[Acupuncture-analgesia/anesthesia: placebo for physician and patient?]

Various non-pharmacological analgesic procedures are attracting interest as a means of treating chronic pain (acupuncture, transcutaneous nerve stimulation, dorsal column stimulation, subcortical stimulation). The gate-control theory and activation of endorphin mechanisms are discussed as explanatory hypotheses for the analgesic effect. The proof of analgesic action in addition to the ever-present placebo effect is difficult. However, in unconscious, superficially anesthetized patients undergoing hysterectomy an analgesic effect of electrostimulation has been demonstrated which resulted in a significant reduction in the need for additional anesthetics. Speculation regarding the future of this method is premature in view of many unanswered questions.