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Introduction The primary purpose of this survey was to investigate the attitudes of patients undergoing elective surgery, towards the application of acupuncture to reduce perioperative complications, and to identify the possible factors that influenced their attitudes. Methods The survey was conducted in the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine in China. A 20-item questionnaire was developed and piloted over a period of eight weeks. Results 176 adult surgical inpatients completed the survey with a response rate of 98.9%. Only about one quarter of the participants had past experience of acupuncture treatment (n = 46, 26.1%) and one third thought acupuncture was effective (n = 61, 34.7%). Less than half of them were willing to use acupuncture for postoperative nausea and vomiting (PONV) (n = 70, 39.8%), postoperative pain (n = 79, 44.9%), preoperative anxiety and insomnia (n = 65, 36.9%), postoperative gastrointestinal dysfunction (n = 76, 43.2%), postoperative urinary retention (n = 81, 46.0%). Patients who were professionals or office workers (chi square = 26.181, p = 0.001) or with better education (chi square = 14.583, p = 0.024) were more willing to use acupuncture, while age or gender did not affect their attitudes. A majority of patients would follow the doctor’s advice about acupuncture (n = 111, 63.1%). Those who had history of PONV were less likely to receive acupuncture (chi square = 10.664, p = 0.005). Conclusions Overall, the surveyed Chinese patients had limited experience and knowledge of acupuncture, and less than half had positive attitudes towards using acupuncture for reducing perioperative complications. Education of patients and their doctors may be promising strategies for improving patients’ willingness to use acupuncture.

Introduction Auricular acupuncture has been used for pain management but a more recent technique which buries an intradermal needle into the skin may provide longer lasting stimulation and enhance analgesia. The purpose of this study was to evaluate the efficacy and feasibility of perioperative auricular acupuncture technique via intradermal needling buried on postoperative movement-evoked pain reduction in patients with advanced gastric cancer following open radical gastrectomy. Methods This research is a protocol for a prospective, assessor- and analyst-blinded, randomized controlled pilot trial with two parallel groups. Forty patients who undergo elective open radical gastrectomy will be recruited from 210-bed oncology surgery ward at a 2500-bed medical center between 2019/8/23 and 2020/2/20. Patients will be randomized to either the control group receiving non-invasive sham auricular acupuncture or to the experimental group receiving auricular acupuncture technique via intradermal needling buried, delivered 24 h before surgery and retained & replaced every 3 days for 6 consecutive days. A standard general anesthetic technique will be used for both groups. Rescue analgesia will be given when the VAS score is≥4. Primary outcome measures are Functional Activity Score (FAS) and Numerical Rating Scale score (NRS) for movement-evoked pain. Secondary outcome measures are NRS score for pain at rest, use of rescues analgesic, total opioid consumption, postoperative nausea and vomiting, physiological recovery Outcomes, Quality of Recovery-9 (QoR-9) and patient’s satisfaction. Ethics and dissemination This protocol has been approved by the Institutional Review Board (IRB) of the Clinical Research Centre (Affiliated Hospital of Nanjing University of Chinese Medicine, IRB No. 2019NL-032-02). In addition, the results of the preliminary study will be disseminated through peer-reviewed publications.

Introduction Electroacupuncture (EA) has been shown to have antiemetic and analgesic effects; however, optimal timing for the therapy is unclear. Our study aims firstly to investigate the effectiveness and safety of preoperative EA, delivered 24 h before surgery, on postoperative nausea and vomiting (PONV) and postoperative pain in patients undergoing gynecologic laparoscopic surgery; and secondly to identify the optimal timing and dose of stimulation of preoperative EA for preventing PONV and postoperative pain. Methods This is a single-center, randomized, controlled, four-arm clinical trial. Participants who meet the selection criteria will be randomly assigned to one of the following four groups: Group 1 (EA delivered 24 h before surgery, n = 103), Group 2 (EA delivered 30 min before surgery, n = 103), Group 3 (EA delivered both 24 h before, and 30 min before surgery, n = 103), Group 4 (usual care, n = 103). All groups will receive routine treatment for PONV and pain. EA will be delivered at bilateral Neiguan (PC6) and Zusanli (ST36). The primary outcomes are the incidence of postoperative nausea (PON) and postoperative vomiting (POV), and pain scores at 24 h after the operation. Secondary outcomes include the incidence of PON and POV, and pain scores at 6 h, 48 h and 72 h after the operation, also the severity of PON and POV, consumption of opioid medications, Quality of Recovery-15 (QoR-15), days in hospital and time to passage of first flatus. The assessor and the treating anesthetists will be blinded from group allocation. Participants in the three EA groups are unaware of the purpose of the study. Discussion An understanding of optimal timing and dosage of preoperative acupuncture will facilitate the implementation of this non-drug therapy and contribute to the overall improvement of post-surgical care.