Battlefield Acupuncture and Its Use In Multimodal Perioperative Anesthesia Care

INTRODUCTION:

Battlefield acupuncture is an auricular therapy that has been used for centuries, with roots tied to Eastern Asian medicine. Ease of application, low cost, and minimal side effects make battlefield acupuncture a perioperative modality that has been linked to decreased morbidity and mortality in patients undergoing surgical procedures and anesthesia (1). In the United States, there is pressure by the government and the medical community to decrease opioid use, especially in the perioperative time period. Opiate use due to postoperative pain, postoperative nausea and vomiting (PONV), perioperative anxiety have all been linked to an increased hospital stay, increased morbidity, and mortality, and ultimately higher healthcare costs (2). Anesthesia providers can be trained in the application of acupuncture in the perioperative time period. Through analysis of rates of postoperative opioid use, postoperative nausea and vomiting and perioperative anxiety, the efficacy, and utility of battlefield acupuncture will be realized as an effective adjunct to multimodal anesthesia care.

STUDY DESIGN AND METHODS:

This will be a prospective randomized study to compare auricular battlefield acupuncture to sham auricular battlefield acupuncture in patients undergoing general surgery and urology cases with general anesthesia. Participants in the study will be randomly assigned to either receive auricular battlefield acupuncture (treatment group) or simulated (placebo; control group) auricular battlefield acupuncture. Battlefield acupuncture needles will be utilized in the test arm and blunt needle pressing and covering with acupuncture stickers will be utilized in the control arm as a sham treatment. Location of needles and stickers will be placed according to 5 VA approved BFA auricular acupuncture points associated with PONV, pain, and anxiety respectively (Figure 1; 3). In both arms, the treatment ear will be covered after treatment so as to blind the patient. Both battlefield acupuncture and control groups will receive small band aids on the battlefield acupuncture needle sites. Both the evaluators for post procedure assessment along with the patient will be blinded in regards to what group they are in.

Inclusion Criteria: