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Acupuncture May Smooth Liver Transplant Recovery

July 30, 2009

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As major surgery requiring general anesthesia, a liver transplant involves the challenging post-operative recovery period. Now researchers from Duke University have found that acupuncture is a safe and effective way to ease the transition between operating table and hospital dismissal.

by Nicole Cutler, L.Ac.

Once chronic Hepatitis C progresses to end stage liver disease, a liver transplant is modern medicine's last hope for a person's recovery. However, like all major surgeries, a liver transplant involves some vital recovery challenges. Recuperating from the surgery itself is one of the first trials a person who has just undergone a transplant must endure. New research from Duke University demonstrates that acupuncture, a relatively inexpensive and effective technique, can aid a person's surgical recovery better than the leading medications.

Anesthesia for a Liver Transplant
In order to remove a patient's diseased liver and replace it with a healthy one, general anesthesia is required. By administering anesthetic drugs, a state of unconsciousness is induced and sensations of pain over the entire body are blocked. General anesthesia has many purposes including:

· Pain relief (analgesia)
· Blocking memory of the procedure (amnesia)
· Producing unconsciousness
· Inhibiting normal body reflexes to make surgery safe and easier to perform
· Relaxing the muscles of the body

Because general anesthetics affect the central nervous system, many repercussions potentially abound. Within a day or two, most of the anesthetic's side effects disappear as the drugs wear off. After a surgery using general anesthesia, the following side effects are commonplace:

· Drowsiness
· Weakness
· Fuzzy thinking
· Vision problems, such as blurred or double vision
· Coordination problems
· Headache
· Muscle pain
· Nausea or vomiting
· Nightmares or unusual dreams

In order to reduce these side effects directly - or reduce the quantity of anesthetics used to lessen the side effects - surgical personnel are always seeking innovative approaches to ease post-operative recovery.

Acupuncture
Acupuncture is a 5,000-year old Chinese medical practice using ultra thin, sterile needles inserted in specific locations throughout the body. This therapy has many possible uses; one of which is to induce an anesthetized state in preparation for surgery. While acupuncture anesthesia has been practiced in China since about 1960, its acceptance in the west has been slow to emerge. Western medical hospitals would not consider relying on acupuncture treatment to anesthetize a patient during major surgery. However, an increasing number of surgeons are recognizing that this therapy may:

1. Help reduce the quantity of drugs needed for general anesthesia
2. Improve the patient's post-surgical recovery process

Although the integration of different styles of medicine has a long way to go, the onslaught of positive reports is improving the likelihood of progressive hospitals incorporating acupuncture into their surgical plans.

Duke Study
Leading the way in integrative medical pursuits, Duke University Medical Center researchers have found that acupuncture is more effective in reducing nausea than the leading medication prescribed for patients recovering from major surgery. Published in the September 22, 2004 journal Anesthesia and Analgesia, the researchers reported that patients who received acupuncture treatments had decreased post-operative pain and increased satisfaction with their post-operative recovery.

Treating post-operative nausea and vomiting is one of the largest medical challenges following general anesthesia. According to Duke anesthesiologist Tong Joo (T.J.) Gan, M.D., about 70 percent of women who undergo major breast surgery requiring general anesthesia suffer from post-operative nausea and vomiting. These adverse side effects are important factors in determining how soon patients can return home after surgery.

As the lead Duke researcher, Gan said, "The patients in our randomized trial who received acupuncture enjoyed a more comfortable recovery from their surgery than those who received an anti-sickness medication. In the areas of PONV (post-operative nausea and vomiting) control, pain relief and general overall satisfaction, acupuncture appears to be more effective than the most commonly used medication, with few to no side effects."

In addition to this study on women undergoing major breast surgery, Gan also led a more recent analysis on this topic by combining data from 15 small, randomized acupuncture clinical trials. He found that patients who received acupuncture had a significantly lower risk of developing the most common side effects associated with opioid drugs compared with a control group. When measured against the control group, the combined results demonstrated that the acupuncture recipients had:

· 1.5 times lower rates of nausea
· 1.3 times fewer incidences of severe itching
· 1.6 times fewer reports of dizziness
· 3.5 times fewer cases of urinary retention

According to Gan, "While the amount of opioids needed for patients who received acupuncture was much lower than those who did not have acupuncture, the most important outcome for the patient is the reduction of the side effects associated with opioids. These side effects can negatively impact a patient's recovery from surgery and lengthen the time spent in the hospital."

The results of Gan's research add to the growing body of evidence that acupuncture can play an effective role in improving the quality of the surgical experience. "Acupuncture is slowly becoming more accepted by American physicians, but it is still underutilized," Gan said. "Studies like this, which show that there is a benefit to using it, should help give physicians sitting on the fence the data they need to integrate acupuncture into their routine care of surgery patients."

This information can be very useful for people with advanced chronic Hepatitis C infection needing a liver transplant. Receiving acupuncture prior to and during a liver transplant can lessen some of the immediate challenges of this surgery. Although a relatively minor addition to a surgical plan, this small shift of protocol can make a big difference. So if you are slated for liver transplant surgery, inquire further about what your operative team will do to expedite your surgical recovery - and consider searching for a program that integrates acupuncture into the process. Because a liver transplant has enough challenges attached to it, your extra investigative effort will benefit you in your recovery process.

References:

http://ecam.oxfordjournals.org, Acupuncture Anesthesia and Analgesia for Clinical Acute Pain in Japan, Reina Taguchi, Oxford Journals, June 2007.

http://healthdailynewscentral.com, Acupuncture Eases Recovery Following Breast Surgery, Lisa Olen, Daily News Central, 2007.

www.debakeydepartmentofsurgery.org, Liver Transplant, Baylor College of Medicine, 2007.

www.dukehealth.org, Acupuncture Reduces Pain, Need for Opioids after Surgery, Duke University Health System, 2007.

www.healthatoz.com, Anesthesia, General, healthatoz, 2007.

www.medpagetoday.com, Acupuncture Points to Easier Surgical Recovery, Crystal Phend, MedPage Today LLC, October 2007.

www.sciencedaily.com, Acupuncture Reduces Pain, Need For Opioids After Surgery, ScienceDaily LLC, October 2007.

Posted by Editors at July 30, 2009 10:07 AM

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