J Acupunct Meridian Stud 2018;11(4):123

Available online at www.sciencedirect.com

Journal of Acupuncture and Meridian Studies

journal homepage: www.jams-kpi.com

- Letter to the Editor -

Comment on “Electroacupuncture-assisted
Craniotomy on an Awake Patient”

To the Editor the commonest neurosurgical procedures. Our hospital

Sidhu et al. [1] describes their experience of using elec-
troacupuncture in a craniotomy for drainage of an acute-
on-chronic subdural hematoma. Owing to concurrent
medical problems, the patient was offered the “option of
using electroacupuncture solely”. The operation was suc-
cessfully completed, and the authors advocate the use of
electroacupuncture during craniotomies.
The article is misleading as electroacupuncture was not
the sole form of surgical analgesia. The authors mention
that the scalp was infiltrated with lignocaine before inci-
sion. In addition, the operation was completed within
1 hour. The duration of surgery falls well within the 1-to 2-
hour duration of the action of lignocaine [2]. Although not
specifically indicated in the article, scalp blocks often use a
mixture of lignocaine and 1:2000000 adrenaline. The addi-
tion of adrenaline reduces scalp bleeding but, more
significantly, prolongs the analgesic effect.
Given that the analgesic effect of lignocaine would be
expected to extend throughout surgery and into the early
postoperative period, it is very difficult to argue that
electroacupuncture had an analgesic role (if any) in this
case.
Second, the article is titled “Electroacupuncture-assis-
ted craniotomy on an awake patient”. The article diagrams
show either a burr hole or a minicraniotomy [1]. This in-
volves making a skull opening of less than 7 cm and is one of
frequently performs these under local anaesthesia.
Although it may be argued that electroacupuncture can be
used as an adjunct in minicraniotomies, its efficacy in
larger craniotomies has not been convincingly studied in
the article.
Financial declaration
None.
References
[1] Sidhu A, Murgahaya T, Narayanan V, Chandran H, Waran V.
Electroacupuncture-assisted craniotomy on an awake patient.
J Acupunct Meridian Stud 2017;10:45e8.
[2] Miller RD, editor. Miller’s Anaesthesia, 8th ed, vol. 2. Phila-
delphia, Saunders: Elsevier Inc; 2015.
Hu Liang Low
Department of Neurosurgery, Queen’s Hospital, Romford,
London RM7 0AG, UK
E-mail: lowhli@hotmail.com
19 March 2018
Available online 1 August 2018

https://doi.org/10.1016/j.jams.2018.07.004
ª 2018 Medical Association of Pharmacopuncture Institute, Publishing services by Elsevier B.V. This is an open access article under the
CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).