Surgery, even relatively minor surgery, is a significant trauma to the body. The surgical incision itself can cause swelling (edema), pain, and bruising; anesthesia frequently causes nausea and bloating. Certain surgeries that damage the body's lymphatic system, such as radical mastectomy, can cause a specific form of long-lasting swelling called lymphedema.
Modern surgery involves numerous sophisticated nondrug techniques to help wounds heal rapidly and completely. Various medications can be used to help offset the side effects of anesthesia.
Principal Proposed Natural Treatments
A variety of herbs, supplements, and other alternative therapies have shown promise for problems encountered following surgery. However, keep in mind that many such substances have shown the potential to increase risk of bleeding during or after surgery. (See Herbs and Supplements to Use Only With Caution). Furthermore, it is not at present possible to determine all the potential interactions between herbs and drugs used for anesthesia. For this reason, herbs and supplements should only be used for surgical support under the supervision of a physician.
According to most but not all studies, proteolytic enzymes may help reduce pain, bruising, and swelling after surgery.
A double-blind, placebo-controlled trial of 80 people undergoing knee surgery found that treatment with mixed proteolytic enzymes after surgery significantly improved rate of recovery, as measured by mobility and swelling.1
Another double-blind, placebo-controlled trial evaluated the effects of a similar mixed proteolytic enzyme product in 80 individuals undergoing oral surgery.2 The results showed reduced pain, inflammation, and swelling in the treated group as compared to the placebo group. Benefits were also seen in another trial of mixed proteolytic enzymes for dental surgery,59 as well as in one study involving only bromelain.3
Other double-blind, placebo-controlled studies have found bromelain helpful in nasal surgery,6 cataract removal,7 and foot surgery.61 However, a study of 154 individuals undergoing facial plastic surgery found no benefit.8
Note : Bromelain thins the blood and could increase risk of bleeding during or after surgery. For this reason, physician supervision is essential.
Oxerutins and Other Bioflavonoids
Oxerutins have been widely used in Europe since the mid-1960s, primarily as a treatment for varicose veins. Derived from a naturally occurring bioflavonoid called rutin, oxerutins were specifically developed to treat varicose veins and related venous problems. However, they may also be helpful for treating swelling following surgery. Closely related bioflavonoids from citrus fruit may be helpful as well.
Women who have undergone surgery for breast cancer may experience a lasting and troublesome side effect: swelling in the arm caused by damage to the lymph system. Along with the veins, the lymphatic system is responsible for returning fluid to the heart. When this system is damaged by breast cancer surgery, fluid accumulates in the arm. Three, small, double-blind, placebo-controlled studies enrolling a total of more than 100 people have examined the effectiveness of oxerutins in lymphedema following breast cancer surgery, with generally good results.9-11
For example, in a small, 6-month, double-blind study, oxerutins reduced swelling and improved comfort and mobility as compared to placebo.11 Another study found benefit with a combination formula containing oxerutins, ginkgo, and the drug heptaminol.82
The citrus bioflavonoids diosmin and hesperidin have also shown promise for lymphedema following breast cancer surgery,16 as has a product containing hesperidin plus a bioflavonoid-rich extract of the herb butcher’s broom.62 Note : Do not use bioflavonoid combinations containing tangeretin if you are taking tamoxifen for breast cancer.
Oxerutins might also be helpful for the ordinary swelling that occurs after any type of surgery. In one double-blind trial, researchers gave oxerutins or placebo for 5 days to 40 people recovering from minor surgery or other minor injuries, and found oxerutins significantly helpful in reducing swelling and discomfort.17
Oligomeric Proanthocyanidins TOP
Oligomeric proanthocyanidins (OPCs), substances found in grape seed and pine bark, may be helpful for recovery from surgery as well. Like oxerutins, to which they are chemically related, OPCs are thought to work by reducing leakage from capillaries.
A double-blind, placebo-controlled study of 63 women with breast cancer found that 600 mg of OPCs daily for 6 months reduced postoperative symptoms of lymphedema.22 Additionally, in a double-blind, placebo-controlled study of 32 people who were followed for 10 days after a face-lift, swelling disappeared much faster in the treated group.23
For more information, including dosage and safety issues, see the full OPCs article.
Acupuncture and acupressure are two related forms of treatment that involve stimulating certain locations on the body, known as acupuncture points. Numerous studies have evaluated treatment on a single acupuncture point—P6—for the relief of nausea following anesthesia. This point is located on the inside of the forearm, about 2 inches above the wrist crease.
Many controlled studies involving more than 2,000 people have tested the potential benefits of stimulation at P6 in people undergoing surgery.12,14,34-47,58,63-67,83,90,95,97,101,105 In most of these trials, treatment was carried out through the surgery itself, as well as afterwards. The results of these many trials, involving various types of surgery and diverse forms of acupuncture/acupressure, tend to contradict one another. On balance, however, it appears that acupuncture/acupressure may reduce nausea during and after surgery to at least some extent beyond that of the placebo effect.
Related to post-operative nausea is a condition called gastroparesis, a common complication of abdominal surgery where the stomach is unable to properly empty its contents after eating. In a controlled trial, 63 people who underwent abdominal surgery were randomized to receive acupuncture or a standard medication used to treat gastroparesis (metoclopramide given intravenously 3 times a day).104 According to the researchers, those in the acupuncture group experienced a higher cure rate.
Acupuncture has also been explored as a means of reducing pain after surgery with inconsistent results.18,29,48-50,63,68,103 In a 2008 review of 15 randomized controlled trial, however, researchers determined that acupuncture is capable of reducing pain and the need for opioid medications (morphine and related agents) immediately following surgery compared with sham (fake) acupuncture.93 An analysis of 5 trials found similar results.102 Patients who received ear acupuncture (auriculotherapy) did not use pain medication as much as those in the control group.
A small randomized trial of 70 patients found that acupuncture may decrease dry mouth and pain after removing lymph nodes in the neck for cancer treatment.99
A randomized trial of 80 women with post-hysterectomy urinary retention showed improvement in bladder function with acupuncture compared to acupoint injection of vitamin B12. Each group had daily treatment over the course of five consecutive days. Improvement was seen in 90% of the acupuncture group after two treatment courses compared to 72.5% in injection group.106
In a randomized trial of 80 patients having total knee arthroplasty, acupuncture was associated with greater reduction in pain and swelling, and quicker return to preoperative range of motion compared to range of motion exercises alone.107
Electric accupuncture was associated with significantly improved time to defectation in 165 patients with colorectal cancer who had laparoscopic surgery compared to sham electric acupuncture and no acupuncture. Electroaccupuncture was also associated with reduced pain, less pain medication, and improved time to walking.108
In pediatric patients undergoing a needle biopsy of the kidney, laser acupuncture significantly lowered heart and breathing rates during the biopsy, and reduced pain afterwards in a randomized trial with 81 people (ages ranged from 7-26 years old). Laser acupuncture was compared to sham acupuncture, which was given before biopsy.109
Contrary to popular belief, acupuncture does not appear to be helpful for providing or enhancing anesthesia itself.19,96
For more information, see the full Acupuncture article.
Other Proposed Natural Treatments TOP
The herb ginger is thought to have anti-nausea effects. In studies, ginger has been given prior to surgery in order to prevent the nausea that many people experience when they awaken from anesthesia. However, despite some early positive results, the preponderance of evidence indicates that ginger is not helpful for this purpose.24-27,69,84
Warning : Do not use ginger either before or immediately after surgery, or labor and delivery, without a physician's approval. Not only is it important to have an empty stomach before undergoing anesthesia, there are theoretical concerns that ginger may affect bleeding.
Preliminary evidence suggests that peppermint oil may be helpful for postoperative flatulence and nausea.53,85
One small double-blind, placebo-controlled study found that magnet therapy patches of the "unipolar" variety reduced pain and swelling after suction lipectomy.52 However, a study of 165 people undergoing various forms of surgery failed to find that use of static magnets over the surgical incision reduced postsurgical pain.30 Furthermore, the positioning of static magnets at the acupuncture /acupressure point P6 in patients undergoing ear, nose, and throat (ENT) or gynaecological surgeries reduced nausea and vomiting no better than placebo in a randomized trial.98 Interestingly, a small, pilot study involving 80 women undergoing breast augmentation procedures found that daily pulsed electromagnetic field therapy reduced postoperative discomfort significantly more than placebo therapy within 3 days of surgery.91
In a double-blind, placebo-controlled study of 37 people undergoing surgery for carpal tunnel syndrome, an ointment made from the herb arnica (combined with homeopathic arnica tablets) appeared to slightly reduce post-surgical pain.70
Horse chestnut has effects similar to OPCs (discussed above) and has also shown promise for reducing postoperative swelling.54 A preliminary study suggests that topically administered capsaicin provides short-term pain relief immediately following hernia repair surgery.94
Good nutrition is essential to recovery from any physical trauma. For this reason, use of a multivitamin and mineral supplement in the weeks leading up to surgery, and for some time afterwards, might be advisable.
A placebo-controlled study failed to find that onion extract can help reduce skin scarring following surgery.21
A randomized trial involving 90 women who had undergone a mastectomy found that the Chinese herbSalvia miltiorrhiza did help to reduce wound complications.100 In this same study, the Chinese herb anisodamine was also helpful, but there were more adverse effects related to this treatment.
Treatment via inhalation of essential oils is called aromatherapy. One controlled trial found that that lavender oil, administered through the oxygen face mask, reduced need for pain medications following gastric banding surgery.32
At least 20 controlled studies, enrolling a total of more than 1,500 people, have evaluated the potential benefit of hypnosis for people undergoing surgery.71 Their combined results suggest that hypnosis may provide benefits both during and after surgery, including: reducing anxiety, pain, and nausea, normalizing blood pressure and heart rate, minimizing blood loss, and speeding recovery and shortening hospitalization. Unfortunately, many of these studies were of very poor quality.
Relaxation therapy techniques, such as meditation, guided imagery, and self-hypnosis, have also shown promise for relieving some of the discomforts of surgery.72-80,92 One study found minimal benefits with music therapy.28
For a discussion of homeopathic approaches to surgery support, see the Homeopathy database.
Herbs and Supplements to Use Only With Caution TOP
Numerous herbs and supplements have the potential to cause problems during or after surgery, including some of those discussed in this article. For this reason, we strongly suggest that you do not use any herb or supplement in the week leading up to surgery, except under physician’s supervision.
For example, the herb garlic significantly thins the blood, and case reports suggest that garlic can increase bleeding during or after surgery.55-57 For this reason, it is probably advisable to avoid garlic supplements prior to surgery and not to restart it after surgery until all risk of bleeding is past. However, raw garlic consumed in food may not present the same risk. A placebo-controlled study found that one-time consumption of actual raw garlic consumed in food at the fairly high dose of 4.2 mg did not impair platelet function. In addition, volunteers who continued to consume the dietary garlic for a week did no show any change in their normal platelet function.33
References[ + ]
1. Rahn H-D. Efficacy of hydrolytic enzymes in surgery. Presented at: Symposium on Enzyme Therapy in Sports Injuries: XXIV FIMS World Congress of Sport Medicine; May 29 1990; Amsterdam, The Netherlands.
2. Vinzenz K. Treatment of edema with hydrolytic enzymes in oral surgical procedures [translated from German]. Quintessenz. 1991;42:1053-1064.
3. Tassman GC, Zafran JN, Zayon GM. Evaluation of a plant proteolytic enzyme for the control of imflammation and pain. J Dent Med. 1964;19:73-77.
4. Zatuchni GI, Colombi DJ. Bromelains therapy for the prevention of episiotomy pain. Obstet Gynecol. 1967;29:275-278.
5. Howat RC, Lewis GD. The effect of bromelain therapy on episiotomy wounds—a double-blind controlled clinical trial. J Obstet Gynaecol Br Commonw. 1972;79:951-953.
6. Seltzer AP. Minimizing post-operative edema and ecchymoses by the use of an oral enzyme preparation (bromelain): a controlled study of 53 rhinoplasty cases . Eye Ear Nose Throat Mon . 1962;41:813-817.
7. Spaeth GL. The effect of bromelains on the inflammatory response caused by cataract extraction: a double-blind study. Eye Ear Nose Throat Mon. 1968;47:634-639.
8. Gylling U, Rintala A, Taipale S, et al. The effect of a proteolytic enzyme combinate (bromelain) on the postoperative oedema by oral application. A clinical and experimental study. Acta Chir Scand. 1966;131:193-196.
9. Taylor HM, Rose KE, Twycross RG, et al. A double-blind clinical trial of hydroxyethylrutosides in obstructive arm lymphoedema. Phlebology Suppl. 1993;1:22-28.
10. Mortimer PS, Badger C, Clarke I, et al. A double-blind, randomized, parallel-group, placebo-controlled trial of O-(beta-hydroxyethyl)-rutosides in chronic arm oedema resulting from breast cancer treatment. Phlebology. 1995;10:51-55.
11. Piller NB, Morgan RG, Casley-Smith JR. A double-blind, cross-over trial of O-(beta-hydroxyethyl)-rutosides (benzo-pyrones) in the treatment of lymphoedema of the arms and legs. Br J Plast Surg. 1988;41:20-27.
12. Habib AS, Itchon-Ramos N, Phillips-Bute BG, et al. Transcutaneous Acupoint Electrical Stimulation with the ReliefBand® for the Prevention of Nausea and Vomiting During and After Cesarean Delivery Under Spinal Anesthesia. Anesth Analg. 2006;102:581-584.
13. Taylor HM, Rose KE, Twycross RG, et al. A double-blind clinical trial of hydroxyethylrutosides in obstructive arm lymphoedema. Phlebology Suppl. 1993;1:22-28.
14. Ho CM, Tsai HJ, Chan KH, et al. P6 acupressure does not prevent emesis during spinal anesthesia for cesarean delivery. Anesth Analg. 2006;102:900-903.
15. Casley-Smith JR, Casley-Smith JR. Modern treatment of lymphoedema II. The benzopyrones. Australas J Dermatol. 1992;33:69-74.
16. Pecking AP, Fevrier B, Wargon C, et al. Efficacy of Daflon 500 mg in the treatment of lymphedema (secondary to conventional therapy of breast cancer). Angiology. 1997;48:93-98.
17. Fassina A, Rubinacci A. Post-traumatic edema: a controlled study into the activity of hydroxyethyl rutoside [translated from Italian]. Gazz Med Ital Arch Sci. 1987;146:103-109.
18. Usichenko TI, Dinse M, Hermsen M, et al. Auricular acupuncture for pain relief after total hip arthroplasty - a randomized controlled study. Pain. 2005;114:320-327.
19. Lee H, Ernst E. Acupuncture analgesia during surgery: a systematic review. Pain. 2005;114:511-517.
20. Roy BD, De Beer J, Harvey D, et al. Creatine monohydrate supplementation does not improve functional recovery after total knee arthroplasty. Arch Phys Med Rehabil. 2005;86:1293-1298.
21. Chung VQ, Kelley L, Marra D, et al. Onion extract gel versus petrolatum emollient on new surgical scars: prospective double-blinded study. Dermatol Surg. 2006;32:193-198.
22. Pecking A, Desprez-Curely JP, Megret G. Oligomeric grape flavanols (Endotelon®) in the treatment of secondary upper limb lymphedemas [translated from French]. Paris, France: Association de Lymphologie de Lange Francaise Hopital Saint-Louis. 1989; 69-73.
23. Baruch J. Effect of Endotelon in postoperative edema. Results of a double-blind study versus placebo in 32 female patients [in French]. Ann Chir Plast Esthet. 1984;29:393-395.
24. Bone ME, Wilkinson DJ, Young JR, et al. Ginger root—a new anti-emetic. The effect of ginger root on postoperative nausea and vomiting after major gynecological surgery. Anaesthesia. 1990;45:669-671.
25. Phillips S, Ruggier R, Hutchinson SE. Zingiber officinale (ginger)—an anti-emetic for day case surgery. Anaesthesia. 1993;48:715-717.
26. Arfeen Z, Owen H, Plummer JL, et al. A double-blind randomized controlled trial of ginger for the prevention of postoperative nausea and vomiting. Anaesth Intensive Care. 1995;23:449-452.
27. Visalyaputra S, Petchpaisit N, Somcharoen K, et al. The efficacy of ginger root in the prevention of postoperative nausea and vomiting after outpatient gynaecological laparoscopy. Anaesthesia. 1998;53:506-510.
28. Bechtold ML, Perez RA, Puli SR, et al. Effect of music on patients undergoing outpatient colonoscopy. World J Gastroenterol. 2006;12:7309-7312.
29. Usichenko TI, Kuchling S, Witstruck T, et al. Auricular acupuncture for pain relief after ambulatory knee surgery: a randomized trial. CMAJ. 2007;176:179-183.
30. Cepeda MS, Carr DB, Sarquis T, et al. Static magnetic therapy does not decrease pain or opioid requirements: a randomized double-blind trial. Anesth Analg. 2007;104:290-294.
31. Wichmann MW, Thul P, Czarnetzki HD, et al. Evaluation of clinical safety and beneficial effects of a fish oil containing lipid emulsion (Lipoplus, MLF541): Data from a prospective, randomized, multicenter trial. Crit Care Med. 2007 Jan 25. [Epub ahead of print]
32. Kim JT, Ren CJ, Fielding GA, et al. Treatment with lavender aromatherapy in the post-anesthesia care unit reduces opioid requirements of morbidly obese patients undergoing laparoscopic adjustable gastric banding. Obes Surg. 2007;17:920-925.
33. Scharbert G, Kalb ML, Duris M, et al. Garlic at dietary doses does not impair platelet function. Anesth Analg. 2007;105:1214-1218
34. Harmon D, Gardiner J, Harrison R, et al. Acupressure and the prevention of nausea and vomiting after laparoscopy. Br J Anaesth. 1999;82:387-390.
35. Harmon D, Ryan M, Kelly A, et al. Acupressure and prevention of nausea and vomiting during and after spinal anaesthesia for caesarean section. Br J Anaesth. 2000;84:463-467.
36. Alkaissi A, Stalnert M, Kalman S. Effect and placebo effect of acupressure (P6) on nausea and vomiting after outpatient gynaecological surgery. Acta Anaesthesiol Scand. 1999;43:270-274.
37. Ho CM, Hseu SS, Tsai SK, et al. Effect of P-6 acupressure on prevention of nausea and vomiting after epidural morphine for post-cesarean section pain relief. Acta Anaesthesiol Scand. 1996;40:372-375.
38. Dundee JW, Chestnutt WN, Ghaly RG, et al. Traditional Chinese acupuncture: a potentially useful antiemetic? Br Med J (Clin Res Ed). 1986;293:583-584.
39. Stein DJ, Birnbach DJ, Danzer BI, et al. Acupressure versus intravenous metoclopramide to prevent nausea and vomiting during spinal anesthesia for cesarean section. Anesth Analg. 1997;84:342-345.
40. Allen DL, Kitching AJ, Nagle C. P6 acupressure and nausea and vomiting after gynaecological surgery. Anaesth Intensive Care. 1994;22:691-693.
41. Fan CF, Tanhui E, Joshi S, et al. Acupressure treatment for prevention of postoperative nausea and vomiting. Anesth Analg. 1997;84:821-825.
42. Agarwal A, Pathak A, Gaur A. Acupressure wristbands do not prevent postoperative nausea and vomiting after urological endoscopic surgery. Can J Anaesth. 2000;47:319-324.
43. Lewis IH, Pryn SJ, Reynolds PI, et al. Effect of P6 acupressure on postoperative vomiting in children undergoing outpatient strabismus correction. Br J Anaesth. 1991;67:73-78.
44. Schwager KL, Baines DB, Meyer RJ. Acupuncture and postoperative vomiting in day-stay paediatric patients. Anaesth Intensive Care. 1996;24:674-677.
45. Schlager A, Boehler M, Puhringer F. Korean hand acupressure reduces postoperative vomiting in children after strabismus surgery. Br J Anaesth. 2000;85:267-270.
46. Schlager A, Offer T, Baldissera I. Laser stimulation of acupuncture point P6 reduces postoperative vomiting in children undergoing strabismus surgery. Br J Anaesth. 1998;81:529-532.
47. Barsoum G, Perry EP, Fraser IA. Postoperative nausea is relieved by acupressure. J R Soc Med. 1990;83:86-89.
48. Gupta S, Francis JD, Tillu AB, et al. The effect of pre-emptive acupuncture treatment on analgesic requirements after day-case knee arthroscopy. Anaesthesia. 1999;54:1204-1207.
49. Christensen PA, Rotne M, Vedelsdal R, et al. Electroacupuncture in anaesthesia for hysterectomy. Br J Anaesth. 1993;71:835-838.
50. Felhendler D, Lisander B. Pressure on acupoints decreases postoperative pain. Clin J Pain. 1996;12:326-329.
51. Magro Filho O, de Carvalho AC. Topical effect of propolis in the repair of sulcoplasties by the modified Kazanjian technique. Cytological and clinical evaluation. J Nihon Univ Sch Dent. 1994;36:102-111.
52. Man D, Man B, Plosker H. The influence of permanent magnetic field therapy on wound healing in suction lipectomy patients: a double-blind study. Plast Reconstr Surg. 1999;104:2261-2266.
53. Tate S. Peppermint oil: a treatment for postoperative nausea. J Adv Nurs. 1997;26:543-549.
54. Wilhelm K, Feldmeier C. Thermometric investigations about the efficacy of beta-escin to reduce postoperative edema [in German; English abstract]. Med Klin. 1977;72:128-134.
55. European Scientific Cooperative on Phytotherapy. Allii sativi bulbus (garlic). Exeter, UK: ESCOP; 1997. Monographs on the Medicinal Uses of Plant Drugs, Fascicule 3.
56. Burnham BE. Garlic as a possible risk for postoperative bleeding . Plast Reconstr Surg . 1995;95:213.
57. German K, Kumar U, Blackford HN. Garlic and the risk of TURP bleeding. Br J Urol. 1995;76:518.
58. Chu YC, Lin SM, Hsieh YC, et al. Effect of BL-10 (tianzhu), BL-11 (dazhu) and GB-34 (yanglinquan) acuplaster for prevention of vomiting after strabismus surgery in children. Acta Anaesthesiol Sin. 1998;36:11-16.
59. Cameron IW. An investigation into some of the factors concerned in the surgical removal of the impacted lower wisdom tooth, including a double blind trial of chymoral. Br J Oral Surg. 1980;18:112-124.
60. Soule SD, Wasserman HC, Burstein R. Oral proteolytic enzyme therapy (Chymoral) in episiotomy patients. Am J Obstet Gynecol. 1966;95:820-823.
61. Frank SC. Use of chymoral as an anti-inflammatory agent following surgical trauma. J Am Podiatr Assoc. 1965;55:706-709.
62. Cluzan RV, Alliot F, Ghabboun S, et al. Treatment of secondary lymphedema of the upper limb with CYCLO 3 FORT. Lymphology. 1996;29:29-35.
63. Kotani N, Hashimoto H, Sato Y, et al. Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses. Anesthesiology. 2001;95:349-356.
64. Boehler M, Mitterschiffthaler G, Schlager A. Korean hand acupressure reduces postoperative nausea and vomiting after gynecological laparoscopic surgery. Anesth Analg. 2002;94:872-875.
65. Weightman WM. Traditional Chinese acupuncture as an antiemetic. Br Med J. 1987;295:1379-1380.
66. Kim KS, Koo MS, Jeon JW, et al. Capsicum plaster at the Korean hand acupuncture point reduces postoperative nausea and vomiting after abdominal hysterectomy. Anesth Analg. 2002;95:1103-1107.
67. Alkaissi A, Evertsson K, Johnsson VA, et al. P6 acupressure may relieve nausea and vomiting after gynecological surgery: an effectiveness study in 410 women. Can J Anaesth. 2002;49:1034-1039.
68. Sakurai M, Suleman MI, Morioka N, et al. Minute sphere acupressure does not reduce postoperative pain or morphine consumption. Anesth Analg. 2003;96:493-497.
69. Pongrojpaw D, Chiamchanya C. The efficacy of ginger in prevention of post-operative nausea and vomiting after outpatient gynecological laparoscopy. J Med Assoc Thai. 2003;86:244-250.
70. Jeffrey SLA, Belcher HJCR. Use of arnica to relieve pain after carpal-tunnel release surgery. Altern Ther Health Med. 2002;8:66-68.
71. Montgomery GH, David D, Winkel G, et al. The effectiveness of adjunctive hypnosis with surgical patients: a meta-analysis. Anesth Analg. 2002;94:1639-1645.
72. Gaston-Johansson F, Fall-Dickson JM, Nanda J, et al. The effectiveness of the comprehensive coping strategy program on clinical outcomes in breast cancer autologous bone marrow transplantation. Cancer Nurs. 2000;23:277-285.
73. Renzi C, Peticca L, Pescatori M. The use of relaxation techniques in the perioperative management of proctological patients: preliminary results. Int J Colorectal Dis. 2000;15:313-316.
74. Deisch P, Soukup SM, Adams P, et al. Guided imagery: replication study using coronary artery bypass graft patients. Nurs Clin North Am. 2000;35:417-425.
75. Hattan J, King L, Griffiths P. The impact of foot massage and guided relaxation following cardiac surgery: a randomized controlled trial. J Adv Nurs. 2002;37:199-207.
76. Tusek DL, Church JM, Strong SA, et al. Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Dis Colon Rectum. 1997;40:172-178.
77. Mandle CL, Jacobs SC, Arcari PM, et al. The efficacy of relaxation response interventions with adult patients: a review of the literature. J Cardiovasc Nurs. 1996;10:4-26.
78. Leserman J, Stuart EM, Mamish ME, et al. The efficacy of the relaxation response in preparing for cardiac surgery. Behav Med. 1989;15:111-117.
79. Mandle CL, Domar AD, Harrington DP, et al. Relaxation response in femoral angiography. Radiology. 1990;174:737-739.
80. Tusek DL,, Cwynar R, Cosgrove DM. Effect of guided imagery on length of stay, pain and anxiety in cardiac surgery patients. J Cardiovasc Manag. 1999;10:22-28.
81. Crowe S, McKeating K. et al. Delayed emergence and St. John's wort. Anesthesiology. 2002;96:1025-1027.
82. Cluzan RV, Pecking AP, Mathiex-Fortunet H, et al. Efficacy of BN165 (Ginkor Fort) in breast cancer related upper limb lymphedema: a preliminary study. Lymphology. 2004;37:47-52.
83. Lee A, Done ML. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2004;CD003281.
84. Eberhart LH, Mayer R, Betz O, et al. Ginger does not prevent postoperative nausea and vomiting after laparoscopic surgery. Anesth Analg. 2003;96:995-998.
85. Fazel N. The effect of supermint oil on pain severity after caesarean section. Asia Pac J Clin Nutr. 2004;13(Suppl):S126.
86. Tyler TF, Nicholas SJ, Hershman EB, et al. The effect of creatine supplementation on strength recovery after anterior cruciate ligament (ACL) reconstruction: a randomized, placebo-controlled, double-blind trial. Am J Sports Med. 2004;32:383-388.
87. Piotrowski MM, Paterson C, Mitchinson A, et al. Massage as adjuvant therapy in the management of acute postoperative pain: a preliminary study in men. J Am Coll Surg. 2003;197:1037-1046.
88. Hauser D, Gayowski T, Singh N. Bleeding complications precipitated by unrecognized Gingko biloba use after liver transplantation. Transpl Int. 2002;15:377-379. Epub 2002 Jun 19.
89. Fessenden JM, Wittenborn W, Clarke L. Gingko biloba: a case report of herbal medicine and bleeding postoperatively from a laparoscopic cholecystectomy. Am Surg. 2001;67:33-35.
90. Agarwal A, Dhiraaj S, Tandon M, et al. Evaluation of capsaicin ointment at the Korean hand acupressure point K-D2 for prevention of postoperative nausea and vomiting. Anaesthesia. 2005;60:1185-1188.
91. Heden P, Pilla AA. Effects of pulsed electromagnetic fields on postoperative pain: a double-blind randomized pilot study in breast augmentation patients. Aesthetic Plast Surg. 2008 May 28.
92. Lang EV, Berbaum KS, Pauker SG, et al. Beneficial effects of hypnosis and adverse effects of empathic attention during percutaneous tumor treatment: when being nice does not suffice. J Vasc Interv Radiol. 2008;19:897-905.
93. Sun Y, Gan TJ, Dubose JW, et al. Acupuncture and related techniques for postoperative pain: a systematic review of randomized controlled trials. Br J Anaesth. 2008 Jun 2.
94. Aasvang EK, Hansen JB, Malmstrom J, et al. The effect of wound instillation of a novel purified capsaicin formulation on postherniotomy pain: a double-blind, randomized, placebo-controlled study. Anesth Analg. 2008;107:282-291.
95. Liu YY, Duan SE, Cai MX, et al. Evaluation of transcutaneous electroacupoint stimulation with the train-of-four mode for preventing nausea and vomiting after laparoscopic cholecystectomy. Chin J Integr Med. 2008;14:94-97.
96. Wang SM, Escalera S, Lin EC, et al. Extra-1 acupressure for children undergoing anesthesia. Anesth Analg. 2008;107:811-816.
97. Allen TK, Habib AS. P6 stimulation for the prevention of nausea and vomiting associated with cesarean delivery under neuraxial anesthesia: a systematic review of randomized controlled trials. Anesth Analg. 2008;107:1308-1312.
98. Klaiman P, Sternfeld M, Deeb Z, et al. Magnetic acupressure for management of postoperative nausea and vomiting: a preliminary study. Minerva Anestesiol. 2008;74:635-642.
99. Pfister DG, Cassileth BR, Deng GE, et al. Acupuncture for pain and dysfunction after neck dissection: results of a randomized controlled trial. J Clin Oncol. 2010;28(15):2565.
100. Chen J, Lv Q, Yu M, Zhang X, Gou J. Randomized clinical trial of Chinese herbal medications to reduce wound complications after mastectomy for breast carcinoma. Br J Surg. 2010;97(12):1798-804.
101. Kim YH, Kim KS, Lee HJ, Shim JC, Yoon SW. The efficacy of several neuromuscular monitoring modes at the p6 acupuncture point in preventing postoperative nausea and vomiting. Anesth Analg. 2011;112(4):819-823.
102. Asher GN, Jonas DE, Coeytaux RR, et al. Auriculotherapy for pain management: a systematic review and meta-analysis of randomized controlled trials. J Altern Complement Med. 2010;16(10):1097-1108.
103. Coura LE, Manoel CH, Poffo R, Bedin A, Westphal GA. Randomised, controlled study of preoperative electroacupuncture for postoperative pain control after cardiac surgery. Acupunct Med. 2011;29(1):16-20.
104. Sun BM, Luo M, Wu SB, Chen XX, Wu MC. Acupuncture versus metoclopramide in treatment of postoperative gastroparesis syndrome in abdominal surgical patients: a randomized controlled trial. Zhong Xi Yi Jie He Xue Bao. 2010;8(7):641-644.
105. White PF, Zhao M, Tang J, et al. Use of a disposable acupressure device as part of a multimodal antiemetic strategy for reducing postoperative nausea and vomiting. Anesth Analg. 2012;115(1):31-37.
106. Yi WM, Pan AZ, Li JJ, et al. Clinical observation on the acupuncture treatment in patients with urinary retention after radical hysterectomy. Chin J Integr Med. 2011;17(11):860-863.
107. Mikashima Y, Takagi T, et al. Efficacy of acupuncture during post-acute phase of rehabilitation after total knee arthroplasty. J Tradit Chin Med. 2012;32(4):545-548.
108. Ng SS, Leung WW, et al. Electroacupuncture reduces duration of postoperative ileus after laparoscopic surgery for colorectal cancer. Gastroenterology. 2013;144(2):307-313.
109. Oates A, Benedict KA, Brakeman PR, Lim J, Kim C. Laser acupuncture reduces pain in pediatric kidney biopsies: a randomized controlled trial. Pain. 2017.158(1):103-109.
Last reviewed December 2015 by EBSCO CAM Review Board
Last Updated: 7/27/2017
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