The effect of auricular acupressure on preoperative anxiety in patients undergoing gynecological surgery

Acupuncture and related techniques have been shown to be effective treatments for acute and chronic anxiety. We hypothesized that auricular acupressure (AA) may relieve preoperative anxiety without undesirable side effects and might also decrease bispectral index (BIS) values before surgery. Forty-three women undergoing elective American Society of Anesthesiologists (ASA) grade I and II gynecological surgery were randomly assigned to 1) sham acupressure (SA) or 2) AA groups. State-Trait Anxiety Inventory state scale (STAI-S) scores were determined before and after the intervention. BIS values, heart rate (HR), and blood pressure (BP) were recorded after the patients arrived at the preoperative preparation room, and at 5, 10, 15, 20, 25, and 30 min of intervention. After the intervention, the STAI-S scores demonstrated lower state anxiety levels in both groups. However, patients in the AA group showed significantly reduced anxiety levels compared to those in the SA group (80.86 ± 12.16 vs. 91.95 ± 10.21, respectively; P = 0.002). Two-way analysis of variance (ANOVA) with repeated measurement analysis revealed a remarkable decrease in BIS values after AA and SA intervention applied to the bilateral relaxation point at every time point, compared with the baseline values. However, patients in the AA group showed significantly lower BIS values than those in the SA group at every time point after the intervention. Therefore, intervention including AA or SA on the bilateral relaxation points could alleviate preoperative anxiety, but the anxiolytic efficacy of AA is better than that of SA.