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Fine-tuning the needle: analysis of acupuncturist response to alarming events during gynecological oncology surgery.
Ben-Arye, Eran; Galil, Galit; Samuels, Noah; Segev, Yakir; Schmidt, Meirav; Gressel, Orit.
Affiliation
  • Ben-Arye E; Integrative Oncology Program, The Oncology Service, Lin, Zebulun, and Carmel Medical Centers, Clalit Health Services, 35 Rothschild St., Haifa, Israel. eranben@netvision.net.il.
  • Galil G; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. eranben@netvision.net.il.
  • Samuels N; Integrative Oncology Program, The Oncology Service, Lin, Zebulun, and Carmel Medical Centers, Clalit Health Services, 35 Rothschild St., Haifa, Israel.
  • Segev Y; Center for Integrative Complementary Medicine, Shaarei Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
  • Schmidt M; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
  • Gressel O; Unit of Gynecological Oncology, Department of Obstetrics and Gynecology, Carmel Medical Center, Haifa, Israel.
Support Care Cancer ; 32(6): 343, 2024 May 13.
Article in En | MEDLINE | ID: mdl-38739310
ABSTRACT

OBJECTIVE:

Examining an intra-operative acupuncture/acupressure setting, with real-time "fine-tuning" in response to alarming events (AEvs) during gynecological oncology surgery.

METHODS:

Narratives of acupuncturists providing intraoperative acupuncture during gynecological oncology surgery were qualitatively analyzed. These described real time "fine-tuning" in response to AEvs during surgery, identified through hemodynamic changes (e.g., systolic/diastolic arterial pressure); bispectral index (BIS) elevation; and feedback from surgeons and anesthesiologists. Documentation of acupuncturist responses to AEvs was addressed as well.

RESULTS:

Of the 48 patients in the cohort, 33 had at least one intraoperative AEv (69%), of which 30 were undergoing laparoscopic surgery and 18 laparotomies. A total of 77 AEvs were documented throughout surgery (range 1-7; mean 2.3 events per patient), identified through increased (63 events) or decreased (8) mean arterial pressure (MAP); increased BIS levels (2), or other hemodynamic parameters (4). Integrative oncology interventions implemented in response to AEs included acupressure alone (59); combining acupressure with acupuncture (10); or acupuncture alone (4). In 54 (70%) events, documentation was provided from beginning to conclusion of the AEv, with a mean duration of 9.7 min, with 32 events including a documented anesthesiologist intervention.

CONCLUSION:

The present study demonstrated the feasibility of intraoperative acupuncture with acupressure, with ongoing "fine-tuning" to AEvs identified through objective pain-related parameters (MAP, heart rate and BIS) and real-time input from surgeons and anesthesiologists. Documentation of the intraoperative IO practitioner's response to these AEvs is important, and should be addressed in future research of the innovative integrative model of care. TRIAL REGISTRATION NUMBER CMC-18-0037 (Carmel Medical Center, June 11, 2018).
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Full text: 1 Database: MEDLINE Main subject: Gynecologic Surgical Procedures / Genital Neoplasms, Female Limits: Adult / Aged / Female / Humans / Middle aged Language: En Journal: Support Care Cancer Journal subject: NEOPLASIAS / SERVICOS DE SAUDE Year: 2024 Type: Article Affiliation country: Israel

Full text: 1 Database: MEDLINE Main subject: Gynecologic Surgical Procedures / Genital Neoplasms, Female Limits: Adult / Aged / Female / Humans / Middle aged Language: En Journal: Support Care Cancer Journal subject: NEOPLASIAS / SERVICOS DE SAUDE Year: 2024 Type: Article Affiliation country: Israel