Electroacupuncture Mechanisms in Managing Preoperative Anxiety and Postoperative Pain Chronification: A Review.

Researchers reviewed how electroacupuncture—a treatment that combines traditional acupuncture needles with gentle electrical stimulation—might help manage anxiety before surgery and prevent pain from becoming chronic afterward. Many patients experience anxiety before operations, which can actually make their pain worse and last longer after surgery, a phenomenon called "hyperalgesic priming" or pain chronification. The research team searched medical databases for studies examining how electroacupuncture affects the brain and body's response to anxiety and pain. They found that electroacupuncture works through multiple pathways in the nervous system. For pre-surgery anxiety, it helps by changing the brain's chemical messengers, reducing inflammation, balancing stress hormones like cortisol, and improving how the nervous system regulates the body's stress response. For preventing long-term pain after surgery, electroacupuncture modifies pain signaling pathways, decreases inflammation at injury sites, and influences how genes are expressed and how pain receptors function. The review suggests electroacupuncture could be particularly valuable because it addresses both the psychological anxiety component and the physical pain processes simultaneously, potentially improving recovery outcomes for surgical patients. Unlike medications that typically target just one pathway, electroacupuncture appears to work on multiple body systems at once. While these findings are promising for patients concerned about surgery-related anxiety and pain, the researchers note that more clinical studies are needed to determine the best treatment protocols and timing. If you're considering electroacupuncture for surgical preparation or pain management, consult with a licensed acupuncturist experienced in perioperative care.

This narrative review examines electroacupuncture's mechanisms in managing preoperative anxiety-induced postoperative hyperalgesic priming. Authors conducted a literature search across PubMed, ScienceDirect, and Google Scholar, synthesizing findings on EA's neurobiological effects. Key mechanisms identified include: (1) anxiety reduction through modulation of neurochemical pathways, HPA axis regulation, and autonomic nervous system rebalancing; (2) prevention of pain chronification via modulation of nociceptive pathways, inflammatory mediator suppression, receptor signaling modification, and neurotransmitter system regulation; (3) epigenetic influences on gene expression related to pain processing. The review emphasizes EA's multimodal approach, simultaneously addressing psychological and physiological components of the anxiety-pain cycle. No specific sample sizes or effect sizes were reported in this synthesis review. Clinical implications suggest EA integration into perioperative protocols may reduce opioid requirements and improve surgical outcomes. Further controlled trials are needed to establish optimal stimulation parameters, timing, and point prescriptions for standardized clinical implementation in surgical settings.