionals, academic trainees, and consumers in more than 130 countries. The institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally. www.hss.edu.