Heart Rate Variability Subsequent to Auriculotherapy Among Individuals Afflicted by Major Burn Scars
Authors: Chen Cha-Chun , Chen San-Pei , Hsu Chung-Hua 
Published: February 2025

Background
Auriculotherapy is commonly used to reduce and alleviate discomfort in patients who suffer pain, itchiness, sleep disturbances, or heightened anxiety; these symptoms of discomfort are known to be influenced by the autonomic nervous system. Patients with extensive burns may experience more serious symptoms such as pain, itching, and sleep disturbances after the wound has healed. Auriculotherapy is suitable for patients affected by significant burn scars, who often encounter severe symptoms of discomfort. The administration of auriculotherapy as an adjuvant therapy has been demonstrated to potentially mitigate the clinical manifestations of these symptoms in individuals with major burn scarring.

Objectives
To address the lack of up-to-date data on the effects of auriculotherapy on the autonomic nervous system, we performed an analysis of parameters of heart rate variability (HRV) to evaluate the function of the autonomic system before and after administration of auriculotherapy in patients who had experienced significant burns.

Methods
Paired-samples t tests and linear regression analysis were used to compare HRV parameters and explore the correlations between these parameters and the total burn scar area before and after auriculotherapy in a cohort of 39 survivors of the 2016 Formosa Color Dust Explosion.

Results
Significant changes in specific HRV parameters, including standard deviation of RR interval (SD), total power, and high-frequency power, were observed before and after auriculotherapy, and a significant negative correlation was detected between the total burn scar area and the total activity of autonomic activity (ANS) was noted.

Discussion
With auriculotherapy, we could find significant increases in the data SD and total power, both of them standing for total activity of the autonomic system. In addition, increase on the parameter high-frequency power, which stands for the activity of parasympathetic system, is more significant. In this study, significance with the activity of sympathetic system is not significant. Auriculotherapy in this study could stimulate the acupoints related to parasympathetic system may explain this scene because the goal of this treatment is to relieve clinical burn scar disorders and insomnia. Negative correlation between burn surface and pre-SD could tell us that after the more server the burn injury may bring more changes in the autonomic activity.

Conclusions
Many researches about HRV show that even if it is variable and may researches are ongoing, it could reflect the psychological and physiological status in patients after major trauma. In our study, major burn, even in scar condition, could change the autonomic activity. With auriculotherapy by stimulation on parasympathetic system more, it may increase the equilibrium and activity of the autonomic nervous system, with parasympathetic nervous system predominantly. However, absolute changes following auriculotherapy on sympathetic and parasympathetic nervous systems are not significant.