Journal de l'ostéoporose et de l'activité physique
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Postoperative analgesia after electroacupuncture

Dalamagka Maria

Post-operative pain after inguinal hernia surgery is attributed to surgical manipulation or placement of the preperitoneal mesh. Perioperative use of acupuncture can probably be a useful adjunct for postoperative analgesia. AIM: The aim of this study was to evaluate the effect of EA in mesh inguinal hernia open repair, using pain scales, anxiety questionnaire, the evaluation of pain with an algometer and measurements of stress hormones. Methods, Participants: 54 male patients were included in the study (23 inguinal left and 31 with inguinal right, classification in ASA I-II) submitted in programmed mesh inguinal hernia open repair with the technique Lichtenstein. Investigation parameters included: 1) Pain scales (VAS, PPI, VRS, SS, FS) and the anxiety questionnaire at 30′, 90′, 10 hours and 24 hours postoperatively. 2) Pain threshold and tolerance were evaluated preoperatively, before and after electroacupuncture, and postoperatively at 30′, 90′, 10 hours and 24 hours after surgery. 3) Blood levels of stress hormones cortisol, corticotropin and prolactin were measured at the same time points (excluding 24 hours). The frequency of complications of opiates was recorded. Patients were randomly allocated in 3 treatment groups of 18 patients. The three groups were: Group 1: placebo EA, Group 2: preoperative (40′) and postoperative (60′) EA, Group 3: preoperative, intraoperative and postoperative EA. The trial used low frequency EA of 2 Hz and frequency scanning mode. Needles were placed bilaterally at points of great analgesic effect. Electroacupuncture was applied to the points in pairs SP6–ST36; LI4–PC6; Shen-Men 55-Thalamus 26a. If the pain VAS score was greater than or equal to 3cm within 90 minutes after surgery, an intravenous bolus dose of 5mg pethidine was given and continuous intravenous infusion pump of pethidine at a rate of 10mg/h was administered for 12 hours.