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      Analgesic effects of perioperative acupuncture methods: A narrative review

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          Abstract

          Postoperative pain occurs immediately after surgery. The most common perioperative analgesic methods are nerve block, patient-controlled intravenous analgesia, and patient-controlled epidural analgesia. However, overuse of opioid analgesics can cause many adverse reactions including excessive sedation, respiratory inhibition, postoperative nausea, and vomiting. In recent years, many clinical trials have shown that perioperative acupuncture has unique advantages in patients. Perioperative acupuncture can relieve intraoperative pain, improve postoperative pain management, reduce postoperative nausea and vomiting, and shorten the length of hospital stay. This study aimed to confirm the analgesic effect of perioperative acupuncture by reviewing studies on the different methods of perioperative acupuncture and their analgesic effects. The cited literature was searched in English and Chinese from PubMed, China National Knowledge Infrastructure, and Wanfang data, using the following keywords: “perioperative pain,” “acupuncture,” “electroacupuncture,” and “perioperative analgesia.” Studies published from 2005 to 2023 were included. All retrieved papers were read in detail. Perioperative acupuncture has benefits in reducing postoperative pain and opioid need. Although analgesic drugs are still the primary means of postoperative pain control, acupuncture provides a safe analgesic supplement or alternative. This review aimed to assist practitioners in choosing appropriate perioperative acupuncture methods by summarizing the recent literature on the role of different acupuncture approaches for perioperative pain management.

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          New Persistent Opioid Use After Minor and Major Surgical Procedures in US Adults.

          Despite increased focus on reducing opioid prescribing for long-term pain, little is known regarding the incidence and risk factors for persistent opioid use after surgery.
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            Mechanisms of acupuncture-electroacupuncture on persistent pain.

            In the last decade, preclinical investigations of electroacupuncture mechanisms on persistent tissue injury (inflammatory), nerve injury (neuropathic), cancer, and visceral pain have increased. These studies show that electroacupuncture activates the nervous system differently in health than in pain conditions, alleviates both sensory and affective inflammatory pain, and inhibits inflammatory and neuropathic pain more effectively at 2 to 10 Hz than at 100 Hz. Electroacupuncture blocks pain by activating a variety of bioactive chemicals through peripheral, spinal, and supraspinal mechanisms. These include opioids, which desensitize peripheral nociceptors and reduce proinflammatory cytokines peripherally and in the spinal cord, and serotonin and norepinephrine, which decrease spinal N-methyl-D-aspartate receptor subunit GluN1 phosphorylation. Additional studies suggest that electroacupuncture, when combined with low dosages of conventional analgesics, provides effective pain management which can forestall the side effects of often-debilitating pharmaceuticals.
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              Treatment of acute postoperative pain.

              Although postoperative pain remains incompletely controlled in some settings, increased understanding of its mechanisms and the development of several therapeutic approaches have substantially improved pain control in past years. Advances in our understanding of the process of nociception have led to insight into gene-based pain therapy, the development of acute opioid-induced hyperalgesia, and persistent postsurgical pain. Use of specific analgesic techniques such as regional analgesia could improve patient outcomes. We also examine the development of new analgesic agents and treatment modalities and regimens for acute postoperative pain. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Medicine (Baltimore)
                Medicine (Baltimore)
                MD
                Medicine
                Lippincott Williams & Wilkins (Hagerstown, MD )
                0025-7974
                1536-5964
                27 October 2023
                27 October 2023
                : 102
                : 43
                : e35759
                Affiliations
                [a ] Department of Anesthesiology, China-Japan Union Hospital of Jilin University, Changchun, China
                [b ] Jilin University, Changchun, China
                [c ] Department of Traditional Chinese Medicine, China-Japan Union Hospital of Jilin University, Changchun, China.
                Author notes
                [* ]Correspondence: Ming Gao, Department of Anesthesiology, China-Japan Union Hospital of Jilin University, 126 Sendai Avenue, Changchun, Jilin Province 130033, China (e-mail: gaoming@ 123456jlu.edu.cn ).
                Author information
                https://orcid.org/0000-0002-2976-2565
                https://orcid.org/0009-0000-1584-1089
                Article
                00109
                10.1097/MD.0000000000035759
                10615492
                9091cba0-a5a7-45d2-9dbe-3de8485f0818
                Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 April 2023
                : 19 August 2023
                : 03 October 2023
                Categories
                3300
                Research Article
                Narrative Review
                Custom metadata
                TRUE

                acupuncture,alternative analgesia,alternative medicine,analgesia,complementary medicine,perioperative acupuncture,postoperative pain

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