Acupuncture during gynecological oncology surgery: A randomized controlled trial assessing the impact of integrative therapies on perioperative pain and anxiety

Anxiety and pain are constant concerns for women facing gynecological oncology surgery. These patients experience a profound transformation in their self-perception, moving from a view of health to the condition of a cancer patient who needs surgical treatment. In addition to emotional challenges such as anxiety, depression, and changes in body image, physical symptoms frequently arise, including fatigue, loss of appetite, gastrointestinal problems, and insomnia. In the postoperative period, decreased functional well-being, emotional distress, and impairment of daily activities are observed.

Preoperative anxiety and depression can even predict more intense pain levels during recovery, making it essential to seek interventions that can improve these patients' quality of life throughout the surgical process.

This pioneering study aimed to evaluate the impact of a multimodal integrative intervention on pain and anxiety in women undergoing gynecological oncology surgery. The research was conducted as a randomized controlled trial in Israel, involving 99 patients with a diagnosis of ovarian, endometrial, or cervical cancer. Participants were divided into three groups through a double-randomization process. Group A received preoperative touch and relaxation techniques, followed by acupuncture during surgery.

Group B received only touch and relaxation techniques before the operation. Group C, the control, received only conventional medical care. Integrative treatments were delivered by experienced professionals trained in Traditional Chinese Medicine and mind-body therapies. Outcome assessment was performed using validated questionnaires that measured pain, anxiety, and quality of life before and after surgery.

The results showed significant benefits for patients who received integrative interventions. Participants in the intervention groups, when compared with the control group, presented superior quality-of-life scores in the postoperative period, including better control of intense pain and lower anxiety. Group A, which received acupuncture during surgery in addition to the preoperative techniques, showed an especially significant reduction in intense pain compared with the control group. Interestingly, both intervention groups showed improvement in depression levels, an effect not observed in the control group.

Group A also demonstrated greater relief from concerns related to overall well-being when compared with Group B. All groups showed natural improvement in anxiety levels after surgery, but this improvement was more pronounced in the groups that received the integrative interventions.

The clinical implications of these findings are promising for patients and healthcare professionals. For patients, the results suggest that simple and safe touch and relaxation techniques applied before surgery can significantly reduce perioperative anxiety. The addition of acupuncture during the operation offers the additional benefit of reducing intense postoperative pain. These treatments can be integrated into conventional surgical protocols without interfering with the safety or efficacy of the procedures.

For clinicians, the study offers evidence that integrative approaches can complement traditional medical care, potentially reducing the need for pain and anxiety medications. The improvement observed in depressive symptoms also suggests broader psychological benefits that may positively impact patients' overall recovery.

Despite the encouraging results, the study has some important limitations that should be considered. The study population was mixed in terms of types of surgery and extent of procedures, which may have influenced the results. The lack of a control group receiving a placebo intervention represents a methodological limitation, since the benefits observed may be partially related to the additional attention received by the intervention groups. The sample size was relatively small, particularly in Group B, and the assessment relied mainly on self-reported questionnaires from patients, without objective measures such as the dosage of analgesic medications used.

Future research should include larger groups of participants, adequate placebo controls, objective measures of pain and anxiety, and assessment of the impact on medication use in the postoperative period. Despite these limitations, this study represents an important first step in understanding how integrative therapies can benefit women undergoing gynecological oncology surgery, offering hope for more humanized and comprehensive care during a particularly vulnerable moment in their lives.