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Complement Ther Med. 2019 Jun;44:51-55. doi: 10.1016/j.ctim.2019.03.003. Epub 2019 Mar 21.

Complementary and alternative medicine interventions for perioperative symptoms: A comparative effectiveness study.

Author information

1
Internal Medicine Department, Bnai Zion Medical Center, Haifa, Israel; Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel; Complementary & Integrative Surgery Service, and the Surgery Department, Bnai-Zion Medical Center, Haifa, Israel. Electronic address: eschiff@bezeqint.net.
2
Complementary & Integrative Surgery Service, and the Surgery Department, Bnai-Zion Medical Center, Haifa, Israel; School of Public Health, University of Haifa, Haifa, Israel. Electronic address: Samuel.attias@b-zion.org.il.
3
Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel; Department of General Surgery, Bnai-Zion Medical Center, Haifa, Israel. Electronic address: matardoc@gmail.com.
4
Department of General Surgery, Bnai-Zion Medical Center, Haifa, Israel; Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel. Electronic address: gideon.sroka@b-zion.gov.il.
5
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beersheba, Israel. Electronic address: bluma180@gmail.com.
6
Complementary & Integrative Surgery Service, and the Surgery Department, Bnai-Zion Medical Center, Haifa, Israel. Electronic address: zahia@yvc.ac.il.
7
Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel. Electronic address: refplus@netvision.net.il.
8
Department of General Surgery, Bnai-Zion Medical Center, Haifa, Israel. Electronic address: ofra.gringerg@b-zion.gov.il.
9
Integrative Oncology Program, the Oncology Service and Lin Medical Center, Clalit Health Services, Haifa, Israel; Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel. Electronic address: eranben@netvision.net.il.

Abstract

INTRODUCTION:

Perioperative symptoms such as pain, nausea and anxiety are often inadequately treated. We conducted a pragmatic trial to evaluate the impact of Complementary and Alternative Medicine (CAM) treatments on these symptoms, within the framework of a general surgery department that integrates CAM.

METHODS:

Patients ≥ 18 years referred to CAM treatments by surgical medical staff were allocated to standard of care with CAM treatment (CAM group) or without, according to patient preference and practitioner availability. CAM treatments included Acupuncture, Reflexology, or Guided Imagery. The primary outcome variable was the change from baseline in symptom severity, measured by Visual Analogue Scale (VAS). Patients and practitioners were asked to report any adverse effects associated with CAM treatments.

RESULTS:

A total of 1127 patients were enrolled, 916 undergoing 1214 CAM treatments and 211 controls. Socio-demographic characteristics were similar in both groups. Patients in the CAM group had more severe baseline symptoms. Symptom reduction was greater in the CAM group compared with controls, with a mean reduction in pain of -2.17 ± 2.4 vs -0.29 ± 2 (P < 0.0001); nausea -1.2 ± 2.42 vs -0.3 ± 1.94 (P < 0.0001); and anxiety -2.23 ± 2.76 vs -0.03 ± 2.54 (P < 0.0001). Acupuncture was more effective for nausea control. No significant adverse events were reported with any of the CAM therapies.

CONCLUSION:

CAM treatments provide additional relief to Standard Of Care (SOC) for perioperative symptoms. Larger randomized control trial studies with longer follow-ups are needed to confirm these benefits. The study is registered with clinical trials.gov at (NCT01733771).

KEYWORDS:

Acupuncture; Anxiety; Complementary and alternative medicine; Guided imagery; Integrative medicine; Nausea; Pain; Reflexology; Surgery

PMID:
31126575
DOI:
10.1016/j.ctim.2019.03.003

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