Acupuncture for Low-Dose Opioid for TKA Replacement

Intraoperative Acupuncture for Low-Dose Opioid Total Knee Replacement: An Observational Prospective Cohort Study

The majority of patients undergoing total knee replacement(TKR) rely on opioids for postoperative analgesia. These medications have undesirable side effects and potential for abuse and addiction. The aim of this cohort study is to determine the incidence rate of patients who are able to maintain a low dose opioid regimen after TKR with the use of a multimodal approach that includes intraoperative auricular acupuncture protocol.

This is a prospective cohort study to assess the feasibility of patients to undergo TKR while adhering to a low-dose opioid regimen by using a multimodal analgesic approach that includes intraoperativeauricular acupuncture. We hypothesize that it will be feasible to maintain a low-dose opioid regimen during TKR while followingthe intraoperative auricular acupuncture protocol, and that patients will be satisfied with their pain control with a low incidence of adverse events.

Inclusion Criteria:

• ASA of 1 or 2
• Age 18-70
• Undergoing primary total knee replacement
• Desire to attempt a low opioid or opioid free pathway

Exclusion Criteria:

• NonEnglish speaking
• Patients with the inability to understand or follow study protocol
• Opioid use in the last 6 weeks or chronic pain patient
• Cannot receive neuraxial anesthesia and/or peripheral nerve block
• Patients with contraindications to intraop protocol (e.g., patient cannot take acetaminophen or ketorolac due to liver or kidney disease)
• Patients with implanted cardiac device such as a pacemaker or AICD
• Active ear infection
• Nonnative ear, previous scarring or surgical manipulation of ear
• Patients with gauges or other deforming ear piercing (small nondeforming ear piercings are ok) present in ears
• Allergy to nickel