Capsicum Plaster at the Acupuncture Point pp. 197-206
Authors: (Kyo Sang Kim, Department of Anesthesiology and Pain Medicine, Hanyang University Hospital, Seoul, Korea)
Abstract: Acupuncture and related techniques are nonpharmacologic modalities that are based on classical teachings in Chinese medicine and can be used for the management of pain. The oldest acustimulation, traditional Chinese manual acupuncture, consists of inserting acupuncture needles into acupuncture points along traditional acupuncture meridians and applying manipulations. In contrast, acupuncture is invasive, unpleasant, frightening and time consuming for children. The acupuncturist thought it was dangerous because it can damage tissue, and difficult as acupuncturist can't access points. The acupuncturist may damage blood vessels, nerves, tendons or bone, which can all be quite painful. Acupressure, acupressure with electrical stimulation, acustimulation with ReliefBand, transcutaneous acupoint stimulation (TAES) and capsicum plaster are all based on the acupuncture. Acupressure, TAES and capsicum plaster are noninvasive. Acupressure uses physical or mechanical pressure applied over the meridians of the body. It can be accompanied by electrical impulses delivered to acupoints via inserted electrodes attached to the skin during electro-acupressure and transcutaneous acupoint stimulation. Capsicum plaster is noninvasive, simple, painless, easy to apply and firmly adhered on the correct point. Capsaicin, the compound in chili peppers that makes them taste hot, binds to nociceptors in the skin, causing an initial excitation of the neurons and a period of enhanced sensitivity . Capsicum plaster (PAS, Sinsin Pharm. Korea) is a low-capsaicin (0.046% w/w) mixture of powdered capsicum 345.80 mg and capsicum tincture 34.58 mg on a sheet (12.2 x 16.4 cm2). Its use as an alternative to acupuncture was first developed and described by the Korean Buddhist priest Namsan . Although this method is widely used in Korea, Western medicine has hardly noticed it, and little research is being performed in this field. The cost of either acupressure ($8)  or transcutaneous electrical nerve stimulation (TENS; ReliefBandTM, Aeromedix Co., Jackson Hole, WY, USA) ($30)  is greater than this capsicum plaster ($1 per five sheets). Capsicum plaster is easy to use and requires no special training and is a good alternative to the routinely prescribed nonpharmacologic techniques for the treatment of PONV , postoperative sore throat  and chronic low back pain [7,8]. The size of capsicum plaster is convenient and small for children (5 x 5 mm) and adult (1 x 1 cm), and it is available for 8 – 12 h due to the capsicum element . The more recent studies [9 - 12] suggest that capsicum plaster at the acupuncture point can be used as an adjuvant in the treatment of postoperative pain such as orthognathic surgery, inguinal hernia repair, abdominal hysterectomy and knee replacement.