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Alternative Medicine Helps Reduce Pre-Op Anxiety, Israeli Study

It is normal to suffer from anxiety prior to surgery. A combination of complementary medicine and standard care is proven to reduce patient anxiety levels and thereby improve surgical outcomes.


screen shot - Doctor- Health - illustration talking-to-patient


Preoperative anxiety, one of the most significant factors in elevated blood pressure, rapid pulse, sugar metabolism changes, and other symptoms, is one of the most significant factors predicting mortality among postoperative cardiovascular patients. In addition, it can also influence and extend the postoperative recovery period.

New Israeli study shows that a combination of complementary medicine along with standard care for preoperative anxiety shows real potential to reduce preoperative anxiety levels and improve the outcome of the operation. reduces anxiety levels among patients.

Professor Lital Keinan Boker of the University of Haifa, said that “Consideration should be given to offering this combination to patients who are interested in it.”

The study conducted by master’s student Samuel Attias, of the University of Haifa, Professor Lital Keinan Boker  and Dr. Elad Schiff of Bnai Zion Hospital supervised this study.

The study involved 360 patients over the age of 16 about to undergo elective or acute surgery in the general surgery ward. The patients were divided into three groups.

The first group received standard care for preoperative anxiety, including anti-anxiety drugs according to the anesthesiologist’s instructions, 120 to 160 minutes before entering the surgical waiting room.

The second group received standard care as well as complementary care, including one of the following therapies: acupuncture, reflexology, individual guided imagery or a combination of reflexology and guided imagery.

The third group received standard care combined with generic guided imagery, provided in the form of a recording for the patient, rather than in person.

Anxiety levels were measured before the surgery on a scale of 1 to 10, before and after the intervention. Scores of 4 and above indicate an intermediate or higher anxiety level.

In general, patients who received the combination of complementary medicine and standard care showed a reduction of 60 percent in their anxiety level, from a mean score of 5.54 to 2.32, representing a reduction from an intermediate-to-high anxiety level to a low anxiety level.

By contrast, standard care alone actually caused the average anxiety level to slightly rise from 4.92 to 5.44, and 70 percent of patients in this group continued to report intermediate to high anxiety even after receiving medication.

The study found that the greatest reduction in anxiety – by an average of 4.22 points – was achieved when patients received a combination of standard care together with reflexology and guided imagery.

The patients who received a combination of standard care and generic guided imagery, without intervention by a caregiver, showed a reduction in preoperative anxiety level from an average of 4.9 to 3.5, although the researchers said this is not clinically significant and acknowledged that this method would be difficult to implement without the presence of a therapist to keep external interruptions to a minimum.

“Despite the growing popularity of complementary medicine, studies providing evidence of its therapeutic effectiveness are still lacking, ” the researchers concluded. “In this study, we showed that complementary treatments are apparently helpful in the context of preoperative anxiety.”

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