Analgesic Effect of Acupuncture in Dogs Undergoing Tibial Tuberosity Advancement Surgery: A Double-blind, Randomized, Controlled Pilot Study

Tibial tuberosity advancement (TTA) surgery restores joint function in dogs with cruciate ligament failure. This study investigated the efficacy of reducing perioperative systemic opioid/non-opioid analgesics (i.e. fentanyl, ketamine), with acupuncture for TTA surgery. Twenty-one dogs admitted for surgery were divided into Controls (inhalation anesthesia, opioid/non-opioid analgesics), Electro-acupuncture (EAP) Group (inhalation anesthesia, EAP), or Dry-needle Acupuncture (DNAP) Group (inhalation anesthesia, DNAP). Intraoperative nociception, boluses of fentanyl, anesthetic recovery, post-extubation pain, duration until first postanesthetic actions, biomarker levels, and isoflurane end-tidal concentration, were recorded. Findings were analyzed for percent change from control/baseline values and statistical significance (p<0.05). Results for percent change from control/baseline included: mean fentanyl boluses during surgery: Control: 3.6±2.0, EAP: 3.6±1.5, DNAP: 2.7±1.2 (25% lower than control); mean recovery score: Control: 2.1±1.2, EAP: 1.5±0.8 (30% better), DNAP: 1.0±0.0 (50% better); median post-extubation pain score: Control: 5.21±4.3, EAP: 4.38±2.1 (16% lower), DNAP: 3.75±1.6 (28% lower), and maximum pain score: Control: 10.83±7.0, EAP: 8.80±3.5 (19% lower), DNAP: 7.92±3.7 (27% lower). DNAP had the greatest increase of serotonin (twice controls) and smallest increase of substance P (half controls) during the 24-hour post-extubation period. Statistically significant findings included: DNAP had shortened duration to postanesthetic micturition; and higher isoflurane end-tidal concentration in acupuncture groups. Under the experimental conditions of this pilot study, perioperative acupuncture treatment may reduce the need for additional opioid/non-opioid analgesics during TTA surgery, along with providing better anesthetic recovery.