On 26 and 27 January Milan hosted the international congress “Pain and Acupuncture” organized by the Italian Society of Acupuncture (SIA), the SoWen School of Milan and Humanitas. Thirty speakers from all over the world illustrated the role of acupuncture in pain management and shared their experience on the hospital and outpatient use of acupuncture. Among them were some specialists from Humanitas.

The objectives of the congress: to promote and share knowledge and awareness on acupuncture

Take stock of the state of the art of this discipline and increase knowledge of acupuncture and its applications against pain among those who already practice it; but also promote information among doctors and then patients and finally raise awareness among health institutions so that they can assess the usefulness of inserting services for analgesic purposes in hospital services. These are the objectives of the event, which in front of more than 350 experts, presented results and data of clinical trials achieved in national and international hospitals and supported by the analysis of scientific literature.

“In the last decade the literature dedicated to acupuncture and its applications is rapidly multiplying – said Dr. Roberta Monzani, head of the outpatient clinic and professor of Traditional Chinese Medicine at the So-Wen Study Center in Milan and anesthesiologist in charge of the Day Hospital Surgery in Humanitas – is still difficult to carry out scientific work because it is difficult to find colleagues and collaborators who are proactive in this discipline and with regard to this approach,” admitted Monzani.

Treatment with acupuncture “is not yet fully shared, the idea is still widespread among doctors that this approach does not have adequate scientific dignity, simply because they do not know the subject”. “In reality in China or Vietnam, it is still the first choice therapy, there are hospitals that have an imprinting totally based on traditional Chinese medicine”.

Studies and applications of acupuncture in Humanitas

Among the outpatient services offered by Humanitas there is also the acupuncture surgery where different types of pain and disorders are treated including headache, insomnia, gastroesophageal reflux, irritable bowel syndrome, gynecological problems, allergic phenomena.

On the occasion of the international congress, some Humanitas specialists presented some applications of this discipline, including Dr. Monzani, Dr. Fabio Intelligente and Dr. Benedetta Basta.

Dr. Monzani presented a report entitled “Intraoperative analgesia with electroacupuncture: a useful alternative to general anesthesia”. “The purpose of this study was to use acupuncture in some elective surgeries and for patients with high clinical risk and to evaluate its advantages and disadvantages,” explained Monzani.

“In the West this technique still has limited indications and is used especially in cases where traditional anesthesia is contraindicated, even if sometimes it is the patients themselves who require a “non-pharmacological” approach to solve their health problems, both medical and surgical – explained the anesthetist -. The analgesia with electroacupuncture is used electively in surgery of the head, neck, chest, perineal region, in caesarean section and in orthopedic surgery. It is less used in abdominal surgery because it does not guarantee sufficient muscle relaxation and the traction on the viscera and months are not made totally painless.

“All the Western authors who have used this method report a result from satisfactory to good for intraoperative analgesia and very good for the postoperative course – explained Monzani -. Based on my experience I consider intraoperative analgesia with electroacupuncture a valid method successfully applicable for selected surgeries, for adequately prepared patients and in all those cases in which there are contraindications to traditional anesthesia techniques”.

“However, it is essential to work as a team – clarified the doctor -: the collaboration of the surgeon, which must be delicate but decisive in its maneuvers, the collaboration of the patient, who must be properly informed and prepared, the role of the anesthetist who must also be an acupuncturist. “The simplicity of execution, the good tolerability on the part of the patient but above all the proven absence of side effects and the good degree of analgesia achieved in most cases, make this technique a valid alternative to general or loco-regional anesthesia,” she concluded.

Acupuncture and fibromyalgia: the relation presented by Dr. Fabio Intelligente

The specialists of Humanitas Dr. Marco Maiola and Dr. Fabio Intelligente presented a paper, written together with Dr. Alberto Lomuscio, entitled “Fibromyalgia: analysis of scientific literature and personal experiences”.

“We have not carried out controlled clinical studies on our patients suffering from fibromyalgia, so we will limit ourselves to exposing our clinical experience gathered over several years of outpatient work with acupuncture,” said the specialists. “In our experience, some clinical elements emerge that have proved useful to alleviate the suffering of patients with fibromyalgia, while always remaining very marked the gap in individual response, in the sense that it passes from patients who have major remissions of symptoms, to others who are not affected only to a minimal extent by the effects of acupuncture therapy.

Among the evidence found following acupuncture treatments highlighted by the authors of the paper there are: a “reduction of pain, which sometimes manifests itself with almost complete remissions that can last even for long periods (up to one month), and then reappear, and in these cases it may be useful, after the cycle of acupuncture sessions (usually 10-12), continue with one session per month of maintenance”; a “marked improvement in the quality of sleep, which generally induces greater general well-being in the patient” and “the feeling of an increase in general energy, in patients in whom asthenia is a very important element of the disease, which disturbs the patient greatly and significantly worsens the quality of life”.

“In this way – conclude the three specialists – the patients feel really taken care of by the doctor, and even if from a strictly symptomatic point of view they do not achieve extraordinary results, nevertheless their quality of life improves, their tolerance to pain increases, and the improved tone of mood makes them more inclined to fight and more full of hope of being able to control the disease”.

Electroacupuncture and postoperative pain: applications after mastectomies presented by Dr Benedetta Basta

Finally, the report by Dr. Benedetta Basta, anaesthetist of the Humanitas Research Hospital Day Hospital service, focused on postoperative pain.

Breast cancer is the most common malignant tumor in women. Mastectomy remains the key surgical treatment for 37-40% of breast cancer patients. “Mastectomy with contemporary reconstruction is an operation that frequently develops persistent chronic pain after surgery, is reported in 25-60% of all cases – explained Basta -. It is a difficult condition to treat, which can last for years or sometimes become permanent and negatively affect the quality of life of patients.

In the two-year period 2015-2017 forty-four patients received two sessions of electroacupuncture after mastectomy and reconstruction: according to the results and data presented by Dr. Basta, relating to this application “electroacupuncture could be considered an adjuvant treatment for the control of pain after mastectomy with plastic reconstruction”.