Effect of Acupuncture on Postoperative Pain in Patients after Laparoscopic Cholecystectomy: A Randomized Clinical Trial

Postoperative pain is one of the main challenges faced by patients, particularly those undergoing laparoscopic cholecystectomy, a minimally invasive procedure for gallbladder removal. Although less traumatic than traditional open surgery, this operation can still cause significant pain that disrupts sleep, generates anxiety, and may prolong recovery time. Adequate management of postoperative pain is essential not only for patient comfort but also to accelerate recovery and reduce complications. Traditionally, anti-inflammatory medications such as parecoxib sodium have been used to control this pain; however, these drugs can cause adverse effects including gastrointestinal and cardiac problems.

In this context, acupuncture emerges as a promising therapeutic alternative — a centuries-old technique from traditional Chinese medicine (TCM) that has demonstrated efficacy in pain control across various clinical settings.

This study aimed to investigate the efficacy and safety of acupuncture compared with parecoxib sodium for postoperative pain control in patients undergoing laparoscopic cholecystectomy. The investigators conducted a randomized controlled trial at a university hospital in China, enrolling 42 patients equally divided into two groups. The acupuncture group received needle treatment at specific body points, while the control group received parecoxib sodium on patient request. The acupuncture protocol included specific bilateral points: Hegu (located on the dorsum of the hand), Waiguan (on the forearm), Yanglingquan (on the leg), and Zulinqi (on the foot).

These points were selected based on TCM theory and clinical experience. Acupuncture was performed by licensed practitioners with at least three years of experience, using sterile disposable needles. Pain intensity was measured using a 0–10 visual analog scale at specific intervals: immediately after surgery, and then at 6, 9, and 12 hours.

Results demonstrated that acupuncture was significantly more effective for pain control during the first hours after surgery. Specifically, at 6 and 9 hours postoperatively, patients in the acupuncture group had lower pain scores than the control group. In addition, fewer patients in the acupuncture group requested rescue analgesia in both the 0–6-hour and the 6–12-hour postoperative windows. The study also evaluated other important aspects of postoperative recovery.

With respect to nausea and vomiting — common symptoms after surgery — the acupuncture group showed lower scores at 6 hours postoperatively. Patient comfort, measured by the Bruggemann scale, again favored the acupuncture group at 6 hours. These differences became less pronounced at later time points; specifically, at 12 hours both groups showed similar results.

These findings have important implications for both patients and clinicians. For patients, acupuncture represents a complementary treatment option that may significantly reduce postoperative pain and the need for analgesics during the first hours after surgery, the most uncomfortable phase of recovery. This is particularly relevant for patients who prefer to avoid medications or who have contraindications to anti-inflammatory drugs. For clinicians, the results suggest that acupuncture can be integrated as part of a multimodal approach to postoperative pain management, potentially reducing reliance on medications and their associated adverse effects.

The technique proved safe, with only minor adverse events such as small bleeding at the insertion site that resolved quickly without significant discomfort.

However, the study has several important limitations that should be considered when interpreting the results. First, no sham-acupuncture group was included, which would have helped distinguish specific acupuncture effects from possible placebo effects. Second, the observation period was limited to 12 hours after surgery, providing no information about longer-term benefits. Third, all patients received the same standardized acupuncture protocol, whereas clinical TCM practice often uses individualized protocols based on patient assessment.

In addition, the study was conducted at a single center with a relatively small number of participants, which may limit generalizability. Despite these limitations, the findings provide valuable preliminary evidence for the potential of acupuncture as adjuvant therapy in postoperative pain management after laparoscopic cholecystectomy, especially during the critical first hours of recovery.