Postoperative pain resulting from surgical trauma is a significant challenge. Opioid analgesics are commonly used to treat postoperative pain; however, these drugs are associated with a number of undesirable side effects. Research indicates that certain modes of acupuncture improves postoperative pain after surgery and reduces opioid use. These findings support the use of acupuncture as an adjuvant therapy in treating postoperative pain.

Mechanistic Evidence

  • Electro-acupuncture stimulates the release of β-endorphin, encephalin, and endomorphin, which in turn activates the μ- and δ-opioid receptors, key receptor sites in the management of acute, chronic, and neuropathic pain [1].
  • High-frequency stimulation (100-200 Hz) provides rapid-onset analgesia that does not appear to be blocked by naloxone (a μ-opioid antagonist), suggesting it may be mediated by norepinephrine, serotonin, and dynorphins [2].
  • Low-frequency (2-4 Hz) and medium-frequency stimulation (15-30 Hz) appear to produce an analgesic effect that is reversed by naloxone, suggesting it is mediated by enkephalins and endorphins [2,3]. These frequencies also appear to produce analgesia that accumulates, lasting at least an hour after treatment [2].


  1. Lin J, Chen W. Acupuncture analgesia: a review of its mechanisms of actions. Am J Chin Med 2008;36:635–45.
  2. Chernyak G, Sessler D. Perioperative acupuncture and related techniques. Anesthesiology 2005;102:1031–78.
  3. Zhao Z. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol 2008;85:355–75.