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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Data availability
Data transparency is available pending to request from the submitting author.
Code availability
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Acknowledgements
We thank Prof. Ofer Lavie, Dr. Michael Grach, Dr. Ludmila Ostrovsky and Dr. Irena Hirsh for their support. We would also like to thank Dr. Inbal Marom, Dr. Nir Kugelman, Dr. Irena Luria, and Dr. Tomer Bar-Noi.
Funding
This Research was funded by the Israel Cancer Association (grant number 20180006).
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All authors contributed to the study conception and design. Material preparation and data collection were performed by Eran Ben-Arye, Galit Galil and Orit Gressel. The first draft of the manuscript was written by Eran Ben-Arye, Galit Galil, Orit Gressel and Noah Samuels and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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The protocol of the study was approved by the Ethics Review Board (Helsinki Committee) of the Carmel Medical Center in Haifa, Israel; and was registered at ClinicalTrials.gov (NCT03560388).
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Ben-Arye, E., Galil, G., Samuels, N. et al. Fine-tuning the needle: analysis of acupuncturist response to alarming events during gynecological oncology surgery. Support Care Cancer 32, 343 (2024). https://doi.org/10.1007/s00520-024-08552-w
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DOI: https://doi.org/10.1007/s00520-024-08552-w