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BBC News 19 October, 2001

Acupuncture reduces patients’ vomiting and nausea after major breast surgery at least as effectively as conventional treatment, doctors have found.

Researchers at the Duke University Medical Center in North Carolina found the treatment also reduced post-operative pain.

As many as 70% of women who undergo major breast surgery suffer significant post-operative nausea and vomiting.

Acupuncture turns out to be just as effective as the drug or better

Dr Tong Joo Gan

Acupuncture is a 5,000-year-old Chinese practice, and the researchers say it is a cheaper, less expensive antiemetic, (a drug which reduces nausea and vomiting), and has fewer side-effects, than the conventional drugs currently used.

The Duke University research was presented to the annual scientific meeting of the American Society of Anaesthesiologists on Monday.

Comparison

Anaesthetist Dr Tong Joo Gan and his colleagues compared acupuncture to one of the most commonly used medications, ondansetron (Zofran).

They used electroacupuncture, which instead of breaking the skin, as the traditional long slender needles do, delivers a small electrical pulse through the skin.

Forty women undergoing major breast augmentations, reductions or mastectomies took part in the study.

All their operations lasted between two and four hours, and most were discharged after spending one night in the hospital.

A third of the women received acupuncture before their operation, a third were given ondansetron and the rest a placebo.

Acupuncture was shown to be more effective in treating nausea.

Two hours after surgery, just 23% of those who were given acupuncture reported nausea, compared to 36% who had taken the drug and 69% of those who had had the placebo.

After 24 hours, 38% of acupuncture patients reported nausea, compared to 57% for the drug and 61% for placebo.

Acupuncture was equally as effective in treating nausea, compared to the drug, with 7% of both groups reporting the symptom after two hours, compared to 23% who received the placebo.

After 24 hours, 23% of acupuncture patients reported vomiting, compared to 28% for the drug and 46% for placebo.

The therapy also appeared to reduce pain, with 31% of patients who received it reporting moderate to severe pain two hours after surgery, compared to 64% of those who took ondansetron and 77% of those given the placebo.

Meridians

Acupuncture needles were applied at the sixth point along the pericardial meridian, two inches below the bottom of the palm of the hand and between the two tendons connecting the lower arm with the wrist.

Chinese healers believe there are about 360 specific points along 14 different lines, or meridians, that course throughout the body just under the skin.

Dr Gan said: “Acupuncture turns out to be just as effective as the drug or better, and our patients also reported much less pain after surgery, a finding that surprised us.”

Research will continue, with larger numbers of patients, and will study if combining Eastern acupuncture and Western antiemetics are more effective when combined.

Dr Richard Halvorsen, spokesman for the British Medical Acupuncture Society, and a GP who uses acupuncture at his central London practice said the Duke findings confirmed earlier research.

“Acupuncture has been shown to be effective in relieving the nausea and vomiting in pregnancy, and that related to chemotherapy.”

He said it was believed acupuncture affected the pain sensor in the brain, releasing the endorphins – the body’s own opiates.

But Dr Halvorsen said it was less clear how it could help treat nausea. “The only explanation is we know it affected the hypothalamus in the brain, and we know that’s involved in nausea and vomiting.”

Professor David Sharpe, past president of the British Association of Aesthetic Plastic Surgeons, said he was naturally quite sceptical about alternative therapies.

But he added: “If its shown to be effective in a scientific study, and those results can be confirmed in further studies, I think this is something which will be used.”

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