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Effect of P6 acustimulation on post‐operative nausea and vomiting in patients undergoing a laparoscopic cholecystectomy
Author(s) -
FREY U. H.,
FUNK M.,
LÖHLEIN C.,
PETERS J.
Publication year - 2009
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2009.02081.x
Subject(s) - retching , medicine , nausea , anesthesia , postoperative nausea and vomiting , vomiting , fentanyl , propofol , antiemetic , surgery
Background Non‐pharmacologic techniques such as electrical acustimulation may mitigate post‐operative nausea and vomiting (PONV). The primary purpose of this study was to investigate the effectiveness of acustimulation on attenuating PONV. Moreover, we tested whether a pre‐ or a post‐induction application of acustimulation results in differences in PONV reduction. Methods In this prospective, double‐blind, randomized, controlled trial, we studied 200 patients undergoing a laparoscopic cholecystectomy during propofol (induction) fentanyl/isoflurane/atracurium (maintenance) anaesthesia. In the acustimulation group ( n =101), subdivided into groups with pre‐induction ( n =57) and post‐induction ( n =44) acustimulation, an active ReliefBand ® device was placed at the P6 acupoint. In the sham group ( n =99), also subdivided into pre‐induction ( n =55) or post‐induction ( n =44) groups, an inactive device was applied instead. The ReliefBand ® remained in place for 24 h after surgery. Nausea and vomiting/retching were recorded at 2, 6, and 24 h post‐operatively. Results The incidence of early nausea (up to 2 h) was significantly lower in the acustimulation than in the sham group (29% vs. 42%; P =0.043). No significant effect could be detected for retching/vomiting. Moreover, acustimulation showed no effect on PONV after 6 and 24 h. Risk factor analysis (female gender, non‐smoker, history of PONV/motion sickness, and post‐operative morphine usage) revealed a relative reduction in risk of 40% for nausea ( P =0.021) and 55% for retching/vomiting ( P =0.048) in patients with three or four risk factors present. The timing of (pre‐ vs. post‐induction) acustimulation had no significant effect on PONV reduction. Conclusion Acustimulation at the P6 acupoint reduces early nausea, but not vomiting, after laparoscopic cholecystectomy, irrespective of its pre‐ or post‐induction application.