Effect of Auricular Acupuncture on Propofol Induction Dose: Could Vagus Nerve and Parasympathetic Stimulation Replace Intravenous Co-Induction Agents?

• Published in: Medical acupuncture Vol. 31; no. 2; pp. 103 - 108
• Main Authors: Fanara, Benoît, Lambiel, Silvia
• Format: Journal Article
• Language: English
• Published: United States Mary Ann Liebert, Inc., publishers 01.04.2019
• Subjects: Original; vagus nerve stimulation; parasympathetic; auricular acupuncture; propofol; general anesthesia; co-induction
• ISSN: 1933-6586; 1933-6594
• DOI: 10.1089/acu.2018.1327

Auricular acupuncture, through a combination of several points, can produce sedative and analgesic effects. The aim of this study was to compare the induction dose of propofol required to obtain a loss of response to verbal commands, with and without a preoperative combination of auricular points. This study involved American Society of Anesthesiologists physical status I and II patients, ages 18- 65, of either sex, having elective ambulatory surgery (digestive or gynecologic) under general anesthesia. The subjects were allocated to 2 groups: (1) patients treated by auricular acupuncture (group AA), compared with (2) patients not treated by auricular acupuncture (group NA). Propofol injection was initiated in each group, 10 mg, every 5 seconds, in order for the anesthetist to determine the minimum dose until there was a loss of response to verbal commands (the clinical hypnotic endpoint). At this point, the main outcome-the dose of propofol given-was noted. There were 32 patients in this study (16 in each group). Age, height, weight, and body mass index were similar in the groups (  ≥ 0.05). The required induction propofol dose was 17.7% lower in group AA than in group NA-a statistically significant difference (  ≤ 0.05). The mean induction dose indexed to weight was 2.18 mg/kg (range: 1.53-3.13 mg/kg) in group NA and 1.79 mg/kg (range: 1.12-2.11 mg/kg) in group AA. There were no complications. Auricular acupuncture is a method for stimulating the vagus nerve and parasympathetic nervous system. Preoperative auricular acupuncture enabled reductions of induction doses of propofol for general anesthesia without any clinically important side-effects.