Acupressure May Calm Children Prior to Surgery

In half the children, a bead was applied to the Extra-1 (Yin-Tang) acupoint, which is located in the midpoint between the eyebrows; in the other half, the bead was applied to a sham spot above the left eyebrow that has no reported clinical effects. A bispectral index (BIS) monitor was applied to all children before the onset of the intervention, and anxiety was assessed at baseline and before entrance to the operating room (OR). Anesthetic techniques were standardized and maintained with an intravenous propofol infusion titrated to keep BIS values of 40-60.

Thirty minutes later, the researchers noted decreased anxiety levels in the children who had the beads applied to the Extra-1 acupoint. Conversely, anxiety levels increased in the sham group. However, no significant changes in BIS values were observed in the preprocedural waiting period between groups, and the total intraprocedural propofol requirements did not differ between the two groups. Overall, the researchers found the use of acupressure had no effect on the actual surgical procedure. The study was published in the September 2008 issue of Anesthesia & Analgesia.

"Anxiety in children before surgery is bad because of the emotional toll on the child and parents, and this anxiety can lead to prolonged recovery and the increased use of analgesics for postoperative pain,” said lead author Zeev Kain, M.D., chair of the department of anesthesiology and perioperative care at UCI. "As anesthesiologists, we need to look at all therapeutic opportunities to make the surgical process less stressful for all patients. We can't assume that Western medical approaches are the only viable ones, and we have an obligation to look at integrative treatments like acupressure as a way to improve the surgery experience.”

A BIS monitor is a neurophysiological monitoring device, which continually analyses a patient's electroencephalograms (EEGs) to assess the level of consciousness during general anesthesia. The use of BIS monitors is increasing, following recommendations from several professional bodies that they be used routinely to measure the depth of anesthesia and awareness status.

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