Randomized Controlled Trial of Wrist-Ankle Acupuncture for Postoperative Pharyngeal Pain in Patients Undergoing Day Surgery Thyroidectomy.

Abstract

Background: Postoperative pharyngeal pain is common in patients with thyroid cancer undergoing day-case surgery, with approximately 60%-90% affected. Wrist-ankle acupuncture (WAA) offers a potential alternative but lacks clinical validation in day surgery settings.

Objective: This study aimed to assess the effectiveness and safety of WAA in reducing postoperative pharyngeal pain in patients with thyroid cancer undergoing day-case surgery.

Methods: Seventy-two patients undergoing thyroidectomy were randomized into the WAA experimental group (n = 36) or the control group (n = 36). The WAA experimental group received standardized care plus subcutaneous needle insertion at wrist points (Upper 1 and Upper 6) postoperatively, whereas the control group received standard care alone. Pain was assessed using the visual analog scale at 3, 4, 9, and 27 hours, and predischarge. Secondary outcomes included the Houston Pain Outcome Instrument and the 15-item Quality of Recovery scale.

Results: At 9 and 27 hours post surgery, the experimental group reported significantly lower pain scores (P < .001); satisfaction with pain control was also significantly higher (P < .001). The WAA group had minor adverse events and no serious complications. Additionally, the experimental group experienced better postoperative sleep and overall health (P < .05).

Conclusions: Wrist-ankle acupuncture significantly relieves postoperative sore throat in patients with thyroid cancer during day surgery. This work establishes a foundation for integrating WAA into modern surgical recovery pathways. However, larger randomized controlled trials are needed to determine effectiveness across different institutions and populations.

Implications for practice: Wrist-ankle acupuncture offers a nonpharmacological alternative for pain management in thyroid cancer surgery. Further studies are needed to confirm its broader applicability and effectiveness in diverse patient populations.