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ACUPUNCTURE ANALGESIA
John A. Amaro D.C., FIAMA, Dipl.Ac. (NCCAOM)

Even though acupuncture has been practiced throughout Asia for more than 4,000 years, acupuncture analgesia for surgical procedures was only developed and first used in 1958. This represents the meaningful interaction between traditional acupuncture procedures and modern Western theories of neurophysiology and neuroanatomy.

The first reported surgery employing acupuncture as the analgesia was a tonsillectomy utilizing the acupoint HeGu (LI 4). By as early as 1980 as much as 25% of all surgery in the major hospitals of China employed acupuncture analgesia as either an adjunct or as the sole analgesia.
Acupuncture analgesia offers a safe and simple alternative to chemical analgesia which Western surgeons and anesthesiologists use exclusively, despite the many adverse effects which may be encountered.

Acupuncture analgesia is easy to perform, requires no elaborate equipment, the patient is conscious during the procedure and can cooperate with the surgeon and is safe to use in the debilitated, elderly or seriously ill patient. Postoperative complications are rare and convalescence is quickened. The patient is historically ambulatory much quicker than conventional anesthesia. They are able to eat and drink earlier following surgery and very seldom require extended intravenous feeding. Cardiorespiratory, pulmonary and electrolyte complications are seldom reported compared to patients having received general chemical analgesia.

Please bear in mind, the apprehensive, tense, anxious patient are much less likely to be a candidate for acupuncture analgesia. This procedure produces "analgesia" not "anesthesia". In other words with acupuncture, the patients pain threshold is diminished but they can still experience and feel pulling, tugging, pressure and various other paraesthesia, just not intense pain from the surgery. Obviously the proper selection of the patient makes all the difference in the world for the success of this procedure.

In selecting patients for acupuncture analgesia, it is recommended the patient be described the actual surgical procedure to avoid suddenly developed apprehensions.

Acupuncture points used in surgery are primarily based on three factors,
1. Previous experience such as Tsu San Li (ST 36) for gastrointestinal and abdominal surgery Nei Guan (P 6) for thoracic surgery.
2. Anatomical region by utilizing local points in the area of the surgery.
3. According to meridian theory meaning the selection of powerful points on the meridian(s) which course through where the surgery is being performed which may be far removed from the actual surgery site. According to tradition "Wherever the Ching mo pathway pass, there lies places amenable to treatment".

Once the proper point is selected, the needle can be either manually or electrically stimulated. In manual stimulation the needle is inserted until the Teh Chi sensation is obtained the needle is then rotated and twirled with a frequency of 120-150 twirls per minute. An up/down motions is also used varying between 0.5 and 1.0 tsun. Induction of the analgesia depends on the individual patient and varies considerably but as a general rule can expect to take place in 15-20 minutes from the time needling began to time of the initial incision.

In electrical application to the needle, the intensity varies from patient to patient according to the comfort level of the patient and continued throughout the surgical procedure. Generally the electrical current is a biphasic spike wave with a frequency in the endorphin producing range of 2-5 pulses/sec.
One of the most significant rewards of reading this article, is that the formulae which follow are classic formulae which are actually used in surgical interventions. But bear in mind, if these points can alleviate the pain of surgery, what do you think they can potentially do as just a treatment
approach to pain?

Even though there are other formulae these are some of the most classic. The majority of people reading this article are not going to employ these in surgical interventions, they are always good to know or use for painful afflictions.

TOOTH EXTRACTION:... ..LI 4-TAI YANG-ST7 EAR POINTS: Tooth extraction points
THYROIDECTOMY:......... LI4-P6-GB20-ST6 " " Shen Men, lung, subcortex,
NASAL POLYPECTOMY: LI4-LI20-SI3 EAR POINTS: nose, apex of tragus, lung, sympathetic
TONSILLECTOMY:.......... LI4-P6-TH6 " " " " throat, tonsil, shen men, sympathetic
LARYNGECTOMY........... LI4-TH6 " " " " adrenal to throat, shen men to sympathetic
lung, kidney
SPLENECTOMY.............. ST36-LI3-SP6-CV15-LI13 EAR POINTS spleen, lung shen men, symphatic
CESAREAN SECTION ......STE6-GB26-SP6 " " uterus, abdomen, shen men, sympathetic, lung
NEPHRECTOMY.............. GB38-SP6-BL60-LI3-SP3-TH5-LI4-P4 EAR POINTS: kidney, shen men,
sympathetic, spleen, liver, bladder, abdomen, lung
HYSTERECTOMY.............CV2-CV4-ST36-SP6-GB-26 EAR POINTS: uterus, shen men
APPENDECTOMY............ ST36-GB26 " " appendix, abdomen shenmen
GASTRECTOMY ...............ST36-ST37-TH17 " " shen men, sympathetic, stomach
LIGATION OF HEMORRHOIDS ...BL3O " " " lung, lower rectum
INTERNAL FIXATION OF FRACTURE OF NECK OF FEMUR.... ST36-BL59-ST40-GB36-GB34-LI5
EAR POINTS: hip, ankle, shen men lung sympathetic, kidney, adrenal
KNEE:............................... ST36-SP12-ST31
LEG (POSTERIOR) .............ST36-BL57-BL54-ST40
LEG (ANTERIOR)................ ST36-LI5-LI3
ANKLE............................... ST36-KI3-SP6-GB39
SOLE OF FOOT.................. BL60-SP4-KI3
DORSUM OF FOOT............ ST36-ST41-BL6O-GB39
FIRST THREE TOES........... ST36-ST41-SP6-SP4-LI3
FOURTH & FIFTH TOES...... ST36-BL54
THIGH (ANTERIOR)............. ST36-GB29-SP12
THIGH (POSTERIOR).......... BL51-BL54
BUTTOCK.......................... BL51-Huo To Chia Chi-GB30
INGUINAL REGION............. ST36-SP4
SMALL FINGER.................. LI4-SI3-HT5
RING FINGER..................... LI4-TH3-HT5
THUMB, INDEX, MIDDLE FINGER......... LI4-LU10-LI10-P6-TH9
NECK................................. LI4-SI3-P6-GB20
SHOULDER.........................LI4-LI15-TH5
SPINE................................ ST36-LI4-Hou To Chia Chi-BL57-GB38-TH5-P6
ELBOW...............................LI4-LI11
LIP...................................... LI4-ST6-ST4
EAR....................................LI4-TH5
FACE..................................LI4-ST6-ST4-SI18-ST2-ST7
FRONTAL SINUS.................GB14-BL2-ST2-TH6-LI4
EYE................................... LI4-SI3-TH6-TH5
EYEBROW......................... LI4-GB14-Yu Yao-Tai Yang
FOREHEAD........................ LI4-GB14-YuYao-TaiYang-BL2
OCCIPUT............................ LI4-GB20-P6

John A. Amaro D.C.,FIAMA, Dipl.Ac.(NCCAOM)
Box 1003 Carefree, Arizona
DrAmaro@IAMA.edu