Anesthesiology's journal-based CME program is open to all readers. Members of the American Society of Anesthesiologists participate at a preferred rate, but you need not be an ASA member or a journal subscriber to take part in this CME activity. Please complete the following steps:

  1. Read the article by Chernyak and Sessler entitled “Perioperative acupuncture and related techniques” on page 1031 of this issue.

  2. Review the questions and other required information for CME program completion (published in both the print and online journal).

  3. When ready, go to the CME Web site: Submit your answers, form of payment, and other required information by December 31 of the year following the year of publication.

The American Society of Anesthesiologists is approved by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.

The American Society of Anesthesiologists designates this continuing medical education program for a maximum of 1 hour of Category 1 credit toward the AMA's Physician Recognition Award. Each physician should claim only those hours of credit actually spent in the activity.

Purpose:  The focus of the journal-based CME program, and the articles chosen for the program, is to educate readers on current developments in the science and clinical practice of the specialty of Anesthesiology.

Target Audience:  Physicians and other medical professionals whose medical specialty is the practice of anesthesia.

Learning Objectives:  After reading this article, participants should have a better understanding of acupuncture and related techniques, as well as their mechanisms and potential clinical applications.

Authors – Grigory V. Chernyak, M.D., and Daniel I. Sessler, M.D.

Grants or research support:  Supported by grant No. GM 061655 from the National Institutes of Health, Bethesda, Maryland; the Gheens Foundation, Louisville, Kentucky; the Joseph Drown Foundation, Los Angeles, California; and the Commonwealth of Kentucky Research Challenge Trust Fund, Louisville, Kentucky.

Consultantships or honoraria:  None

Question Writer – Peter L. Bailey, M.D.

Dr. Bailey has no grants, research support, or consultant positions, nor does he receive any honoraria from outside sources, which may create conflicts of interest concerning this CME program.

Based on the article by Chernyak and Sessler entitled “Perioperative acupuncture and related techniques” the May issue of Anesthesiology, choose the one correct answer for each question:

1. Which complementary therapeutic approach listed below has the highest  rate of physician referral?

A. Acupuncture.

B. Chiropractic care.

C. Homeopathic care.

D. Herbal therapy.

2. Which of the following statements concerning the theory of traditional Chinese acupuncture is least  likely true?

A. Each organ has a corresponding meridian with acupuncture points located along it.

B. Meridians travel inside the body and on the body's surface.

C. The unique purpose of the meridians is to control pain.

D. Meridians are connected to each other and other organs.

3. Which of the following statements concerning factors helpful in locating acupuncture points is most  likely true?

A. All points are located on small elevations on the skin surface.

B. Acupuncture points are usually more tender compared to surrounding skin.

C. Patients cannot detect appropriate stimulation of an acupuncture point.

D. Acupuncture points on the skin are smooth to the touch compared to surrounding skin.

4. Which of the following statements concerning acupuncture points is least  likely true?

A. Most acupuncture points are 3–15 mm below the skin surface.

B. The size of any one particular acupuncture point may vary in one patient.

C. Each acupuncture point has a specific indication for its use.

D. All evidence suggests that acupuncture mechanisms only involve systemic and not regional responses.

5. Which of the following statements concerning the mechanisms of acupuncture is least  likely true?

A. Acupuncture blocks ascending pain transmission in the spinothalamic tract by stimulating the release of enkephalin and dynorphin in the spinal cord.

B. Acupuncture stimulation of midbrain structures such as the periaqueductal gray matter and the raphe nucleus results in descending inhibition of pain transmission.

C. Acupuncture stimulates the pituitary–hypothalamic complex to release β endorphin.

D. Acupuncture, performed over time, does not result in the development of any tolerance to its effects.

6. The most  common type of acupuncture involves the use of

A. electrostimulation.

B. moxibustion.

C. acupressure.

D. dry needles.

7. Which of the following statements concerning the use of acupuncture to reduce postoperative nausea and vomiting (PONV) is most  likely true?

A. Acupuncture does not reduce PONV in children.

B. Acupuncture can be as effective as pharmacological approaches in reducing PONV.

C. Acupuncture works best when administered intraoperatively.

D. Only the P 6 (Neiguan) acupuncture point is effective for reducing PONV.