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Randomized Controlled Trial
. 2023 Sep;149(11):8177-8189.
doi: 10.1007/s00432-023-04758-3. Epub 2023 Apr 15.

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

Eran Ben-Arye  1   2 , Irena Hirsh  3 , Yakir Segev  4   5 , Michael Grach  3 , Viraj Master  6 , Arie Eden  3 , Noah Samuels  7 , Nili Stein  8 , Orit Gressel  9   4 , Ludmila Ostrovsky  5 , Galit Galil  9 , Meirav Schmidt  3 , Elad Schiff  4   10 , Ofer Lavie  4   5
Affiliations
Randomized Controlled Trial

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

Eran Ben-Arye et al. J Cancer Res Clin Oncol. 2023 Sep.

Abstract

Context and objectives: The present study examined the impact of intraoperative acupuncture on anesthesia-related parameters in patients undergoing gynecological oncology surgery.

Methods: Participants 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.

Results: A 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.

Conclusion: Intraoperative 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.

Keywords: Acupuncture; Gynecological oncology; Integrative medicine; Integrative oncology; Intraoperative; Pain.

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Conflict of interest statement

Eran Ben-Arye, Irena Hirsh, Yakir Segev, Michael Grach, Noah Samuels, Viraj Master, Arie Eden, Nili Stein, Ludmila Ostrovsky, Orit Gressel, Galit Galil1, Meirav Schmidt, Elad Schiff, and Ofer Lavie declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Study algorithm
Fig. 2
Fig. 2
Hemodynamic and Bispectral Index changes during open surgery
See this image and copyright information in PMC

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References

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