Opioids are often prescribed to manage pain postoperatively for total knee arthroplasty (TKA). Acupuncture, specifically electroauricular acupuncture, is a better alternative, reducing and even eliminating the need for opioids, according to a prospective cohort study by S. Cheng, and colleagues, involving 41 patients.
All patients were "undergoing primary unilateral TKA under neuraxial anesthesia received a standardized, opioid-free intraoperative protocol including electroauricular acupuncture," and did not report chronic pain or opioid use within six weeks before surgery.
Electroauricular acupuncture was administered at eight specific ear points: Hypothalamus, Amygdala, Hippocampus, Prefrontal Cortex, Point Zero, Shen Men, Insula, and Vagus. Patients were discharged with a one-time prescription for 42 oxycodone pills (5 mg dose per pill) or an equivalent opioid (hydromorphone or tramadol).
The primary outcome measure: ability to maintain a "low-dose" opioid regimen, defined as 15 or fewer oxycodone pills (or 112.5 oral morphine equivalents) from surgery until 30 days postoperatively. Approximately two-thirds (65 percent) were able to do so, with 7 percent not using opioids at all for 30 days. None of the 41 patients used opioids after 30 days.
While this study did not have a comparison group, the authors note in their paper, published in Medical Acupuncture: "When comparing this cohort to a previous hospital-wide survey of patients who underwent TKA, the percentage of patients maintaining a low-dose opioid regimen was statistically significantly improved (65% versus 9%) ... While the survey data were over a 6-week period (rather than 30 days as in the current cohort), the current authors believe this had little effect as all of the current study patients had stopped opioid use by POD 30."
Acupuncture, a key pillar of traditional Chinese medicine (TCM), has been practiced for thousands of years to promote healing and restore balance within the body. However, with rapid technological advancements reshaping health care, acupuncture is entering a new era. The integration of artificial intelligence (AI) and data analytics is revolutionizing diagnostics, treatment precision, education, and research – enhancing patient outcomes like never before.
Interestingly, although lots of attention has recently been given to the role psychedelic medicines employed in therapy could play in healing PTSD and trauma generally, new research has just been published showing acupuncture can also be of significant help in alleviating this widespread disorder, and may act similarly to psychedelics on a particular quality of our brains to heal and remodel themselves: neuroplasticity.
Long COVID has challenged conventional medical paradigms. There is certainly a growing need for therapies that bridge traditional pharmacology with integrative strategies. Among the more unconventional options, nicotine – delivered via low-dose transdermal patches – has surfaced as a potential tool. While the idea may sound wacky, emerging evidence and clinical anecdotes suggest it warrants exploration.
