Acupuncture and Anxiety During Medical Procedures

Over the years I have become impressed with the increasing research on something close to my own heart: how to use the best of scientific medicine in conjunction with less orthodox approaches. And, for that matter, when each is best left on its own.

I have mentioned that a few years ago I had to have surgery for a potentially serious problem. The surgeon – widely regarded as one of the best in this neck of the woods – was stunned by the speed of my recovery.

“I have seen it with my own eyes, “ He said, “But how did you do it?”

“Well,” I said, “You are an excellent surgeon. But I also some outside help: acupressure, homeopathic remedies, qigong and three prayer groups. We call it Integrated Medicine. You may think that it’s odd, but that’s what I did.”

“Oh no,” he said, “I have been in practice for over 35 years: I trust my senses far more than I trust some graph with p values on it!”

Although anxiety has never been one of my problems, I was pleased to see two new publications on the use of acupuncture to reduce anxiety during medical procedures.

A randomized controlled study was carried out to determine whether a combination of auricular and body acupuncture is effective as an adjunctive treatment for pre-procedural anxiety and pain, in 56 patients undergoing lithotripsy (ultrasonic destruction of kidney stones). In the acupuncture group, pre-procedural auricular acupuncture was combined with intra-procedural electro-acupuncture stimulation, while in the control group both treatments were sham. Patients in the acupuncture group were less anxious pre-procedure than those in the sham group and they also used a significantly smaller amount of analgesic during the procedure than those in the sham control group. Patients in the acupuncture group also reported significantly lower pain scores on admission to the recovery room.

Meanwhile an Italian study has found that patients undergoing cataract removal are less anxious after receiving acupuncture. People underwent phacoemulsification, in which the cloudy eye lens is emulsified with an ultrasound probe, before being aspirated and replaced by an artificial lens. The procedure is carried out under topical anesthesia while the patient is awake and can therefore provoke significant anxiety. In this prospective randomized double-blind controlled trial, anxiety levels were assessed before and after surgery in three groups (no acupuncture, true acupuncture and sham acupuncture) of 25 patients. Preoperative anxiety levels were significantly lower only in the true acupuncture group. The difference in postoperative anxiety levels between the real acupuncture and no acupuncture groups was also significant.

These studies are particularly interesting in the light of a recent analysis of the published research on acupuncture and anxiety, that did not include these studies. There is not much research out there, but what we have suggests that it may perhaps help with generalized anxiety disorder. The best evidence is indeed in using it to allay anxiety before, during or after surgery, though we still need a lot more research to be sure.

I have heard people say that using acupuncture like this somehow belittles it: that an ancient and self-contained system should not become the handmaiden of Western medicine.

That is only half true. First, traditional Chinese medicine was developed at a time and placed very different from today. Human beings have changed radically in the intervening centuries. That is why acupuncturists in modern China are discovering and developing new way to treat people that do not always conform to the precepts laid down hundreds of years ago.

Second, many of us have failed to recognize the treasures in our midst. Acupuncture and acupressure are two of them. If using them together with conventional medicine is the best way for people to come to know of them, that is all to the good.

There are several other similar studies that will be coming out in the next few months, and I shall keep you informed.