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

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 ±â€¯2.4 vs -0.29 ±â€¯2 (P < 0.0001); nausea -1.2 ±â€¯2.42 vs -0.3 ±â€¯1.94 (P < 0.0001); and anxiety -2.23 ±â€¯2.76 vs -0.03 ±â€¯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).

Analgesic Effects of Reflexology in Patients Undergoing Surgical Procedures: A Randomized Controlled Trial.

OBJECTIVE: Inadequate treatment of pain in patients undergoing surgery is associated with unsatisfactory perioperative outcomes. The aim of this study was to examine the role of reflexology in addition to standard analgesic treatment in postoperative pain management. DESIGN: This was a prospective, unblinded pragmatic controlled trial. SETTING/LOCATION: Study participants included patients who were admitted to the general surgery department. INTERVENTIONS: Patients in the intervention group received reflexology while standard analgesic care was administered similarly in both groups. OUTCOME MEASURES: Pain intensity at rest and in motion was evaluated using visual analog scale (VAS [0-10]) at baseline, and 60-90 min after treatment. RESULTS: Pain reduction was clinically and statistically significant in the reflexology group, both for pain at rest (from mean VAS of 4.4 to 3.1, N = 77, p < 0.0001) and for pain in motion (from 6.2 to 4.2, N = 77, p < 0.0001). In the control group, pain at rest was not reduced at follow-up (from 4.7 to 4.6, N = 87, p = 0.92), nor was pain in motion (from 5.8 to 5.7, N = 87, p = 0.65). Comparison of mean difference for pain showed significant improvement in the reflexology group compared to the standard of care group (p < 0.0001). The most significant pain reduction in the reflexology group was observed among patients who had moderate-severe baseline pain (VAS >4). CONCLUSION: Adding reflexology to standard analgesic care is effective in reducing postoperative pain at rest and in motion, especially for patients experiencing moderate to severe pain.