Page 15 - CASA Bulletin of Anesthesiology 2019 Vol 6 No 5

Vol.6, No.5, 2019

that can occur when not performed properly include infections, organ injury, and nerve damage .
This typically results from use of nonsterile needles and improper use. The FDA classifies acu-
puncture needles as medical devices and require that practitioners be licensed, and manufactur-
ers are held to industry standards (11) . With the minimal risks posed by the use of acupuncture
in the hands of properly trained practitioner, it seems like a missed opportunity to not pursue .

Isolated intraoperative acupuncture is rarely used by itself . This is not referring to “acupunc-

ture anesthesia” a term used to describe acupuncture being used as the sole means of anesthetic .
With reference to isolated intraoperative acupuncture, definition being needles being placed af-
ter induction of anesthesia and removed before emergence . Listed below are some pros and cons
specific to isolated intraoperative acupuncture.

Pros
No awareness of needle placement
Treatment at the same time as the surgical pain is being caused
Full standard ASA monitoring by an experienced provider

Ability to blind patients adequately for research purposes
Increased patient satisfaction
Minimal equipment cost for needles and stimulators .

Cons
Inability to get patient feedback for “De Qi” sensations if using body points
Logistically cumbersome – Possible dislodgement of needles by surgical drapes
Requirement for a certified provider to work intraoperatively/ability of provider to monitor
ongoing good placement
Inadvertent needle retention
Exposure of staff to inadvertent needle sticks

Currently, insurance will not reimburse for intraoperative acupuncture .

Clinical Pearls

It is important to touch on the fact that there are various types of acupuncture that is being
utilized . For the purposes of this article however, auricular acupuncture will be discussed for the

sole reason that for the majority of surgical operations, the anesthesiologist will have full access
to the ear . This is obviously not the case for Otolaryngology and Neurosurgery, for which, body
points might be more practical . The logistics of intraoperative auricular acupuncture requires
equipment and a qualified provider, and it’s important to know that hospital and state require-
ments can vary from site to site . This author has passed the American Academy of Medical
Acupuncture Board Exam and is a certified medical acupuncturist allowed to practice in New
York State . If there is not a medical acupuncture provider available, licensed acupuncturist can
be hired to insert the needles after induction. Specifically, for orthopedic procedures performed
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