The application of an acupressure bead between a pediatric patient's eyebrows can reduce their pre-op anxiety, according to researchers.

In a study published in the September issue of the journal Anesthesia & Analgesia, Zeev Kain, MD, the anesthesiology and perioperative care chair at the University of California Irvine, and his colleagues applied adhesive acupressure beads to 52 children before endoscopic stomach surgery.

The beads were applied to either the midpoint between the eyebrows (known as the Extra-1 acupuncture point) or to a spot above the left eyebrow known to have no clinical effects and the children were observed with consciousness monitoring devices.

Thirty minutes later, the children with beads at the Extra-1 acupuncture point were observed to have less anxiety than previously, while children in the sham acupressure group were viewed as having more anxiety, based on the monitoring devices' readings.

"What's great about the use of acupressure is that it costs very little and has no side effects," says Dr. Kain in a press release. He also studies the use of music, massage and acupuncture in calming patients before surgery, noting that reducing pre-op anxiety can help reduce post-op stays and the need for post-op analgesics.

"We need to look at all therapeutic opportunities to make the surgical process less stressful for all patients," he says. "We can't assume that Western medical approaches are the only viable ones."

Kent Steinriede

Two brothers who ran an illegitimate medical clinic in Canton, Ga., were unqualified for the surgical procedures they performed and the medications they prescribed there, say authorities that raided the site last week. Miguel Velez was charged with 11 counts of practicing medicine without a license and Raul Velez faces 22 counts of prescription documents signed in blank.

Neither man is a registered physician in the state of Georgia, say Canton police, which acted on a report from the state's board of medical examiners that the clinic had used the name of a registered physician who was not on its staff and did not give permission for his name to be used.

During their raid, police uncovered controlled substances and 22 pre-signed blank prescription forms in a safe. During a search of Miguel Velez's home, they found medications, documents relating to the clinic, medical equipment and paper bags full of cash that "appeared to be forgotten about," says a Canton police spokeswoman, who added, "They made a lot of money."

The spokeswoman says police are aware of at least two procedures that were performed at the clinic from patients who have identified Miguel Velez as the one performing the procedures. During one, the removal of an abscess from a female patient's right breast, the patient did not receive pain medication and "had to be held down" during the surgery.

Three other facilities owned and operated by the brothers remain under investigation. Authorities have also issued an arrest warrant for Miguel Velez' son Omar Velez, another listed owner of the busted clinic, for false statements and writings. He remains at large.

Daniel Cook

Before she shot onto the national scene as Republican presidential candidate John McCain's running mate, Alaska Gov. Sarah Palin tried to repeal her state's certificate of need law.

Her push to eliminate Alaska's CON requirements for building healthcare facilities didn't succeed, however. Strongly opposed by hospitals, the bill did not make it out of the legislature.

"Hospitals engaged right away in fighting this," says Anna Kim, special assistant to the governor. "A lot of their resistance revolved around outpatient surgeries and imaging."

While running for office, Gov. Palin criticized CON regulations as unwarranted government interference with business, according to a published report in the Juneau Empire.

In February, she wrote an opinion piece for the Anchorage Daily News in which she argued that the certificate program drove health care costs up by not allowing more competition and potentially better health care in newer facilities.

Dan O'Connor

For 38 percent of the 29 facility leaders who answered last week's online poll, outpatient surgery is immune from today's tough financial times. But 25 percent say they've seen more patients canceling procedures and 24 percent report that more patients are unable to pay their copays. Another 10 percent say they've been forced to freeze staff salaries and 3 percent say they've laid off staff.

Based on the letters we've received, we're expecting this week's poll question to be a controversial one: Which anesthesia providers are more cost-effective, CRNAs or anesthesiologists? Voice your opinion on our simple weekly poll, located on the lower right hand side of our front page.

Dan O'Connor