The Use of Auricular Acupuncture to Reduce Preoperative Anxiety

Preoperative anxiety is a natural and very common reaction that affects the great majority of patients preparing for surgery. This anxiety can cause significant discomfort and, in some cases, interfere with the surgical process and recovery. Traditionally, physicians use anxiolytic medications or psychological programs to help patients cope with these feelings of apprehension and nervousness. Although these approaches are effective, they can have important drawbacks: medications can cause unwanted side effects, psychological programs are time-consuming, and both options increase treatment costs.

For this reason, researchers continue to seek simpler, safer, and more cost-effective alternatives to help anxious patients before surgical procedures.

Auricular acupuncture, also known as ear acupuncture, represents one such promising alternative. This technique, similar to reflexology, was developed in French and Chinese medicine in the 1950s and is based on the theory that different points on the outer ear correspond to different parts and functions of the body. According to this approach, by stimulating specific points on the ear, it is possible to influence symptoms and conditions in other parts of the organism, including emotional states such as anxiety. Previous studies had already demonstrated that auricular acupuncture could reduce day-to-day situational anxiety in healthy individuals, but there was still no clear evidence about its efficacy specifically for preoperative anxiety.

To investigate this question, researchers at Yale University conducted a randomized controlled study with 91 adult patients undergoing elective ambulatory surgery. Participants were between 19 and 66 years of age, had no history of psychiatric illness, and had never experienced acupuncture before. The study divided patients into three different groups: the first received acupuncture based on traditional Chinese medicine, using points related to the kidney, heart, and shenmen, which according to Chinese theory are associated with fear, anxiety, and calming the mind. The second group received acupuncture at points specifically documented to promote relaxation and decrease anxiety.

The third group served as a control, receiving needles at points known to have no effect on anxiety. All patients had small needles placed in the non-dominant ear for 30 minutes, without any additional stimulation, and were able to maintain their normal activities during this period.

To measure anxiety levels, the researchers used a validated scientific questionnaire called the State-Trait Anxiety Inventory, which evaluates both momentary anxiety and the person's general tendency to feel anxiety. Patients completed this questionnaire before treatment and again after the 30 minutes of acupuncture. It is important to highlight that no patient received sedative medications during the study, allowing a more accurate assessment of the effects of acupuncture.

The results were quite encouraging and revealed important differences between the groups studied. Patients who received acupuncture at the relaxation points showed a significant reduction in anxiety levels compared with the control group. Specifically, while the control group maintained similar anxiety levels before and after the procedure, the group that received treatment with relaxation points showed a clear and statistically significant decrease in anxiety. Interestingly, the group that received traditional Chinese medicine-based acupuncture also showed some improvement, but this reduction was not as pronounced as that observed in the relaxation group, nor statistically different from the control group.

These findings have important implications for both patients and health professionals. For patients, auricular acupuncture represents a non-pharmacological option that can help reduce preoperative anxiety without the risks of side effects associated with medications. The procedure is quick, taking less than a minute to apply, relatively inexpensive, and allows the patient to maintain normal activities during the preoperative period. This can be especially valuable for patients who prefer to avoid medications or who may have contraindications to anxiolytic use.

For health professionals, this technique offers an additional tool in the therapeutic arsenal for managing preoperative anxiety, and can be easily integrated into existing preoperative care protocols.

However, the study has some important limitations that should be considered. The researchers used only subjective measures of anxiety through questionnaires, not including objective physiological indicators such as blood pressure or heart rate, although previous studies have shown that these parameters are not significantly affected by acupuncture. In addition, a large percentage of participants (about 70%) already believed in the efficacy of alternative medicine, which may have positively influenced the results, although this characteristic was equally distributed across all groups studied.

Another point to consider is that the exact mechanism by which auricular acupuncture produces its effects is still not fully understood. Some theories suggest that the technique may influence the release of neurotransmitters such as serotonin, which is involved in mood and emotional well-being regulation, but more research is needed to confirm these hypotheses. Despite these limitations, the results suggest that auricular acupuncture, particularly when applied at specific relaxation points, can be a valuable addition to existing strategies for managing preoperative anxiety, offering a safe, fast, and cost-effective alternative for patients seeking non-pharmacological options to deal with their fears and concerns before surgery.