ASA: Intraoperative Acupuncture May Help Cut Post-TKA Opioid Use

Acupuncture was applied to ipsilateral ear during total knee arthroplasty; all patients discontinued opioids by postoperative day 30
acupuncture needles
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WEDNESDAY, Oct. 13, 2021 (HealthDay News) -- Integrating intraoperative electroauricular acupuncture is feasible for minimizing postoperative opioid usage among patients undergoing total knee arthroplasty (TKA), according to a study presented at the annual meeting of the American Society of Anesthesiologists, held from Oct. 8 to 12 in San Diego.

Stephanie Cheng, M.D., from the Hospital for Special Surgery in New York City, and colleagues enrolled 41 patients undergoing primary TKA in a single center. Patients received a standardized opioid-sparing multimodal protocol, including mepivacaine spinal, IPACK and adductor canal nerve block, and a periarticular injection. Intravenous medications included ketamine, ketorolac, ondansetron, dexamethasone, midazolam, and propofol. After patients achieved level 2 sedation, a board-certified medical acupuncturist needled eight points on the ipsilateral ear and applied electrostimulation to certain points; all needles were removed after 60 minutes. Oral acetaminophen, intravenous ketorolac, and intravenous dexamethasone were used for postoperative pain management. Patients were discharged with daily oral meloxicam, acetaminophen, and a prescription for low-dose oxycodone pills without refills.

The researchers found that all patients had discontinued their opioid medication after postoperative day 30. In the period from induction of anesthesia to 30 days after surgery, 26 of 40 patients (65 percent) either maintained a low-dose opioid regimen (57.5 percent) or remained opioid-free (7.5 percent).

"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," Cheng said in a statement. "Most studies fail to incorporate nontraditional techniques, such as acupuncture, to help decrease the dependence on opioid medications for postoperative pain control."

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