Increased postoperative pain and consumption of analgesics following acupuncture

Acupuncture was given to patients before (preoperative-acupuncture group, PRE-ACU, n = 25) or after (postoperative-acupuncture group, POST-ACU, n = 25) operative removal of impacted mandibular third molars. Sixty patients did not receive acupuncture and participated as a control group (CG). All patients completed a questionnaire in order to characterize state tension and stress, degrees of neuroticism, extroversion, depression and psychosomatic disorders. We also recorded intraoperative discomfort and pain intensity, postoperative pain intensity and consumption of analgesics for 72 h. The PRE-ACU was significantly more tense following surgery and found the operative procedure more unpleasant than the other two groups. The PRE-ACU further rated intraoperative pain intensity higher than the CG and experienced higher pain intensity immediately postoperatively compared with POST-ACU and CG. Of the PRE-ACU patients 15/24 needed additional local anesthesia intraoperatively while none in the POST-ACU or CG requested extra lidocaine. Postoperatively patients in both PRE- and POST-ACU reported a higher total sum of pain scores (pain intensity) and the PRE-ACU consumed more analgesics compared with the CG. A significantly larger number of patients suffering from "dry socket" (a complication during wound healing) was found in both PRE- and POST-ACU compared with the CG. No correlation was found between assessed personality characteristics and reported postoperative pain/consumption of analgesics in any group and could thus not explain the observed differences between the groups. The reason for our unexpected "negative" findings is unclear but some hypothetical explanations are discussed.