Search JIM Advanced Search

Journal of Integrative Medicine ›› 2015, Vol. 13 ›› Issue (2): 99-104.doi: 10.1016/S2095-4964(15)60159-5

• Research Article • Previous Articles     Next Articles

Acupuncture accelerates recovery after general anesthesia: A prospective randomized controlled trial

Marco Gemma, Elisa Nicelli, Luigi Gioia, Elena Moizo, Luigi Beretta, Maria Rosa Calvi   

  1. Department of Anesthesia and Neurointensive Care, San Raffaele Scientific Institute, 20132 Milan, Italy
  • Received:2014-10-20 Accepted:2014-11-21 Online:2015-03-10 Published:2015-03-15

Acupuncture anesthesia was created in the 1950's in China and continues to be used there today during most major surgeries. It is widely used in China for such complex operations as brain, heart, and abdominal surgery. It is popular in China because it is economical, practical, and beneficial to the patients. With acupuncture anesthesia there is less bleeding during surgery and there is also quicker post-operative recovery.
This randomized prospective study aims at comparing the effect of two acupoints (Yongquan, KI1 and Renzhong, DU26) with sham acupuncture and no acupuncture on the time to recovery of consciousness after general anesthesia by means of the Bispectral Index monitor (BIS).
Design, setting, participants and interventions
This is a prospective randomized controlled study. We randomly assigned 50 patients to 5 groups during recovery from surgical anesthesia. Four groups had acupuncture on KI1 (group A), DU26 (groups B), both KI1 and DU26 (group C), and sham points (group D), and one had no acupuncture (group E).
Main outcome measures
Bispectral Index (BIS), time to spontaneous eye opening, time to tracheal extubation, and time to following commands were measured as the main outcome measures.
Time to spontaneous eye opening differed among groups (P = 0.002), as well as time to tracheal extubation (P < 0.0001) and time to following commands (P = 0.0006). BIS values differed significantly among groups both 5 and 10 min after the end of anesthesia (P < 0.0001 and = 0.0004, respectively). BIS values of groups D and E were lower than those of the other groups and those of group C were higher. The same pattern was observed also 15 and 30 min after the end of anesthesia, although the difference among groups was not significant at these time points (P = 0.164 and P = 0.104, respectively).
Acupuncture on DU26 and KI1 accelerates recovery of consciousness after general anesthesia. Moreover, a possible synergistic effect of DU26 and KI1 is suggested. This issue may play a role in the optimization of operating room management and raise interest about the usefulness of acupuncture on unconsciousness states of different nature.

Key words: Acupuncture therapy, Anesthesia, General, Anesthesia recovery period, Randomized controlled trial

[1] Chernyak GV, Sessler DI . Perioperative acupuncture and related techniques. Anaesthesiology, 2005,102(5):1031-1049
doi: 10.1097/00000542-200505000-00024
[2] Lin YC . Perioperative usage of acupuncture. Paediatr Anaesth, 2006,16(3):231-235
doi: 10.1111/pan.2006.16.issue-3
[3] Lao L, Bergman S, Hamilton GR, Langenberg P, Berman B . Evaluation of acupuncture for pain control after oral surgery: a placebo-controlled trial. Arch Otolaryngol Head Neck Surg, 1999,125(5):567-572
doi: 10.1001/archotol.125.5.567
[4] Dundee JW, Chestnutt WN, Ghaly RG, Lynas AG . Traditional Chinese acupuncture: a potentially useful antiemetic? Br Med J (Clin Res Ed). 1986; 293(6547):583-584.
doi: 10.1136/bmj.293.6547.583 pmid: 1341376
[5] al-Sadi M, Newman B, Julious SA . Acupuncture in the prevention of postoperative nausea and vomiting. Anaesthesia, 1997,52(7):658-661
doi: 10.1111/j.1365-2044.1997.143-az0147.x pmid: 9244025
[6] Kotani N, Hashimoto H, Sato Y, Sessler DI, Yoshioka H, Kitayama M, Yasuda T, Matsuki A . Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses. Anaesthesiology, 2001,95(2):349-356
doi: 10.1097/00000542-200108000-00015
[7] Lee CK, Chien TJ, Hsu JC, Yang CY, Hsiao JM, Huang YR, Chang CL . The effect of acupuncture on the incidence of postextubation laryngospasm in children. Anaesthesia, 1998,53(9):917-920
doi: 10.1046/j.1365-2044.1998.00535.x pmid: 9849290
[8] Gioia L, Cabrini L, Gemma M, Fiori R, Fasce F, Bolognesi G, Spinelli A, Beretta L . Sedative effect of acupuncture during cataract surgery: prospective randomized double-blind study. J Cataract Refract Surg, 2006,32(11):1951-1954
doi: 10.1016/j.jcrs.2006.06.027
[9] Tu XH, He ZY, Fu X, Chen YH, Chen YL, Kang SJ . Brain arousal dysfunction in severe craniocerebral injury treated with acupuncture. Zhongguo Zhen Jiu, 2010,30(12):974-976
pmid: 21290831
[10] Peng F, Chen ZQ, Luo JK . Clinical observation on continuous electroacupuncture at Neiguan(PC6) for arousing consciousness of comatose patients with severe craniocerebral trauma. Zhongguo Zhen Jiu, 2010,30(6):465-468
[11] Fu YY, Cao SQ, Zhuang JX, Hu L, Chen DK, Gu FJ . Observation on electroacupuncture combined with routine Western medicine therapy for promoting consciousness of the patient with coma caused by craniocerebral trauma. Zhongguo Zhen Jiu, 2010,29(2):107-110
[12] Liu JP, Yang ZL, Wang MS, Shi R, Zhu BP . Observation on therapeutic effect of electroacupuncture therapy for promoting consciousness of patients with coma. Zhongguo Zhen Jiu, 2010,30(3):206-208
[13] He J, Wu B, Zhang Y . Acupuncture treatment for 15 cases of post-traumatic coma. J Tradit Chin Med, 2005,25(3):171-173
[14] Cao BF, Zhang C, Liang WH, Chen L . Effects of early acupuncture combined with exercise therapy on the consciousness-regaining treatment of coma patients in neurosurgery. Zhongguo Zhen Jiu, 2011,31(2):121-123
[15] Chen XY, Zhu Y, Huang XS . Effect of strong stimulation of acupuncture at twelve Jing-well points as main for neurosurgery patients with disorder of consciousness. Zhongguo Zhen Jiu, 2009,29(8):619-622
[16] Tamai H, Kawamura Y, Watanabe E, Kanda M, Yamaguchi T, Kikuchi S, Fujita A, Saito K, Hyodo A, Seo N . Acupuncture treatment for a patient with prolonged consciousness disturbance after a brain tumor surgery. Masui, 2009,58(3):349-353
[17] Lee DC, Clifford DH, Lee MO, Nelson L . Reversal by acupuncture of cardiovascular depression induced with morphine during halothane anaesthesia in dogs. Can Anaesth Soc J, 1981,28(2):129-135
doi: 10.1007/BF03007256
[18] Chang CL, Lee JC, Tseng CC, Chang YH, Cheng JT . Decrease of anesthetics activity by electroacupuncture on Jen-Chung point in rabbits. Neurosci Lett, 1995,202(1-2):93-96
doi: 10.1016/0304-3940(95)12214-1 pmid: 8787839
[19] Gemma M, Bricchi M, Giannini A, Coffano B, Grandi L, Quirico P . Acupuncture accelerates recovery from general anaesthesia. Can J Anaesth, 1993,40(12):1224-1225
doi: 10.1007/BF03009621 pmid: 8281607
[20] Cabrini L, Gioia L, Gemma M, Cedrati V, Crivellari M . Bispectral index evaluation of the sedative effect of acupuncture in healthy volunteers. J Clin Monit Comput, 2006,20(5):311-315
doi: 10.1007/s10877-006-9026-z pmid: 16988894
[21] Keats AS . The ASA classification of physical status — A recapitulation. Anaesthesiology, 1978,49(4):233-236
doi: 10.1097/00000542-197810000-00001
[22] Ramsay MA, Savege TM, Simpson BR, Goodwin R . Controlled sedation with alphaxalone-alphadolone. Brit Med J, 1974,2(5920):656-659
doi: 10.1136/bmj.2.5920.656 pmid: 1613102
[23] Biella G, Sotgiu ML, Pellegata G, Paulesu E, Castiglioni I, Fazio F . Acupunture produces central activations in pain regions. Neuroimage, 2001,14(1 Pt 1):60-66
doi: 10.1006/nimg.2001.0798 pmid: 11525337
[24] Langevin HM, Yandow JA . Relationship of acupuncture points and meridians to connective tissue planes. Anat Rec, 2002,269(6):257-265
doi: 10.1002/ar.10185 pmid: 12467083
[25] Baraskov GN, Staroverov AT. Effects of acupuncture on the neuronal mechanism of respiration. In: Theory and practice of acupuncture. Leningrad: Institute of Postgraduate Studies. 1984.
[26] Inchauspe A . Traditional Chinese medicine K1 Yongquan and resuscitation: another kind of “Lazarus phenomenon”. Resuscitation, 2010,81(4):505-506
doi: 10.1016/j.resuscitation.2009.12.009
[27] Hsu CH, Hua Y, Jong GP, Chao CL, Liu JY, Hwang KC, Chou P . Shock resuscitation with acupuncture: case report. Emerg Med J, 2006,23(3):e18
doi: 10.1136/emj.2004.023218 pmid: 16498142
[28] Deng S . Acupuncture treatment of syncope based on differentiation of signs and symptoms. J Tradit Chin Med, 1990,10(3):182-188
pmid: 2277515
[1] Yang-hao-tian Wu, Wen-bo He, Yin-yan Gao, Xue-mei Han. Effects of traditional Chinese exercises and general aerobic exercises on older adults with sleep disorders: A systematic review and meta-analysis. Journal of Integrative Medicine, 2021, 19(6): 493-502.
[2] Si-chun Gu, Jie Zhou, Qing Ye, Can-xing Yuan. Pingchan granule for depressive symptoms in Parkinson’s disease: A randomized, double-blind, placebo-controlled trial. Journal of Integrative Medicine, 2021, 19(2): 120-128.
[3] Gerli E.G. Herr, Fábio Goulart da Silva, Francisco José Cidral-Filho, Fabricia Petronilho, Lucinéia Gainski Danielski, Mariana Pereira de Souza Goldim, Afonso Shiguemi Inoue Salgado, Franciane Bobinski, Daniel Fernandes Martins, Eliane R. Winkelmann. Effects of the use of bioceramic wraps in patients with lower limb venous ulcers: A randomized double-blind placebo-controlled trial. Journal of Integrative Medicine, 2020, 18(1): 27-.
[4] Wen Qiang Lee, Jeremy Teoh, Pei Zheng Kenneth Lee, Zhi Xiong Gerard Low, Xueling Sim, Foong Fong Mary Chong, Norbert Ludwig Wagner. Factors influencing communication of traditional Chinese medicine use between patients and doctors: a multisite cross-sectional study. Journal of Integrative Medicine, 2019, 17(6): 396-403.
[5] Li-gong Liu, Arthur Yin Fan, Hong Zhou, Jun Hu. The history of acupuncture anesthesia for pneumonectomy in Shanghai during the 1960s. Journal of Integrative Medicine, 2016, 14(4): 285-290.
[6] Bosch Peggy, van den Noort Maurits, Yeo Sujung, Lim Sabina, Coenen Anton, van Luijtelaar Gilles. The effect of acupuncture on mood and working memory in patients with depression and schizophrenia. Journal of Integrative Medicine, 2015, 13(6): 380-390.
[7] Maria Sousa Cláudia, Coimbra Daniela, Machado Jorge, J. Greten Henry. Effects of self-administered exercises based on Tuina techniques on musculoskeletal disorders of professional orchestra musicians: A randomized controlled trial. Journal of Integrative Medicine, 2015, 13(5): 314-318.
[8] Kwan Leung Chia. Symptomatic Tarlov cyst and electroacupuncture: More studies required. Journal of Integrative Medicine, 2015, 13(1): 58-60.
[9] Wen-li Wang, Wei-dong Shen. A summary of studies in countries other than China on acupuncture in anesthesia and for postoperative complications. Journal of Chinese Integrative Medicine, 2009, 7(8): 797-799.
Full text



[1] Jin-rong Fu. Establishment of multivariate diagnosis and treatment system of modern gynecology of traditional Chinese medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 22-24
[2] Hao Li, Ming-jiang Yao, Wen-ming Zhao, Jie Guan, Lin-lin Cai, Ling Cui. A randomized, controlled, double-blind trial of Huannao Yicong capsule in senile patients with mild cognitive impairment. Journal of Chinese Integrative Medicine, 2008, 6(1): 25-31
[3] Zhi-chun Jin. Problems in establishing clinical guideline for integrated traditional Chinese and Western medicine. Journal of Chinese Integrative Medicine, 2008, 6(1): 5-8
[4] SUN Ming-yu, ZUO Jian, DUAN Ji-feng, HAN Jun, FAN Shi-ming, ZHANG Wei, ZHU Li-fang, YAO Ming-hui. Antitumor activities of kushen flavonoids in vivo and in vitro. Journal of Chinese Integrative Medicine, 2008, 6(1): 51-59
[5] Min Cheng, Qiong Feng, Shu-wen Qian, Hui Gao, Cui-qing Zhu. Preliminary assay of p-amyloid binding elements in heart-beneficial recipe. Journal of Chinese Integrative Medicine, 2008, 6(1): 68-72
[6] Ning-qun Wang, Liang-duo Jiang, Zong-xing Li. Research progress in asthma-related quality of life. Journal of Chinese Integrative Medicine, 2008, 6(1): 93-97
[7] Jing-yuan Mao, Chang-xiao Liu, Heng-he Wang, Guang-li Wei , Zhen-peng Zhang, Jie Xing, Wang Xian liang , Ying-fei Bi . Effects of Shenmai Injection on serum concentration and pharmacokinetics of digoxin in dogs with heart failure. Journal of Chinese Integrative Medicine, 2010, 8(11): 1070-1074
[8] Zhi-mei Wang, Bin Zhang. A study on translation of ellipses in Huangdi Neijing from perspective of hermeneutic theory. Journal of Chinese Integrative Medicine, 2010, 8(11): 1097-1100
[9] Gui Yu, Jie Wang. Thinking on building the network cardiovasology of Chinese medicine. Journal of Chinese Integrative Medicine, 2012, 10(11): 1206-1210
[10] Pedro Saganha João, Doenitz Christoph, Greten Tobias, Efferth Thomas, J. Greten Henry. Qigong therapy for physiotherapists suffering from burnout: a preliminary study. Journal of Chinese Integrative Medicine, 2012, 10(11): 1233-1239