# Cryogenic auriculotherapy reduces pain and opioid use in patients undergoing endoscopic carpal tunnel release surgery: a retrospective analysis

## TL;DR

Cryogenic auriculotherapy reduced pain and opioid use after carpal tunnel surgery, offering a promising alternative for postoperative pain management.

## Contribution

This study demonstrates the analgesic efficacy of cryogenic auriculotherapy in a surgical setting, reducing opioid consumption.

## Key findings

- Cryogenic auriculotherapy was associated with a 44% reduction in opioid consumption compared to the control group.
- Patients in the auriculotherapy group reported significantly lower pain scores over three postoperative days.
- No patients required additional medication at 21 days post-surgery.

## Abstract

Effective perioperative pain management for patients undergoing hand surgery is critical because of the risk of opioid misuse. Complementary approaches, including auriculotherapy (AT), for perioperative pain management have gained increasing attention. This study was designed to assess the analgesic properties of AT in patients undergoing endoscopic carpal tunnel surgery (CTR).

This retrospective study analyzed medical records of patients who underwent unilateral ambulatory CTR performed by a single surgeon under a regional block plus sedation, with or without the use of AT using a cryogenic approach. All procedures were performed between 1 October 2016 and 30 May 2017. A total of 38 consecutive patients were included in the analysis. At discharge, patients received a standard analgesic prescription for 3 days and were asked to record pain scores, using a verbal scale (0–10), and analgesic consumption on postoperative days (POD) 1, 2, and 3. The primary end points were overall consumption—expressed as the area under the curve (AUC) for oral morphine equivalent (OME) in mg—and pain scores between POD1 and POD3. Secondary end points included pain and opioid and non-opioid analgesic consumption. Data are presented as median (interquartile range) (25–75 percentile); p < 0.05 was considered significant.

A total of 38 consecutive patients were included in the analysis. There were 19 patients in the AT group (16 women and three men), with a mean age 54 ± 7.9 years, and 19 patients in the control group (15 women and four men), with a mean age of 57 ± 12.8 years. The use of cryo-AT was associated with a 44% reduction in OME consumption (0.0 [0.0; 10.0] OME mg in the AT group vs. 10 mg [0.0; 30.0] OME mg in the control group; p = 0.015) and lower pain scores (AUC POD1– 3; 0.33 [0.0;1.0] in the AT group vs. 1.67 [0.67; 2.3] in the control group; p = 0.0061). Naproxen consumption was not significantly different. At 21 days, no patient required further medication.

Our study suggests that cryogenic AT is an effective complementary alternative to opioids to control postoperative pain following CTR. Further investigations are required to confirm these findings.