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Delia MINCHEVICI, Nadejda NEGARÎ, Alin BOUR, Angela GÎLEA, Stela VUDU, Veronica SARDARI, Victoria CHIHAI. Comprehensive Evaluation of the Efficacy, Neurophysiological Mechanisms, and Clinical Integration of Acupuncture as an Adjuvant Therapy Post-Total Thyroidectomy. Biochemical Mechanisms of Acetylsalicylic Acid in Metastatic Chemoprevention: Platelet–Tumor Cell Interactions, the Cyclooxygenase-1/Thromboxane A2 Axis, and the Role of Protein Acetylation: A Review; Proceedings of NanoBioMat 2026(1); 158-170
Comprehensive Evaluation of the Efficacy, Neurophysiological Mechanisms, and Clinical Integration of Acupuncture as an Adjuvant Therapy Post-Total Thyroidectomy
Delia MINCHEVICI4,*, Nadejda NEGARÎ1,5, Alin BOUR¹, Angela GÎLEA4, Stela VUDU3, Veronica SARDARI2, Victoria CHIHAI6
¹ Department of Surgery nr. 5, “Nicolae Testemițanu” State University of Medicine and Pharmacy, Chișinău, Republic of Moldova
2 Department of Biochemistry and Clinical Biochemistry, “Nicolae Testemițanu” State University of Medicine and Pharmacy, Chișinău, Republic of Moldova
3 Department of Endocrinology “Nicolae Testemițanu” State University of Medicine and Pharmacy, Chișinău, Republic of Moldova
4 Department of Alternative and Complementary Medicine “Nicolae Testemițanu” State University of Medicine and Pharmacy, Chișinău, Republic of Moldova
5 Department of Anatomy and Clinical Anatomy, “Nicolae Testemițanu” State University of Medicine and Pharmacy, Chișinău, Republic of Moldova
6 Department of Medical Rehabilitation, Physical Medicine and Manual Therapy, “Nicolae Testemițanu” State University of Medicine and Pharmacy, Chișinău, Republic of Moldova
*Correspondence: delia.minchevici@gmail.com
ABSTRACT
Introduction: The problem of postoperative complications after total thyroidectomy is one of the most common in modern practice. Complications include neck and pharynx pains, PONV, hypocalcemia, and dysphonia. The development of ERAS procedures in recent years allows one to use non-drug approaches to treatment, which includes electroacupuncture (EA), TEAS, and WAA. Aim of the study: The goal of this paper is the critical analysis and synthesis of scientific data on the effectiveness of acupuncture techniques as adjuvant postoperative treatment after total thyroidectomy. Methods and materials: A systematic review of literature from 2022 to 2026 was conducted across PubMed, Embase, and Cochrane databases. Inclusion criteria comprised randomized controlled trials, meta-analyses, and translational molecular studies evaluating perioperative acupuncture in endocrine surgery. Non-peer-reviewed articles, case reports, and non-surgical interventions were excluded. Data were extracted and critically synthesized for clinical and mechanistic evaluation. Results: Acupuncture neuromodulation significantly lowers post-thyroidectomy Visual Analogue Scale (VAS) pain scores by 30%-40% and lowers requirements for rescue opioids up to 36%. Regarding the treatment of PONV, TEAS application in the PC6 acupoint significantly diminishes incidence of emetic episodes by around 50%, revealing superiority of 2-hour symptom remission compared to the action of metoclopramide (77.6% vs. 55.2%). On the mechanistic level, acupuncture modulates sterile neuroinflammation (decrease of TNF-alpha and IL-6 levels) by means of vagal cholinergic anti-inflammatory effect and promotes tissue remodeling with activation of Wingless-type MMTV integration site family, member 3A (Wnt3a) and VEGF-A pathways. Targeted stimulation of the ST36 and SP6 acupoints accelerates parathyroid bed revascularization, thus restoring plasma levels of calcium and parathyroid hormone while lowering symptomatic hypocalcemia incidence from 13.2% to 7.8%. Conclusions: Acupuncture and its variations are validated scientifically and represent an efficient and reliable addition to anesthesia in surgery. Integration of such neuromodulating approaches in multimodal ERAS protocols is helpful in stabilizing autonomous nervous activity, overcoming surgical stress and improving recovery after total thyroidectomy.
Keywords: Total thyroidectomy; Acupuncture; Electroacupuncture; Postoperative nausea and vomiting; Enhanced Recovery After Surgery.