A randomized-controlled trial assessing the effect of intraoperative acupuncture on anesthesia-related parameters during gynecological oncology surgery

被引:5
作者
Ben-Arye, Eran [1 ,2 ,3 ,4 ]
Hirsh, Irena [5 ]
Segev, Yakir [4 ,6 ]
Grach, Michael [5 ]
Master, Viraj [7 ,8 ]
Eden, Arie [5 ]
Samuels, Noah [9 ]
Stein, Nili [10 ]
Gressel, Orit [1 ,2 ,3 ,4 ]
Ostrovsky, Ludmila [6 ]
Galil, Galit [1 ,2 ,3 ]
Schmidt, Meirav [5 ]
Schiff, Elad [4 ,11 ,12 ]
Lavie, Ofer [4 ,6 ]
机构
[1] Clalit Hlth Serv, Lin Med Ctr, Oncol Serv, Integrat Oncol Program, 35 Rothschild St, Haifa, Israel
[2] Clalit Hlth Serv, Zebulun Med Ctr, Oncol Serv, Integrat Oncol Program, 35 Rothschild St, Haifa, Israel
[3] Clalit Hlth Serv, Carmel Med Ctr, Oncol Serv, Integrat Oncol Program, 35 Rothschild St, Haifa, Israel
[4] Technion Israel Inst Technol, Rappaport Fac Med, Haifa, Israel
[5] Carmel Hosp, Dept Anesthesiol Crit Care & Pain Med, Haifa, Israel
[6] Carmel Hosp, Dept Obstet & Gynecol, Haifa, Israel
[7] Emory Univ, Dept Urol, Atlanta, GA 30322 USA
[8] Emory Univ, Winship Canc Inst, Atlanta, GA 30322 USA
[9] Hebrew Univ Jerusalem, Shaarei Zedek Med Ctr, Fac Med, Ctr Integrat Complementary Med, Jerusalem, Israel
[10] Carmel Hosp, Dept Community Med & Epidemiol, Haifa, Israel
[11] Bnai Zion Hosp, Dept Internal Med, Haifa, Israel
[12] Bnai Zion Hosp, Integrat Med Serv, Haifa, Israel
关键词
Integrative oncology; Gynecological oncology; Acupuncture; Pain; Intraoperative; Integrative medicine; HEART-RATE-VARIABILITY; INTEGRATIVE MEDICINE; NOCICEPTION LEVEL; STIMULATION; CANCER; EFFICACY;
D O I
10.1007/s00432-023-04758-3
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Context and objectivesThe present study examined the impact of intraoperative acupuncture on anesthesia-related parameters in patients undergoing gynecological oncology surgery.MethodsParticipants underwent preoperative integrative oncology (IO) touch/relaxation treatments, followed by intraoperative acupuncture (Group A); preoperative IO treatments without acupuncture (Group B); or standard care only (Group C). Mean arterial pressure (MAP), heart rate (HR), MAP variability (mean of MAP standard deviation), bispectral index (BIS), and calculated blood pressure Average Real Variability (ARV) were measured intraoperatively.ResultsA total of 91 patients participated: Group A, 41; Group B, 24; Group C, 26. Among patients undergoing open laparotomy, Group A showed lower and more stable MAP and HR compared to Group B, (MAP, p = 0.026; HR, p = 0.029) and Group C (MAP, p = 0.025). Mean BIS, from incision to suture closing, was lower in Group A (vs. controls, p = 0.024). In patients undergoing laparoscopic surgery, MAP was elevated within Group A (p = 0.026) throughout surgery, with MAP variability significantly higher in Group A (P = 0.023) and Group B (P = 0.013) 10 min post-incision (vs. pre-incision). All groups showed similar intraoperative and post-anesthesia use of analgesic medication.ConclusionIntraoperative acupuncture was shown to reduce and stabilize MAP and HR, and reduce BIS in gynecology oncology patients undergoing laparotomy, with no impact on perioperative analgesic medication use. In the laparoscopic setting, intraoperative acupuncture was associated with elevated MAP. Further research is needed to explore the hemodynamic and BIS-associated benefits and risks of intraoperative acupuncture, and the impact on the use of analgesic drugs in response to these changes.
引用
收藏
页码:8177 / 8189
页数:13
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