Page 14 - CASA Bulletin of Anesthesiology 2019 Vol 6 No 5

CASA Bulletin of Anesthesiology

training (2) . Throughout this time and even into present day, there are critics who do not believe
in its effectiveness . However, within the past few years, especially in the face of the opioid
epidemic, “alternative medicine” has gained popularity . According to the most recent survey
conducted by the national center for complementary and integrative health (a branch of the Na-
tional Institutes of Health) in 2007, the use of complementary alternative medicine (CAM) has
increased significantly from 2002 (the previous survey). In the 2007 survey, in the United States
alone, 38% percent of adults and 12% of children use some form of CAM (3) . It has been over
10 years since that survey report, there is little doubt that these numbers have only increased .
According to the National Center for Health Statistics on the expenditures on CAM in 2012 –
for just adults utilizing specialists, such as acupuncturists, $14 .1 Billion was spent . This survey

also shows that there has been an increase in the number of adult patients who saw an acupunc-
turist as an out-ofpocket expense . No difference was seen in the percentage of adult patients
who had health insurance coverage (4) . With this increasing demand of such treatment modali-
ties by patients, conventional practitioners will need to be, at the very least, well versed enough
to recommend for or against these modalities .

Mechanism

There are many theories and debates of how acupuncture works . Many of these studies are
written in non-English languages, most in Chinese, which makes it much more difficult for
Western Medicine to adopt and understand how to integrate it into their practice . Touching on
just a few theories, early in the 1960’s, discovery of areas of low resistance correlating with acu-
puncture points was originally described by a French scientist, Niboyet (5) and then confirmed
by many others including scientists in upstate NY(6). Chinese scientists found “propagative
sensation along channels” or PSAC that travelled at a rate of 1-10 cm per second, which is 5-1200
times slower than the rate of visceral or somatic nerve conduction (7) . This correlates to the
ache and/or electrical feeling created by needling acupuncture points – known as the “De Qi”

Sensation . This phenomenon does not follow somatosensory distribution of the nerves nor does
it occur in a dermatomal fashion . There has been shown that stimulation of LI15 sends a signal
down to the finger, and when stimulation stops, so does the signal (8). In 1980, the theory that
acupuncture has an effect on the opioid peptide transmission with in the body was researched
and found that needling of the body can release various endorphins (9) . Low frequency, high
intensity stimulation has shown enkephalin and dynorphin release, a treatment that can be made
ineffective with naloxone (10) . There are other theories such as blood chemistry, immune sys-
tem changes as well as many others that are too numerous to discuss for the purposes of this
article .

Safety

According to the National Center for Complementary and Integrative Health (a branch of the
NIH), there are relatively few complications from the use of acupuncture . The complications
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