Zhao MY, Xie CY, Zhao EH, Li ZM, Pan JY, Wang WQ, Zhou GW, Yang GH, Xu B, Liu Y, Xu TC. Acupuncture-assisted anesthesia in surgical procedures: A comprehensive review of operational methods, technical details, ear and body acupoints application. World J Transl Med 2026; 12(3): 124320 [DOI: 10.5528/wjtm.124320]
Corresponding Author of This Article
Tian-Cheng Xu, Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, No. 138 Xianlin Avenue, Qixia District, Nanjing 210023, Jiangsu Province, China. xtc24203@163.com
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Anesthesiology
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review-article
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Zhao MY, Xie CY, Zhao EH, Li ZM, Pan JY, Wang WQ, Zhou GW, Yang GH, Xu B, Liu Y, Xu TC. Acupuncture-assisted anesthesia in surgical procedures: A comprehensive review of operational methods, technical details, ear and body acupoints application. World J Transl Med 2026; 12(3): 124320 [DOI: 10.5528/wjtm.124320]
World J Transl Med. Sep 28, 2026; 12(3): 124320 Published online Sep 28, 2026. doi: 10.5528/wjtm.124320
Acupuncture-assisted anesthesia in surgical procedures: A comprehensive review of operational methods, technical details, ear and body acupoints application
Meng-Ying Zhao, Cong-Yi Xie, En-He Zhao, Zi-Mu Li, Jing-Yan Pan, Wei-Qian Wang, Bin Xu, Yun Liu, Tian-Cheng Xu, Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
Guo-Wei Zhou, Department of General Surgery, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, Jiangsu Province, China
Guan-Hu Yang, Department of Specialty Medicine, Ohio University, Athens, OH 45701, United States
Co-first authors: Meng-Ying Zhao and Cong-Yi Xie.
Co-corresponding authors: Yun Liu and Tian-Cheng Xu.
Author contributions: Zhao MY and Xie CY was responsible for the idea and conceptual framework as co-first authors; Zhao MY, Xie CY, Zhao EH, Li ZM, Pan JY, and Wang WQ wrote the first draft of the manuscript; Zhao EH and Wang WQ were responsible for drafting and organizing the forms; Xie CY was responsible for graphical abstract; Zhou GW, Yang GH, Xu B, Liu Y, and Xu TC reviewed the manuscript and critically revised it for important intellectual content; Liu Y and Xu TC contributed equally as co-corresponding authors; All authors have reviewed and approved the final version of the manuscript.
AI contribution statement: We used Doubao to revise individual sentences and conduct native-level linguistic polishing. No AI-generated writing content was used throughout the entire writing and revision process.
Supported by National Natural Science Foundation of China Youth Science Fund Project, No. 82305376; Young Talent Support Program of the China Association for Acupuncture-Moxibustion, No. 2024-2026ZGZJXH-QNRC005; 2024 Jiangsu Provincial Young Scientific and Technological Talent Support Program, No. JSTJ-2024-380; and Talent Cultivation Program for Young Researchers, Key Laboratory of the Ministry of Education Project, No. zyqt202501 and No. zyqt202503.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Corresponding author: Tian-Cheng Xu, Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, Nanjing University of Chinese Medicine, No. 138 Xianlin Avenue, Qixia District, Nanjing 210023, Jiangsu Province, China. xtc24203@163.com
Received: June 18, 2026 Revised: July 30, 2026 Accepted: August 20, 2026 Published online: September 28, 2026 Processing time: 80 Days and 12.3 Hours
Abstract
Due to its benefits of minimum physiological interference, few complications, and promotion of postoperative recovery, acupuncture-assisted anesthesia (AA), an inventive fusion of modern anesthesiology and traditional Chinese medicine, has been used more frequently in clinical surgical practice. This review systematically summarizes the specific operational techniques and technical details of AA across various surgical procedures. Mechanistically, AA produces analgesia, sedation, and organ protection through modulation of the nervous, endocrine, and immune systems. In terms of operational specifications, auricular points are primarily stimulated via acupressure or needling at Shenmen (TF4) and surgical site-specific reflex zones, while body acupoints including Hegu (LI4), Zusanli (ST36), and Neiguan (PC6) are selected according to local, distant, and empirical principles, combined with standardized electroacupuncture parameters (frequency, intensity, and waveform). Clinical evidence demonstrates that auricular acupuncture reduces intraoperative fentanyl requirement by 15% compared with sham acupuncture. These clinical benefits depend on the standardized implementation of the following practices: Preoperative formulation of individualized acupoint combinations based on surgical type and patient constitution, intraoperative application of 2/100 Hz dense-disperse electroacupuncture at appropriate intensity, and postoperative continuation of auricular acupressure to consolidate analgesic effects and promote gastrointestinal recovery. To give clinicians a standardized, useful reference to enhance the safety and efficacy of AA application and encourage the thorough integration of traditional Chinese medicine and contemporary surgical anesthesia, the present difficulties and future development directions of AA in surgical practice are finally outlined.
Core Tip: Analgesia, sedation, and organ protection are provided during surgery via acupuncture-assisted anesthesia, which combines traditional acupuncture with contemporary anesthesiology. Standardized procedures for body points and auricular points across different surgeries are described in this review, with a focus on surgical site-specific tactics. Acupuncture-assisted anesthesia works by coordinating neuroendocrine-immune control, which includes immunomodulation, vagal reflexes, endogenous opioid release, and peripheral afferent activation. The review also highlights clear clinical benefits, including reduced anesthetic use and fewer complications. However, issues like methodological limitations and non-standardized protocols remain. Future multicenter trials and multi-omics research will help better integrate this approach into modern anesthesia.
