Cheek Acupuncture Reduces Postoperative Sore Throat After Double-Lumen Endobronchial Intubation: A Randomized Controlled Trial

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Abstract
Purpose: Postoperative sore throat (POST) is highly prevalent following double-lumen endobronchial tube (DLT) intubation and negatively impacts recovery. Cheek acupuncture, a micro-needle therapy, provides targeted analgesia through specific acupoint stimulation. This study aimed to evaluate the efficacy of cheek acupuncture in mitigating POST in patients undergoing thoracoscopic lung surgery with DLT intubation. Patients and Methods: Eighty-eight patients were equally randomized to receive either cheek acupuncture (CA group) at bilateral cervical, upper energizer, and upper cervical points for 30 minutes before surgery completion, or sham acupuncture at identical acupoints (CT group). The primary outcome was overall POST incidence within postoperative 48 hours, and secondary outcomes included POST severity, wound pain, rescue analgesic consumption, postoperative nausea and vomiting (PONV) incidence, time to first flatus, postoperative pulmonary complications, adverse events, satisfaction scores, and hospitalization duration. Results: The overall 48-hour postoperative POST incidence was 34.1% in the CA group versus 65.9% in the CT group (risk ratio: 0.517, 95% confidential interval: 0.326 to 0.821, P = 0.003), with the most pronounced reduction observed during the 0– 30 min interval (P < 0.05). Moreover, POST severity was significantly reduced in the CA group at 30 min postoperatively (P < 0.05). Cheek acupuncture was also associated with reduced early wound pain, rescue analgesic requirement, 48-hour PONV incidence, and improved overall anesthesia satisfaction (P < 0.05), and no significant intergroup difference in time to first flatus or hospitalization duration was found (P > 0.05). Conclusion: A single intraoperative session of cheek acupuncture reduces the incidence of early POST after DLT intubation for thoracoscopic lung surgery, with a favorable safety profile.

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