1/ Presentation summary

Background and aims
Postoperative pain is a major complication of several types of surgery. The management consists of opioidadministration with or without adjuvant anti-neuropathic drugs. Side effects, especially the opioid inducedconstipation can delay the postoperative recovery.
A systematic literature review of 15 RCT’s comparing acupuncture with sham control found a significantreduction in pain, opioid use and side effects in the acupuncture group.
The principles of traditional Chinese medicine link three major themes: nutrition and microbiome,neuroplasticity, and homeostasis while considering the side effects of medication.

Methods
patients scheduled for a painful surgery (thoracotomy, mastectomy, hip and knee,cancer surgery) receivedacupuncture prior to surgery and 2 additional session afterwards.
The evaluation is for 3 months on sleep, quality of life, pain intensity, functional revalidation using differentscales.
The multimodal treatment uses; besides acupuncture, pharmaconutrition to reduce the inflammation.
Post-operative pain intensity, opioid consumption and opioid-related side effects were retrieved.

Results
The patients, included pre-operative, had a faster recovery, needed less opioids than other patients and hadless side effects.
The patients who already had post-operative pain had a 50% pain reduction at the first session.

Conclusions
Our findings are in-line with the findings of the meta-analysis.
Moreover, the inclusion of acupuncture and a pharmaconutritional regimen pre-operatively may reduce thesensitization and prevent neuropathic pain.
Acupuncture could be integrated into the standard protocol for treatment and prevention of post-operativepain.T his therapeutic approach may also reduce the risk of postoperative CRPS.
The need for multidisciplinary assessment and treatment focused on drug metabolism and chronobiology isemphasized.
The multimodal management should be studied to find the most efficacious

2/ Presentation summary

Laser : Light at the Heart of Cells
Laser acupuncture combines the ancestral principles of Traditional Chinese Medicine (TCM) with technological advances in photomedicine. This method stimulates acupuncture points with low-intensity infrared or red laser, replacing traditional needles while maintaining the same therapeutic objectives.

Main Advantages :
This technique presents significant benefits: it is completely painless and non-invasive, eliminating infectious risks associated with needles. It is particularly suitable for children, elderly people, or those sensitive to needlepricks. Its efficacy is recognized for treating stress, joint pain, skin disorders, addictions, and various pathologies.

Mechanisms of Action :
The laser acts on several biological levels. It stimulates cellular metabolism by activating the mitochondrial respiratory chain, increasing ATP production by 150%. It improves microcirculation through nitric oxide production, enhancing blood flow by 40%. These photochemical reactions promote detoxification, tissue repair,and reduce inflammation.
Comparison with Traditional Acupuncture
Unlike classical acupuncture, the laser version eliminates the sensation of pricking and infectious risks. The precision of the light beam allows targeted stimulation of acupuncture points, with comparable clinical efficacy.

Conclusion : 
Laser acupuncture initiates multiple mechanisms including stimulation of energy flow, release of neurotransmitters, cellular modifications, immune and neuroendocrine regulation, as well as biophoton and photosensitivity theories. Current research uses various approaches (neurophysiological analyses,biochemical measurements, imaging techniques, acupuncture point assessment, and clinical efficacy studies)to understand and validate these mechanisms, notably revealing potential modulation of the ascending reticular activating system. Robot-assisted laser acupuncture, now a clinical reality, will facilitate investigation of mechanisms