Acupuncture and Its Place in Postoperative Pain Management
Postoperative pain results from surgical trauma and remains a major challenge to patients and healthcare providers. About 75 percent of patients in health care centers may either experience severe or moderate pain after having a surgery (Lu & Lu, 2013). Postoperative pain is normally treated using opioid analgesics, including fentanyl, morphine, meperidine, and hydromorphine (Lu & Lu, 2013; McCartney & Nelligan, 2014). However, such drugs are associated with undesirable side effects to patients, which can slow down the rate of recovery. Common side effects include: decreased gut motility, nausea, sedation, and vomiting (Lu & Lu, 2013; Wu, et al., 2016). Using customized strategies in analgesic administration results in improved pain control to patients (Lu & Lu, 2013). For instance, patient controlled analgesia is used to decrease the use of opioid analgesics. Because patients may not respond well to drug therapy or its side effects, health care providers should recommend acupuncture as an alternative for safely managing postoperative pain.
Background
Acupuncture is a common method for pain management. Acupuncture refers to a type of treatment that is derived from Chinese medicine (Chon & Lee, 2014; Cho, et al., 2015). Several studies have shown that it is safe in comparison to routine care (Chao, et al., 2016; Chon & Lee, 2014; Patil, et al., 2016). In this type of treatment, an individual is inserted with tiny needles at specific parts of the body for preventative or therapeutic purposes (Cho, et al., 2015; Patil, et al., 2016). The method is used in many hospices and pain clinics in different parts of the world. Acupuncture is considered a form of alternative medicine to opioids used in the treatment of a wide range of health conditions. For example, it may be used in the treatment of migraines, lower back pain, and severe headaches (Patil, et al., 2016; Cho, et al., 2015). It is also used in the treatment of musculoskeletal conditions and different types of pain such as dental pain, postoperative pain, and joint pain (Chon & Lee, 2014). Thus, with its universal use, acupuncture offers an alternative option to pain management for postoperative patients.
Acupuncture Is Safe
Opioids that have a short period of analgesic activity have more disadvantages than advantages. Opioids are also associated with adverse side effects, such as vomiting, as a result of using controlled release (CR) morphine, and constipation, associated with controlled release oxycodone (Clark, 2012). The metabolites of opioids that are excreted by the kidney increase toxicity to the body (Clark, 2012). Further, if opioids are used for a long time, they change how nerve cells work, leading to dependence on opioids such that when they are eliminated, the patient develops unpleasant reactions and feelings from withdrawal (Groppetti, et al., 2011). Therefore, despite their wide use, opioids have been shown to have adverse side effects when used in managing pain for postoperative patients.
In comparison, acupuncture has fewer side effects as compared to opioids during pain management. Research shows that treatment using acupuncture methods has negligible adverse effects as opposed to medical procedures and prescribed medications adopted to treat similar health conditions (Garcia, et al., 2013). Most of the side effects from acupuncture only last for a short time and may include: visual changes, headaches, and dry mouth (Patil, et al., 2013). Considering acupuncture’s effectiveness in pain management, these side effects are manageable to most patients.
Apart from the manageable side effects, acupuncture’s performance as a pain management treatment makes it a viable alternative in pain management. According to Clark (2012), opioid medications are supposed to be taken several times in a day, causing interference to daily activities carried out by a patient. According to a study conducted by Groppetti et al. (2011), the use of acupuncture is more effective than application of opioids. The findings showed that acupuncture is an effective technique of providing analgesia as compared to opioids. Acupuncture provides prolonged analgesia and does not need further medication as opposed to opioids (Chao, et al., 2016). Additionally, unlike opioids, acupuncture can be used as a preventive treatment (Groppetti, et al., 2011). Thus, these properties not only make it a better option in postoperative pain management but also a viable alternative to opioids.
Universality of Acupuncture
Moreover, application of acupuncture in treatment can be used to any age group and on patients with diverse characteristics. According to Garcia, et al. (2013), the elderly, children, and adults can use this pain management method since it is safe and does not cause significant harm to patients. Additionally, the application of acupuncture in treatment can be done without causing interference to other types of ongoing medications and treatment (Garcia, et al., 2013). Acupuncture is also a viable alternative for those that cannot take opioids due allergies or prior issues with addiction. Therefore, acupuncture offers an alternative solution that is safe for postoperative patients of any age and will not interact with other treatments, unlike opioids.
Counterargument
Although patients may accept the risks associated with acupuncture, other adverse effects should also be considered. The first risk is the danger of infection. Several cases have been documented where patients receiving treatment through acupuncture contract hepatitis and other diseases resulting from infections that develop after the piercings (Lu & Lu, 2013). The Hepatology journal documented that 35 out of 366 patients contracted hepatitis B in a clinic based in America following the use of acupuncture in pain management (Lu & Lu, 2013). The infections were mainly caused by re-using unsterilized needles. Additionally, using alcoholic solutions to store used needles is not sufficient to sterilize needles. As a result, hepatitis viruses and other secondary infections are transmitted once the same needles are reused on a different patient (Lu & Lu, 2013). Also, the needles may puncture a major organ or nerve; the puncture may become extremely painful to the patients (Patil, et al., 2016). For instance, needling the base of an individual’s skull may lead to adverse consequences such as brain damage (Chon & Lee, 2014). Thus, even with its inherent benefits, acupuncture has challenges that require proper management and assessment of the patient to avoid severe side effects.
Refutation
The benefits of employing acupuncture significantly outweigh the side effects discussed. As Patil et al. (2016) outline, the side effects of applying the treatment method are not quite harmful and rarely develop. Additionally, since the effects of applying acupuncture are short lived, if safety measures are strictly followed, then the method can be safe and effective (Patil, et al., 2016). For example, if needles are properly sterilized, the risk of infection is removed. If precautions are taken when placing needles near organs, the needles will not cause serious injury. Therefore, acupuncture cannot be disregarded as an effective postoperative pain management option because its side effects can reasonably be avoided if safety precautions are taken with an experienced provider.
Acupuncture is a reasonable treatment method for all people suffering from postoperative pain, regardless of age, current treatment, substance abuse, or medication allergies. Acupuncture helps ease different postoperative pain such as neck pain, low-back pain, and osteoarthritis (Chon & Lee, 2014). The method has been shown to relieve patients from back, joint, and neck pains after surgeries (Cho, et al., 2015). Although there are theoretical risks with inserting needles into the body, there are relatively few complications that have been reported on the use of acupuncture in postoperative pain management (Patil, et al., 2016).
Conclusion
The benefits of using acupuncture outweigh its few side effects and the inherent adverse effects of opioids, making it an alternative pain management option to opioids for postoperative patients. The adverse effects of using acupuncture are only experienced for a short time, with most of them lasting for a few minutes or hours. Further, it is safely used among patients with other treatment plans and diverse age groups. Since opioids have side effects such as vomiting and constipation after the use of controlled-release morphine, cognitive impairment among the elderly, and unbearable pain from withdrawal, using acupuncture as an alternative can improve the effectiveness of post-operative pain management for patients who choose not to or cannot use pain medication. Therefore, health care providers should recommend acupuncture as an alternative for safely managing postoperative pain.
References
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