[Observation on clinical therapeutic effects of electroacupuncture combined with moving cupping on somatoform disorders].
Cong Shen,Fang Li
Zhongguo zhen jiu = Chinese acupuncture & moxibustion
OBJECTIVE:To observe therapeutic effect of electroacupuncture combined with moving cupping therapy on somatoform disorders. METHODS:Twenty-five cases of somatoform disorders meeting CCMD-3 criteria were treated with electroacupuncture and moving cupping for 4 therapeutic courses (20 sessions), and the improvement of symptoms and therapeutic effect were observed after treatment. RESULTS:After treatment, of the 25 cases, 13 were markedly effective, 9 improved and 3 ineffective, the total effective rate being 88.0%; the score of SCL-90 factor decreased significantly (P < 0.05). CONCLUSION:Electroacupuncture combined with moving cupping therapy can early control target symptoms and improve bad emotion for the patient of somatoform disorders.
[Use of magnesium sulfate for controlling postoperative shivering].
Beliaev A V,Ryzhin S M,Dubov A M
In intravenous administration of magnesium sulphate, the postoperative shivering was cupped off in 87.8% of the patients. The mean effective dosage of the preparation was 32.2 mg/kg of body weight. In rapid intravenous administration of the preparation, in 3% of the patients, the nausea and vomiting+ occurred. Hypotension (3% of cases) and ++re-curarization of the mandibular muscles (3%) were eliminated by means of the intravenous administration of calcium chloride. Cupping off the shivering permitted to prevent the hypothermal reaction after the operation and narcosis.
The effectiveness of dry-cupping in preventing post-operative nausea and vomiting by P6 acupoint stimulation: A randomized controlled trial.
Farhadi Khosro,Choubsaz Mansour,Setayeshi Khosro,Kameli Mohammad,Bazargan-Hejazi Shahrzad,Zadie Zahra H,Ahmadi Alireza
BACKGROUND:Postoperative nausea and vomiting (PONV) is a common complication after general anesthesia, and the prevalence ranges between 25% and 30%. The aim of this study was to determine the preventive effects of dry cupping on PONV by stimulating point P6 in the wrist. METHODS:This was a randomized controlled trial conducted at the Imam Reza Hospital in Kermanshah, Iran. The final study sample included 206 patients (107 experimental and 99 controls). Inclusion criteria included the following: female sex; age>18 years; ASA Class I-II; type of surgery: laparoscopic cholecystectomy; type of anesthesia: general anesthesia. Exclusion criteria included: change in the type of surgery, that is, from laparoscopic cholecystectomy to laparotomy, and ASA-classification III or more. Interventions are as follows: pre surgery, before the induction of anesthesia, the experimental group received dry cupping on point P6 of the dominant hand's wrist with activation of intermittent negative pressure. The sham group received cupping without activation of negative pressure at the same point. Main outcome was that the visual analogue scale was used to measure the severity of PONV. RESULTS:The experimental group who received dry cupping had significantly lower levels of PONV severity after surgery (P < 0.001) than the control group. The differences in measure were maintained after controlling for age and ASA in regression models (P < 0.01). CONCLUSION:Traditional dry cupping delivered in an operation room setting prevented PONV in laparoscopic cholecystectomy patients.
Systematic review and meta-analysis of the effect of transcutaneous electrical acupoint stimulation on gastrointestinal function after laparoscopic surgery.
Zhang Sheng,Guo Wenping,Jiao Yalou,Guo Xiangyan,Xu Lijia,Gao Hui
Annals of palliative medicine
BACKGROUND:Postoperative gastrointestinal dysfunction (PGD) leading to nausea, vomiting, and abdominal distension are common complications after laparoscopic surgery for abdominal diseases. However, drugs cannot completely stop PGD. Over the years, transcutaneous electrical acupoint stimulation (TEAS) therapy has shown potential in preventing PGD, but there is no medical evidence that TEAS represents the best choice for the treatment of PGD. This network meta-analysis sought to evaluate the effectiveness of TEAS therapy in preventing PGD in patients after abdominal laparoscopic surgery. METHODS:Articles (published from the establishment of the databases to July 2021) were retrieved from the following databases: PubMed/Medline, Cochrane Library, Web of Science, Embase, China Biomedical Literature Database (CBM), China Technical Journal VIP Database (CQVIP), China Knowledge Infrastructure (CNKI), and the Wanfang Database. The Cochrane risk of bias tool was used to evaluate the quality of the included studies, and a network meta-analysis was performed using RevMan 5.20. RESULTS:A total of 7 randomized controlled trials, comprising 440 TEAS-treated patients and 468 control patients, were included in the meta-analysis. The meta-analysis showed that there was no significant difference between the TEAS treatment group and the control group in relation to postoperative nausea and vomiting [relative risk (RR) =0.66; 95% confidence interval (CI): 0.37-1.21; P=0.18], postoperative abdominal distension (RR =0.53; 95% CI: 0.40-0.72; P<0.0001), the time of first postoperative fart (imply gastrointestinal motility) [mean difference (MD) =-7.31; 95% CI: -11.33 to -3.30; P=0.0004], and the time of first postoperative bowel movement (MD =-5.28; 95% CI: -7.23 to -3.33; P<0.0001); there were significant differences among these 3 indicators. DISCUSSION:We found that TEAS can promote postoperative fart and bowel movement, and has good clinical value in promoting postoperative gastrointestinal function recovery.
[Effects of perioperative transcutaneous electrical acupoint stimulation on postoperative analgesia in patients undergoing shoulder arthroscopic surgery].
Pan Lu-Ping,Yang Yu,Shao Jin,Ren Zhi-Wei,Yu Li-Na,Yan Min
Zhongguo zhen jiu = Chinese acupuncture & moxibustion
OBJECTIVE:To observe and evaluate the effects of transcutaneous electrical acupoint stimulation (TEAS) at different time points on postoperative analgesia in perioperative period in patients undergoing shoulder arthroscopic surgery, and to explore the optimal time to use TEAS for shoulder arthroscopic surgery. METHODS:A total of 120 patients undergoing unilateral shoulder arthroscopy under general anesthesia, graded withⅠtoⅡaccording to ASA criteria were randomly divided into 3 groups, 40 patients in each one. The patients in the group A were treated with preoperative TEAS at sham acupoints combined with postoperative TEAS at Hegu (LI 4) and Neiguan (PC 6); the patients in the group B were treated with preoperative TEAS at Hegu (LI 4) and Neiguan (PC 6) combined with postoperative TEAS at sham acupoints; the patients in the group C were treated with TEAS at sham acupoints before and after operation. The parameters of TEAS were dilatational wave, 2 Hz/100 Hz in frequency, 30 min. When the resting-state visual analogue scale (VAS) of incision was more than 3 points, the patient-controlled intravenous analgesia (PCIA) pump of sufentanil was administered to maintain the VAS no more than 3 points. The time point when PCIA pump was firstly used, the used dose of sufentanil and effective pressing number of PCIA pump within 24 hours after surgery were recorded. Intraoperative anesthetic doses were recorded in the three groups. The resting-state and task-state VAS were evaluated at 0, 6, 12, 24 hours after surgery; the patient's satisfaction rate and adverse effects were recorded. RESULTS:The time when PCIA pump was firstly used in the group A and the group B was significantly longer than that in the group C, and the used dose of sufentanil and effective pressing number of PCIA pump within 24 hours after surgery in the group A and group B were significantly less than those in the group C (all <0.05); the incidence of postoperative nausea-vomiting and sore throat was reduced (all <0.05). The time when PCIA pump was firstly used in the group A was significantly longer than that in the group B, and the used dose of sufentanil and effective pressing number of PCIA pump within 24 hours after surgery in the group A were significantly less than those in the group B (all <0.05); no significant difference of the incidence of postoperative nausea-vomiting and sore throat was observed between the group A and group B (both >0.05). There were no statistically significant difference in VAS score at different postoperative time points and postoperative analgesia satisfaction rate between the two groups (all >0.05). CONCLUSION:Perioperative TEAS could improve the postoperative analgesia in patients undergoing arthroscopic shoulder surgery, delay the time when PCIA pump is firstly used, reduce the dosage of postoperative analgesics and adverse events. Compared before surgery, postoperative TEAS has better analgesia.
Clinical Research on Prevention and Treatment of Respiratory Tract Complications With Acupoint Application After Operation Under General Anesthesia.
Lu Xiang-Hong,Zhang Xin-Mei,Liu Si-Lan,Jiang Fang-Qin,Ding Ren-Xian,Bin Xi,Jie Yang,Gou Xiao-Jun
The Journal of craniofacial surgery
There are various respiratory tract complications in patients undergoing general anesthesia, with postoperative sore throat (POST) being the most commonly seen. Although measures have been taken to prevent and treat POST in clinical practice, the control of POST is still not satisfactory. In this study, 880 ASA patients with grade I to II general anesthesia were randomly assigned into control group and experimental group. After patients entered into the operating room, the plasters were applied to the designated points (Tianzhu, Lianquan, Dazhui, etc), and the clinical efficacy of acupoint application in prevention and treatment of respiratory tract complications after general anesthesia was observed. The results showed that patients starting using acupoint application before operation could significantly reduce the incidence of postoperative respiratory tract complications, and the effects lasted for up to 24 hours. In this study, acupoint application was used, providing a simple, safe, efficient, and durable approach to prevent and treat respiratory tract complications after operation under general anesthesia.
Dexamethasone alone vs in combination with transcutaneous electrical acupoint stimulation or tropisetron for prevention of postoperative nausea and vomiting in gynaecological patients undergoing laparoscopic surgery.
Yang X-Y,Xiao J,Chen Y-H,Wang Z-T,Wang H-L,He D-H,Zhang J
British journal of anaesthesia
BACKGROUND:Postoperative nausea and vomiting (PONV) is commonly reported after surgery and anaesthesia. We compared the effects of combinations of electrical acupoint stimulation or tropisetron with dexamethasone with the effects of dexamethasone alone, for inhibition of PONV in gynaecological patients undergoing laparoscopic surgery. METHODS:We randomized 157 patients undergoing elective gynaecological laparoscopic surgery under general anaesthesia into the following three groups: acupoint stimulation+dexamethasone (Group Acu, n=53), tropisetron+dexamethasone (Group Trp, n=53), and dexamethasone alone (Group Dxm, n=51). The incidence of nausea, vomiting, and need for rescue antiemetics was recorded 2, 6, 24, and 48 h after surgery. RESULTS:We found significant differences in the incidence of PONV during 24 h after surgery between the combination therapy groups and the dexamethasone-alone group (P=0.021). In the first 24 h, 28% of patients in Group Acu, 26% of patients in Group Trp, and 50% of patients in Group Dxm experienced nausea, vomiting, or both. The incidence of 24 h PONV in Group Acu was significantly lower than that in Group Dxm (P=0.048; odds ratio 0.389; 95% CI 0.170-0.891). The incidence of 24 h PONV in Group Trp was also significantly lower than that in Group Dxm (P=0.042; odds ratio 0.359; 95% CI 0.157-0.819). There was no significant difference between Group Acu and Group Trp (P=0.857). The need for antiemetic rescue medication was similar in the three groups. All groups expressed similar patient satisfaction. CONCLUSIONS:Combined with dexamethasone, electrical acupoint stimulation or tropisetron is more effective in PONV prophylaxis than dexamethasone alone in gynaecological patients undergoing laparoscopic surgery. CLINICAL TRIAL REGISTRATION:NCT 02096835.
Transcutaneous Electrical Acupoint Stimulation Combined with Dexamethasone and Tropisetron Prevents Postoperative Nausea and Vomiting in Female Patients Undergoing Laparoscopic Sleeve Gastrectomy: a Prospective, Randomized Controlled Trial.
Xiong Qiuju,Min Su,Wei Ke,Yang Yanmei,Ma Jingyue,Liu Dan,Zeng Menghua,Zou Lei
BACKGROUND:Despite the administration of prophylactic antiemetics, some patients who undergo laparoscopic sleeve gastrectomy (LSG) remain at high risk for postoperative nausea and vomiting (PONV). Although many trials have been conducted, the effectiveness of transcutaneous electrical acupoint stimulation (TEAS) on the prevention of PONV remains unknown. METHODS:Sixty-two female patients undergoing elective LSG were randomly assigned to the TEAS combined with dexamethasone and tropisetron (TEAS group, n = 31) or dexamethasone and tropisetron (control group, n = 31) groups. The incidence and severity of PONV, as well as the need for rescue antiemetics, were collected within 48 h after surgery. RESULTS:The patients in both groups had similar clinical characteristics and underwent the same surgical procedure. In the TEAS group, 13 patients (41.9%) had PONV within 48 h after LSG compared to 24 patients (77.4%) in the control group (P = 0.004, relative risk: 0.39 [0.19, 0.80]). The severity of PONV differed significantly between groups, with five patients (16.1%) in the TEAS group and 15 patients (48%) in the control group experiencing clinically important PONV (P = 0.007, relative risk: 0.62 [0.42, 0.90]). Moreover, fewer patients required antiemetic rescue medication in the TEAS group compared with the control group (29.0% vs. 58.1%, P = 0.021). CONCLUSION:Multimodal antiemetic prophylaxis consisting of TEAS and antiemetics was effective in reducing PONV incidence and intensity in high-risk patients undergoing LSG.
Non-needle acupoint stimulation for prevention of nausea and vomiting after breast surgery: A meta-analysis.
Sun Ran,Dai Wei,Liu Yang,Liu Changli,Liu Yongning,Gong Ying,Sun Xiaohong,Shi Tieying,Song Mingzhi
BACKGROUND:Breast disease has been a global serious health problem, among women. Surgery is the main treatment for the patients suffering from breast disease. Postoperative nausea and vomiting are still disturbing. Acupoint stimulation, an effective treatment of traditional Chinese medicine, has been used to reduce postoperative nausea and vomiting. Recently, non-needle acupoint stimulation becomes a new intervention. Though several clinical trials have been done, there is still no final conclusion on the efficacy. This Meta-Analysis aims at evaluating the efficacy of non-needle acupoint stimulation for prevention of nausea and vomiting after breast surgery. METHODS:Systematic searches were conducted in PubMed, Embase, Cochrane, and Wanfang Med Online databases for studies. The review period covered from the inception of databases to December 31, 2017. The outcome measures of interest were frequency of nausea, frequency of vomiting, frequency of PONV, verbal rating scale of nausea, and use of rescue antiemetic. Data extraction and risks of bias evaluation were accomplished by 2 independent reviewers using the Cochrane Collaboration Review Manager software (RevMan 5.3.5). RESULTS:Fourteen randomized controlled trials with a total of 1009 female participants in the non-needle acupoint stimulation group and control group met the inclusion criteria. Although the therapeutically effect on vomiting within postoperative 2 hours was not obvious, non-needle acupoint stimulation still had an important role in reducing nausea and vomiting within postoperative 48 hours. According to Jadad scale, there was moderate quality evidence for the pooled analysis results in this study. In addition, stimulating acupoint by wristband acupressure was more likely to cause adverse reactions. CONCLUSION:Non-needle acupoint stimulation can be used for female patients undergoing breast surgery to reduce postoperative nausea and vomiting. Into consideration, we recommend transcutaneous acupoint electrical stimulation on PC6 from 30 minutes before induction of anesthesia to the end of surgery for application. This non-pharmaceutical approach may be promising to promote the recovery of patients after breast surgery.
[Clinical observation of acupoint application of Chinese herbal medicine in preventing postoperative nausea and vomiting after orthopaedic surgery under general anesthesia].
Zhongguo gu shang = China journal of orthopaedics and traumatology
OBJECTIVE:To explore clinical effect of acupoint application of Chinese herbal medicine in preventing postoperative nausea and vomiting after orthopaedic surgery under general anesthesia. METHODS:From January 2018 to December 2019, 168 patients who met inclusion criteria and were underwent selective spine surgery, were double-blind divided into two groups according to central random system, 84 patients in each group. In control group, there were 39 males and 45 females aged from 30 to 65 years old with an average of (53.83±9.17) years old, 37 patients were classified to typeⅠand 47 patients were typeⅡ according to American Society of Anesthesiologists (ASA) grading. In experiment group, there were 39 males and 45 females aged from 30 to 65 years old with an average of (54.08±9.00) years old; 32 patients were classified to typeⅠand 52 patients were typeⅡ according to ASA grading. Both of two groups were obtained acupoint application before anesthesia induction, and acupoint application were put on (CV 12) and bilateral (PC 6) for 6 h, changed after 24 h, last for 2 d. The drug prescription of plasters in experimental group was consist of Rhizome Pinelliae Preparata, Ginger and Clove. The plasters in control group was consistent with drug plasters in experimental group in appearance and smell to the greatest extent. The ingredients were flour and excipients with 10% of experimental drug concentration. Incidence of nausea vomiting, visual analogue scale (VAS) of narusea degree at 24 h and 24 to 48 h after operation between two groups were compared, SF- 12 simple quality of life score before operation, 24 and 48 h after operation were also compared by using R3.6.1 Rstudio software by the third-party. RESULTS:There were no statistical differences in incidence of nausea vomiting, VAS of narusea degree at 24 h after operation (>0.05), while there were no differences in incidence of nausea vomiting, VAS of narusea degree at 24 to 48 h after operation (>0.05) . There were no statistical differences in SF-12 before operation, 24 and 48 h after opertaion (>0.05). CONCLUSION:The curative effect of acupoint application of traditional Chinese medicine on the prevention and treatment of postoperative nausea and vomiting is not obvious.
Acupuncture in preventing postoperative nausea and vomiting: efficacy of two acupuncture points versus a single one.
Alizadeh Reza,Esmaeili Sara,Shoar Saeed,Bagheri-Hariri Shahram,Shoar Nasrin
Journal of acupuncture and meridian studies
Despite recent advances in anesthesiology and postoperative care, postoperative nausea and vomiting are common complaints. Although acupuncture techniques have received attention in anesthesiology, the ideal technique and selection of the most appropriate acupuncture points are still under debate. This study compared the efficacy of two simultaneous acupuncture points with that of a single point in the prevention and treatment of postoperative nausea and vomiting following general anesthesia through a double-blind, randomized, controlled trial involving 227 surgical patients undergoing general anesthesia who were randomly assigned into two groups. The first group received acupuncture by stimulation only on the PC6 point (single group), and the second group underwent concomitant stimulation of the PC6 and the L14 acupuncture points (combined group) during surgery under general anesthesia. The prevalences of postoperative nausea and vomiting were compared between the two groups. No significant differences were observed between the two groups (p>0.05). Of 115 patients in the combined group, 80 (69.6%) complained about nausea and vomiting compared with 96 (85.7%) in the single group, a significantly lower proportion (p<0.05). Our findings favor a combination of PC6 and LI4 stimulation for the treatment of postoperative nausea and vomiting.
Acupuncture with different acupoint combinations for chemotherapy-induced nausea and vomiting: study protocol for a randomized controlled trial.
Gao Lili,Chen Bo,Zhang Qiwen,Zhao Tianyi,Li Bo,Sha Tao,Zou Jinxin,Guo Yongming,Pan Xingfang,Guo Yi
BMC complementary and alternative medicine
BACKGROUND:Acupuncture is beneficial for controlling chemotherapy-induced nausea and vomiting (CINV). However, the effect of different acupoint combinations on controlling CINV remains unknown. This study aims to compare the effects of distal-proximal point association and local distribution point association on controlling CINV. METHODS/DESIGN:The study is a single-center, randomized controlled trial. A total of 240 participants will be randomly divided into four groups. The control group will receive standard antiemetic only, whereas three acupuncture groups will receive four electro-acupuncture treatments once a day with the standard antiemetic. Acupuncture group I and II will receive distal-proximal point association ("Neiguan (PC6) and Zhongwan (CV12)", and "Zusanli (ST36) and CV12", respectively); Acupuncture group III will receive local distribution point association ("Shangwan (CV13) and CV12"). The primary outcome measures are the frequency and distress of nausea and vomiting. The secondary outcome measures are the grade of constipation and diarrhea, electrogastrogram, quality of life, etc. Assessment is scheduled from the day before chemotherapy to the fifth day of chemotherapy. Follow-ups are performed from the sixth day to the twenty-first day of chemotherapy. DISCUSSION:Results of this trial will help in evaluating the efficacy and safety of electro-acupuncture with different acupoint combinations in the management of CINV. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT02478047 .
[Clinical trial of gastroesophageal reflux disease with the disharmony between liver and stomach syndrome treated with acupuncture regulating based on the compatibility of the five meridians].
Pan Shimin,Li Jinxiang,Zhang Xi,Li Ying,Yan Jie,Zhang Wei,Hu Sha
Zhongguo zhen jiu = Chinese acupuncture & moxibustion
OBJECTIVE:To observe the clinical effects of the acupuncture regulating based on the compatibility of the five meridians and common western medication for gastroesophageal reflux disease with the disharmony between liver and stomach. METHODS:Sixty patients were divided into two groups according to non-erosive reflux disease (NERD) and reflux esophagitis (RE). Those in the two groups were randomly assigned into an observation group and a control group. There were 57 cases included (28 in the observation group with 2 dropping, 29 in the control group with 1 dropping). Based on the life care, patients in the observation group were treated with 30 min acupuncture regulating based on the compatibility of the five meridians at Zusanli (ST 36), Chongyang (ST 42), Weishu (BL 21), Zhongwan (CV 12), Xingjian (LR 2), Shaofu (HT 8), Dadun (LR 1), Taichong (LR 3), Ganshu (BL 18), Qimen (LR 14), Danzhong (CV 17), Zhongting (CV 16), three times a week. Patients in the control group were treated with rabeprazole orally. All the treatment was given for consecutive 8 weeks. The clinical symptom score was observed before and after treatment and 4 weeks after treatment. The effects were evaluated from 3 aspects, including the main symptoms, esophagitis improvement under gastroscope and total clinical symptoms. RESULTS:After treatment and at follow-up, the symptom scores decreased in the two groups compared with those before treatment (all <0.05), with better improvement in the observation group at follow-up (<0.05). The symptom scores after treatment of the two types in the two groups decreased compared with those before treatment (all <0.05). The total effective rate of heartburn after treatment in the observation group was 82.1% (23/28), which was lower than 93.1% (27/29) of the control group (<0.05). The total effective rate of belching after treatment in the observation group was 94.1% (16/17), which was better than 75.0% (15/20) in the control group (<0.05). The total effective rate of the esophagitis improvement under gastroscope after treatment in the observation group was 75.0% (12/16), and that in the control group was 82.4% (14/17), without statistical significance (>0.05). The total effective rate of the clinical symptoms after treatment in the observation group was 82.1% (23/28), and that in the control group was 86.2% (25/29), without statistical significance (>0.05). CONCLUSION:Acupuncture regulating based on compatibility of the five meridians can effectively improve clinical symptoms and inflammation under gastroscope for gastroesophageal reflux disease with the disharmony between liver and stomach. This treatment has a longer curative effect and a greater alleviation of belching.
The effectiveness of electro-acupuncture combined with dyclonine hydrochloride in relieving the side effects of gastroscopy: a controlled trial.
Chen Jian-Ming,Li Dong-Dong,Chen Yi-Shan,Lian Bo,Wang Xiao-Peng,Guo Yu-Hong,Xu Xiao-Long,Huang Po,Chen Teng-Fei,Liu Yang,Liu Qing-Quan
Annals of palliative medicine
BACKGROUND:The present study aimed to explore the effectiveness of electro-acupuncture (EA) in combination with a local anesthetic used in Western medicine in preventing the side effects of gastroscopy. METHODS:A sample group of 150 patients were divided into three groups based on treatment methods: an EA group, a dyclonine hydrochloride mucilage group, and a combined treatment group. In the EA group, EA stimulation was given at the Hegu, Neiguan, and Zusanli acupoints; in the dyclonine hydrochloride mucilage group, patients took 10 mL of dyclonine hydrochloride mucilage orally; in the combined treatment group, prevention of side effects was attempted by administration of both acupuncture and oral local anesthetic. The incidences of nausea, emesis, salivation, cough, restlessness, and breath holding during gastroscopy were observed and recorded for the three groups. Mean arterial pressure, heart rate, and oxygen saturation were recorded before the examination, and changes in these measures were recorded as the gastroscope passed through the pylorus and after the examination. The visual analogue scale (VAS) values of nausea and emesis, the rate of successful first-pass intubation, and the time of gastroscopy were also recorded. Statistical analysis was performed using R-3.5.3 software. RESULTS:Incidences of side effects (e.g., nausea, emesis, salivation, restlessness, and breath holding) during the examination were lower in the combined treatment group than in the EA group and the dyclonine hydrochloride mucilage group (P<0.05 and P<0.01, respectively). Furthermore, the changes in heart rate and oxygen saturation when the gastroscope passed through the pylorus and after the examination were better in the combined treatment group than in the EA group and dyclonine hydrochloride mucilage group (P<0.01). The VAS values of nausea and emesis, the first-pass success rate, and examination duration were also better for the combined treatment group than for the other two groups (P<0.05 and P<0.01). CONCLUSIONS:EA combined with local anesthesia with dyclonine hydrochloride mucilage can alleviate side effects during gastroscopy, reduce patient pain, and improve the efficiency of the procedure.
Transcutaneous Electrical Acupoint Stimulation Improves the Postoperative Quality of Recovery and Analgesia after Gynecological Laparoscopic Surgery: A Randomized Controlled Trial.
Yao Yusheng,Zhao Qiuyan,Gong Cansheng,Wu Yihuan,Chen Ying,Qiu Liangcheng,Wu Xiaodan,Chen Yanqing
Evidence-based complementary and alternative medicine : eCAM
Background. We conducted this prospective, randomized, double-blind, placebo-controlled study to evaluate the effects of transcutaneous electric acupoint stimulation (TEAS) on the quality of recovery (QoR) and postoperative analgesia after gynecological laparoscopic surgery. Methods. 74 American Society of Anesthesiologists physical status (ASA) I or II patients undergoing gynecological laparoscopic surgery were randomly allocated to TEAS or control groups. The primary outcome was the quality of recovery, which was assessed on the day before surgery and 24 h after surgery using a 40-item questionnaire. Secondary outcomes included postoperative pain scores, the incidence of postoperative nausea and vomiting (PONV), duration of postanesthesia care unit (PACU) stay, and patient's satisfaction. Results. The TEAS group had higher QoR scores than control group upon 24 h after surgery (177 versus 165; P < 0.001). Compared with the control group, postoperative pain scores and the cumulative number of opioids administered were lower in the TEAS group patients (P = 0.04). TEAS reduced the incidence of PONV and dizziness, as well as duration of PACU stay. Simultaneously, the patient's satisfaction scores were higher in the TEAS group (P = 0.002). Conclusion. Preoperative TEAS enhances QoR, improves postoperative analgesia and patient's satisfaction, alleviates postoperative side effects, and accelerates discharge after general anesthesia for gynecological laparoscopic surgery.
Does transcutaneous electric acupoint stimulation improve the quality of recovery after thyroidectomy? A prospective randomized controlled trial.
Chen Yanqing,Yang Yang,Yao Yusheng,Dai Dongsheng,Qian Bin,Liu Pingping
International journal of clinical and experimental medicine
BACKGROUND:We evaluated the effects of transcutaneous electric acupoint stimulation (TEAS) on the postoperative quality of recovery after thyroidectomy with general anesthesia in this prospective, randomized, double-blind, placebo-controlled study. METHODS:Eight-four American Society of Anesthesiologists physical status (ASA) I or II patients undergoing thyroidectomy were randomly allocated to TEAS or control groups. The primary outcome was the quality of recovery, which was assessed on the day before surgery and 24 h after surgery using the Quality of Recovery 40 questionnaire (QoR-40). Secondary outcomes included the incidence of postoperative nausea and vomiting (PONV), postoperative pain intensity, duration of post anesthesia care unit (PACU) stay and patient's satisfaction. RESULTS:Global QoR-40 score at 24 h after surgery was higher in the TEAS group (median [interquartile range], 183 [172-190]) compared with the control group (168 [154-183]) (P < 0.001). Compared with the control group, postoperative pain intensity and the cumulative number of opioids administered was lower in the TEAS group patients (P < 0.001). TEAS reduced the incidence of PONV and dizziness (P = 0.001), as well as the duration of PACU stay (P < 0.001). Simultaneously, the patient's satisfaction scores were higher in the TEAS group (P = 0.002). CONCLUSION:Preoperative TEAS enhances the quality of recovery, postoperative analgesia and patient's satisfaction, alleviates postoperative side effects and accelerates discharge after general anesthesia for thyroidectomy.
Transcutaneous electric acupoint stimulation at Jiaji points reduce abdominal pain after colonoscopy: a randomized controlled trial.
Chen Yanqing,Wu Weilan,Yao Yusheng,Yang Yang,Zhao Qiuyan,Qiu Liangcheng
International journal of clinical and experimental medicine
BACKGROUND:Transcutaneous electric acupoint stimulation (TEAS) at Jiaji acupuncture points has therapeutic potential for relieving viscera pain and opioid-related side effects. This prospective, randomized, triple-blinded, placebo-controlled trial was to investigate the efficacy of TEAS on abdominal pain after colonoscopy. METHODS:Consecutive outpatients with American Society of Anesthesiologists (ASA) physical status I or II underwent selective colonoscopy were randomly assigned into two groups for either TEAS or sham pretreatment. The primary outcomes were the incidence of abdominal pain after colonoscopy. The secondary outcomes included the incidence of abdominal distension, postoperative nausea and vomiting (PONV), duration of PACU stay, and patient's satisfaction and acceptance. RESULTS:Among the 229 patients analyzed, fewer occurrence of post-procedural abdominal pain (11.4% vs 25.2%, P = 0.007) and distension (1.8% vs 7.8%, P = 0.032) were observed in TEAS group, when compared with the sham group. The duration of PACU stay was significant shortened in TEAS group (P < 0.001). Meanwhile, patients' satisfaction score to medical service was higher (P < 0.001), and their acceptance to colonoscopy was improved (P = 0.011). CONCLUSION:Pretreatment with TEAS can reduce post-procedural discomfort, provide more efficient medical resources utilization, and improved patient's satisfaction and colonoscopy acceptance.
Electrical stimulation of the heart 7 acupuncture site for preventing emergence agitation in children: A randomised controlled trial.
Hijikata Toshiyuki,Mihara Takahiro,Nakamura Nobuhito,Miwa Takaaki,Ka Koui,Goto Takahisa
European journal of anaesthesiology
BACKGROUND:Emergence agitation is common in children recovering from general anaesthesia. The prevention of emergence agitation remains an important challenge in the field of paediatric anaesthesia. OBJECTIVE:We aimed to examine the effectiveness of electrically stimulating the heart 7 (HT7) acupuncture site with a peripheral nerve stimulator (PNS) during surgery, for preventing emergence agitation in paediatric patients recovering from general anaesthesia. DESIGN:A double-blind, randomised, controlled, parallel-group trial. SETTING:Kanagawa Children's Medical Centre, Yokohama, Japan. PATIENTS:One hundred and twenty patients aged 18 to 96 months (American Society of Anesthesiologists physical status I or II) undergoing minor elective surgery under general anaesthesia with sevoflurane. INTERVENTION:Patients were randomly assigned to either undergo bilateral stimulation of HT7 with two PNS devices (1 Hz, 50 mA) during surgery (Group HT7) or a control group that did not undergo electrical stimulation of HT7 during surgery. MAIN OUTCOME MEASURES:The primary outcome was the incidence of emergence agitation evaluated in the postanaesthesia care unit (PACU) using the Paediatric Anaesthesia Emergence Delirium scale. The secondary outcomes were the time from operation completion to tracheal extubation, PACU stay duration and postoperative pain scores. RESULTS:The incidence of emergence agitation was significantly lower in the HT7 group compared with the control group (31.7 vs. 56.7%, respectively; P = 0.010). The risk ratio was 0.56 (95% confidence interval 0.36 to 0.86) and the number needed to treat was 4 (95% confidence interval 3 to 13). There were no statistically significant differences between groups in time from operation completion to tracheal extubation, PACU stay duration or postoperative pain. CONCLUSION:Bilateral electrical stimulation of HT7 using two PNS devices significantly decreases the incidence of emergence agitation. TRIAL REGISTRATION:UMIN Clinical Trial Registry (registry number: UMIN000011704).
P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting in children.
Wang Shu-Ming,Kain Zeev N
BACKGROUND:P6 acupuncture in adults is reported to be an effective preventive treatment for postoperative nausea and vomiting (PONV). It is not clear, however, whether this technique is effective as a preventive treatment for PONV in children. METHODS:Children undergoing anesthesia and surgery were randomized to four groups: (a) intravenous saline + bilateral P6 acupoint injections (n = 50); (b) intravenous droperidol + bilateral P6 sham acupuncture (n = 49); (c) intravenous saline + bilateral sham point injections (n = 43); (d) intravenous saline +bilateral P6 sham acupuncture (n = 45). The perioperative anesthetic technique was standardized in all subjects. The incidence of postoperative nausea and vomiting (PONV) was evaluated in postanesthesia care unit (PACU) and 24 h after surgery. RESULTS:Incidence of nausea in the PACU was significantly lower in the acupoint group as compared with the sham point group (32% vs. 56%, P = 0.029) and P6 sham group (32% vs. 64%, P = 0.002) but not as compared with the droperidol group (32% vs. 46%, P = ns). Similarly, subjects in the acupoint group had a significantly lower incidence of vomiting in the PACU as compared with the sham point group (12% vs. 33%, P = 0.026) and P6 sham group (12% vs. 31%, P = 0.029) but not as compared with the droperidol group (12% vs. 18%, P = ns). The combined incidence of early PONV was also lower in the acupoint group as compared with the sham point group (P = 0.045) and P6 sham group (P = 0.004) but not as compared with the droperidol group (42% vs. 51%, P = ns). Finally, significantly fewer subjects in the acupoint group required intravenous ondansetron as an initial rescue therapy (P = 0.024). At 24 h after surgery, however, the incidence of late PONV was similar among the four study groups (P = ns). CONCLUSION:In children, P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting.
Effects of transcutaneous electrical acupoint stimulation at different frequencies on perioperative anesthetic dosage, recovery, complications, and prognosis in video-assisted thoracic surgical lobectomy: a randomized, double-blinded, placebo-controlled trial.
Huang Shun,Peng WenPing,Tian Xue,Liang Hansheng,Jia Zhe,Lo Theresa,He Miao,Feng Yi
Journal of anesthesia
BACKGROUND:Transcutaneous electrical acupoint stimulation (TEAS), a non-invasive and non-pharmacological adjunctive intervention for perioperative analgesia, may also reduce the incidence of postoperative pulmonary complications. The effect of TEAS on video-assisted thoracic surgical (VATS) patients is still unknown, however. The purpose of this study was to investigate the effects of TEAS of different frequency on perioperative anesthetic dosage, recovery, complications, and prognosis for patients undergoing VATS lobectomy. METHODS:Eighty VATS lobectomy patients with no previous experience of TEAS or acupuncture were randomly assigned to four groups: control (con), 2/100, 2, and 100 Hz. The last three experimental groups received TEAS at the indicated frequencies for 30 min before induction, during the operation, and for another 30 min 24 and 48 h after surgery. 2/100 Hz is a type of alternating frequency which goes between 2 and 100 Hz every 3 s. TEAS was administered over acupoints Neiguan, Hegu, Lieque, and Quchi on the sick lateral. Electrodes were applied to the patients in the control group, but no TEAS was used. Anesthetic dosage, blood gas analysis results, lung function indexes FEV and FVC, post-anesthesia care unit (PACU) status, postoperative complications, and quality of life scores were recorded and analyzed statistically. RESULTS:Intraoperative opioid consumption was lowest in the 2/100 Hz group, with statistical significance (con, P ≤ 0.001; 2 Hz, P ≤ 0.001; 100 Hz, P = 0.026). Compared with preoperative FEV and FVC, postoperative FEV and FVC were significantly lower in all groups; during one-lung ventilation, arterial oxygen partial pressure (PaO) decreased more slowly in the 2/100 Hz group than in the con group (P = 0.042). Moreover, in the 2/100 Hz group extubation time was shorter (P = 0.038), visual analgesia scale score lower (P = 0.047), and duration of PACU stay shorter (P = 0.043) than in the con group. In the 100 Hz group incidence of postoperative nausea and vomiting (PONV) was lower than the con group (P = 0.044). In all groups mean postoperative physical component scores were significantly lower than mean preoperative scores. CONCLUSIONS:TEAS is a safe noninvasive adjunctive intervention for anesthesia management among patients undergoing VATS lobectomy. TEAS at 2/100 Hz can reduce intraoperative opioid dosage and slow the decrease of PaO during one-lung ventilation. It can also effectively reduce pain score, extubation time, and PACU stay immediately after surgery. Further, 100 Hz TEAS can reduce PONV morbidity.
[Transcutaneous electrical acupoint stimulation promotes general anesthesia recovery in patients undergoing gastrointestinal surgery].
Tian Wei-Qian,Hu Cheng,Yang Guang
Zhen ci yan jiu = Acupuncture research
OBJECTIVE:To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on the recovery of patients undergoing gastrointestinal surgery under general anesthesia. METHODS:Sixty patients (ASA Ⅱ-Ⅲ) selected for scheduled gastrointestinal surgery were randomly divided into control group and TEAS group (=30 cases per group). Patients in the two groups received general anesthesia, and those of the TEAS group also received TEAS for 30 min (8-12 mA) immediately after surgery. The changes of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) before anesthesia, before acupoint stimulation, before extubation, immediately after extubation, 10 and 30 min after extubation were recorded. The recovery time of spontaneous breathing, extubation time, VAS scores and Bruggman comfort scale (BCS) scores at the time of discharging from postanesthesia care unit (PACU) were recorded. RESULTS:Compared with the control group, the recovery time of spontaneous breathing and extubation time were significantly shorter （<0.05）, the VAS score was significantly lower (<0.05), and the BCS score significantly increased in the TEAS group (<0.05). There were no significant differences between two groups in the levels of SBP, DBP and HR at each time point (>0.05). CONCLUSION:TEAS can accelerate the gastrointestinal surgery patients' recovery from general anesthesia, enhance the postoperative analgesic effect, improve patients' discomfort, has less adverse reactions, and is thus conducive to promote the postoperative rehabilitation.
[Effect of transcutaneous electrical acupoint stimulation on catheter related bladder discomfort after ureteroscopic lithotripsy].
Gao Peng,Shao Bing,Diao Yu-Gang,Zhang Tie-Zheng,Li Lin
Zhongguo zhen jiu = Chinese acupuncture & moxibustion
OBJECTIVE:To verify the efficacy of transcutaneous electrical acupoint stimulation (TEAS) on catheter related bladder discomfort after ureteroscopic lithotripsy. METHODS:Sixty male patients with selective ureteroscopic lithotripsy under general anesthesia were randomly divided into a TEAS group (30 cases, one case dropped off) and a sham TEAS group (30 cases, 2 cases dropped off). Before anesthesia induction, the patients in the TEAS group were treated with TEAS at Guanyuan (CV 4), Zhongji (CV 3), Zusanli (ST 36) and Sanyinjiao (SP 6) for 30 min, with disperse-dense wave, frequency of 2 Hz/ 15 Hz and current intensity of 6 to 10 mA. The patients in the sham TEAS group were treated with the same TEAS device at the same acupoints, but no electrical stimulation was given. After 30 min, anesthesia induction started. The total dosages of propofol and remifentanil in the two groups were recorded, and the time of operation and anesthesia, the time of wake-up and the time of stay in postanesthesia care unit (PACU) were recorded. The postoperative recovery was evaluated 5 min (T) after wake-up, 1 h (T), 2 h (T) and 6 h (T) after the operation, including the severity of urinary tract irritation and visual analogue scale (VAS) score. The occurrence of adverse reactions was observed, such as nausea and vomiting, dizziness and headache. RESULTS:The dosage of remifentanil in the TEAS group was significantly lower than that in the sham TEAS group (<0.05); but the dosage of propofol had no significant difference between the two groups (>0.05). Compared with the sham TEAS group, the incidence of more-than-moderate urinary tract irritation symptoms in the TEAS group was reduced (<0.05), and the VAS scores 1 and 2 h after operation were reduced (<0.05). CONCLUSION:The 30-min TEAS at Guanyuan (CV 4), Zhongji (CV 3), Zusanli (ST 36) and Sanyinjiao (SP 6) before anesthesia induction could significantly control the severity of postoperative urinary tract irritation in patients with ureteroscopic lithotripsy, reduce the dosage of anesthetic drugs and relieve postoperative pain.
[Effect of acupoint stimulation on the quality of recovery in patients with radical thyroidectomy under the concept of enhanced recovery after surgery: a randomized controlled trial].
Jiang Qun,Mo Yun-Chang,Jin Dan,Jin Wen-Jun,Pan Yuan-Yuan,Wang Yu-Fei,Du Wen-Wen,Wang Jun-Lu
Zhongguo zhen jiu = Chinese acupuncture & moxibustion
OBJECTIVE:To observe the effect of acupoint stimulation on the quality of recovery in patients with radical thyroidectomy under the concept of enhanced recovery after surgery (ERAS). METHODS:A total of 62 patients with radical thyroidectomy were randomized into an observation group and a control group, 31 cases in each one. In both of the two groups, general anesthesia with tracheal intubation was applied, the same anesthesia induction and maintenance medication were given. In the observation group, auricular point pressing with magnetic beads was adopted at bilateral shenmen (TF) and transcutaneous electrical acupoint stimulation (dilatational wave, 2 Hz/100 Hz in frequency, 6 to 12 mA) was performed at bilateral Hegu (LI 4) and Neiguan (PC 6) from 30 min before anesthesia induction to the end of the anesthesia. In the control group, medical adhesive plaster was pasted at bilateral shenmen (TF) and the electrodes were plastered at bilateral Hegu (LI 4) and Neiguan (PC 6) with no corresponding stimulation. In both of the two groups, visual analogue scale for anxiety (VAS-A) score was observed to evaluate the anxiety severity before anesthesia induction; the total intraoperative dosages of sufentanil, remifentanil and propofol were recorded; the numerical rating scale (NRS) score was used to assess the pain severity of instant time (T0) and 30 min (T1) of entering post-anesthesia recovery room (PACU), motor and static mode at 2 h (T2), 6 h (T3), 12 h (T4), 24 h (T5) after surgery; time of first anal exhaust, time of getting out of bed after surgery, total hospitalization time and the incidences of postoperative nausea and vomiting were observed; the quality of recovery was assessed by the 40-item quality of recovery score (QoR-40). RESULTS:The VAS-A score and the total intraoperative dosage of remifentanil in the observation group were reduced compared with the control group (<0.05). The NRS scores at T0-T4 in the observation group were lower than those in the control group (<0.01, <0.05), while the difference between the two groups in NRS score at T5 was not significant (>0.05). The time of first anal exhaust and getting out of bed after surgery in the observation group were advanced than those in the control group (<0.05), there was no significant difference between the two groups in total hospitalization time and incidences of postoperative nausea and vomiting (>0.05). Compared with the control group, the QoR-40 score was increased in the observation group (<0.05). CONCLUSION:Acupoint stimulation can improve the preoperative anxiety in patients with radical thyroidectomy, reduce the intraoperative anesthetic dosage and postoperative pain, advance the time of anal exhaust and getting out of bed, improve the quality of postoperative recovery and enhance the recovery process.
[Effect of electroacupuncture on laparoscope postoperative shivering in patients undergoing general anesthesia].
Fang Rui,Zhou Min-Tao,Zhang Cai-Ju,Fu Jin-Hou
Zhongguo zhen jiu = Chinese acupuncture & moxibustion
OBJECTIVE:To observe the effect of electroacupuncture (EA) on laparoscope postoperative shivering in patients undergoing general anesthesia and explore its effect mechanism. METHODS:A total of 80 patients with elective laparoscopic resection of intestinal tumor under general anesthesia were randomly divided into an EA group and a tramadol group, 40 cases in each group. Thirty min prior to the end of the operation, in the EA group, EA was exerted at Neimadian and Zusanli (ST 36), with disperse-dense wave, 2 Hz/100 Hz in frequency, 1 mA in intensity, and lasting 30 min. In the tramadol group, tramadol hydrochloride injection was dropped intravenously, 1 mg/kg. The conditions of shivering, dizziness, nausea, vomiting and agitation were observed in the post-anesthesia care unit (PACU). Heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were observed before treatment (T), at the moment of extubation (T), in 3 min of extubation (T) and 1 h after operation (T). Using ELISA, at T and T, the expression levels of interleukin 6 (IL-6) and 5-hydroxytryptamine (5-HT) in plasma were detected separately. Choking and agitation were recorded during extubation. RESULTS:① In the EA group, the incidence of shivering, dizziness, nausea, vomiting and agitation in the PACU was lower than that in the tramadol group (<0.05). ②Compared with T, HR, SBP and DBP were increased at T and T in the tramadol group (<0.05). HR, SBP and DBP in the EA group were lower than the tramadol group at T and T (<0.05). ③Compared with T, the expression levels of IL-6 and 5-HT in plasma were increased at T in the tramadol group (<0.05). The expression levels of IL-6 and 5-HT in the EA group were lower than the tramadol group at T (<0.05). ④The incidence of choking and agitation during exudation in the EA group was lower than that in the tramadol group (<0.05). CONCLUSION:Electroacupuncture can reduce the incidence of laparoscopic postoperative shivering under general anesthesia. The potential mechanism mays related to the modulation of the expression levels of IL-6 and 5-HT caused by surgical trauma.
Auricular Acupressure in the Prevention of Postoperative Nausea and Emesis A Randomized Controlled Trial.
Feng Cynthia,Popovic Jovan,Kline Richard,Kim Jung,Matos Rafael,Lee Sarah,Bosco Joseph
Bulletin of the Hospital for Joint Disease (2013)
INTRODUCTION:Successful antiemesis contributes significantly to quality, safety, and patient satisfaction. Patients undergoing general anesthesia often experience postoperative nausea and vomiting (PONV). Acupressure offers a side effect-free alternative to common first-line antiemetics. Because the patient may perceive needle acupuncture as uncomfortable, acupressure is a desirable alternative for the prevention of PONV. METHODS:This study was a randomized, prospective, double-blinded clinical trial investigating the effect of acupressure in patients with a history of PONV and motion sickness. The three auricular acupressure points chosen were shen men, point zero, and the subcortex point. Rescue treatment for PONV with 4 mg intravenous ondansetron was used if the patient reported persistent nausea. A blinded observer recorded antiemetic rescue data, and postoperative analgesic use was recorded over 24 hours. Nausea, vomiting, and retching were assessed in the post-anesthesia care unit (PACU). RESULTS:Using univariate analysis, we ruled out the null hypothesis of equal means as a function of intervention group (p = 0.001). Pair-wise comparisons revealed a difference between placebo and test groups (p = 0.000) and also sham and test groups (p = 0.033) where age (p = 0.048) and gender (p = 0.003) were significant covariates. DISCUSSION:Our data reveal that auricular acupressure significantly decreases nausea during the PACU stay and within the 24 hours postoperatively. It is not clear whether the intervention decreases nausea as a primary effect or as a secondary result by decreasing narcotic requirements. Also, perception of nausea may be in part subjective. This is evidenced by our results in which subjects who received sham points fared better than the placebo subjects.
Effect of BL-10 (tianzhu), BL-11 (dazhu) and GB-34 (yanglinquan) acuplaster for prevention of vomiting after strabismus surgery in children.
Chu Y C,Lin S M,Hsieh Y C,Peng G C,Lin Y H,Tsai S K,Lee T Y
Acta anaesthesiologica Sinica
BACKGROUND:Stimulation of P6 (Neiguan) acupoint can prevent nausea and vomiting in adults. However, there is no antiemetic effect in children undergoing strabismus surgery. The effect of P6 may act only on hollow organs; in contrast, BL-10 (Tianzhu), BL-11 (Dazhu) and GB-34 (Yanglinquan) are more related to the meridians of the eye. Therefore these three more relevant acupoints, BL-10, BL-11 and GB-34 were stimulated to evaluate the antiemetic effect in children undergoing strabismus surgery. METHODS:Sixty-five children, ASA physical status I, between 3 and 14 years of age, were randomly divided into two groups as follows: placebo group (n = 31) and acuplaster group (n = 34). Bilateral acupressure using the Vital Point Needleless Acuplaster (Koa, Japan) was applied to BL-10, BL-11 and GB-34 points the night before surgery. Anesthesia was induced and maintained with halothane and nitrous oxide in oxygen. Postoperative emesis was assessed at early (at PACU) and late (at ward) phases, and was recorded by an investigator blind to the treatment characteristics. RESULTS:In the early emesis phase, the incidence of vomiting was 35.5% for placebo group, compared with 14.7% for acuplaster group. In the late emesis phase, acuplaster patients had a significantly lower incidence of vomiting (23.5% vs. 58.1% in placebo patients, p < 0.05). The overall postoperative vomiting incidence in the acuplaster patients in a 24 h period which was significantly decreased was 29.4% as opposed 64.5% in the placebo group (p < 0.05). CONCLUSIONS:The results demonstrated that prophylactic use of bilateral noninvasive acuplaster on the BL-10, BL-11, and GB-34 acupoints significantly reduces vomiting after strabismus correction. The mechanism may be dispersal of these three acupoints, thus diminishing the parasympathetic stimulation resulting from surgical traction of eye muscles.
The effects of acupressure on the incidence of postoperative nausea and vomiting in postsurgical patients.
Windle P E,Borromeo A,Robles H,Ilacio-Uy V
Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications. Aside from pharmacological interventions, other complementary healing modalities have been introduced to assist patients in decreasing PONV and improving postoperative outcomes. This study examined acupressure as a potentially holistic and safe complement to the more traditional approach of using drugs to prevent and/or relieve nausea and vomiting in the postoperative patient. Acupressure involves constant pressure (without puncture of the skin) on the Nei Guan acupuncture points through the use of a British product called Sea-Bands (Sea Band UK Ltd, Leics, England). These bands are made of elasticated fabric, with a small round plastic button inside. A quasi-experimental research design was used to examine the effects of unilateral and bilateral application of acupressure on 157 patients who are prone to PONV: postgynecological, postplastic, and posturological surgery patients. The incidence of PONV was determined through retrospective chart reviews. The hypothesis was that there would be a difference in the incidence of PONV between 5 groups: group 1 (Sea-Bands with acupressure on both wrists), group 2 (Sea-Bands with acupressure on one wrist), group 3 (wristband without acupressure on both wrists), group 4 (wristband without acupressure on one wrist), and group 5 (no wristband). This hypothesis was examined by using a one-way analysis of variance (ANOVA); it was not supported. Neither unilateral nor bilateral application of acupressure significantly affected the incidence of nausea and vomiting. These findings must be viewed with caution, however, because power analysis showed low effect sizes and an inadequate sample size. Further research is recommended with a larger sample size. This study has made perianesthesia nurses more aware of other complementary modalities to assist patients with nausea and vomiting.
Unilateral electrical stimulation of the heart 7 acupuncture point to prevent emergence agitation in children: A prospective, double-blinded, randomized clinical trial.
Nakamura Nobuhito,Mihara Takahiro,Hijikata Toshiyuki,Goto Takahisa,Ka Koui
BACKGROUND:Emergence agitation (EA) is a frequent phenomenon in children recovering from general anaesthesia and increases the risk of self-injury. Previously, our group reported that stimulating the heart 7 (HT7) acupuncture point bilaterally using two neuromuscular transmission monitoring devices (NTMs) decreased the incidence of EA. However, bilateral stimulation is a barrier to clinical use because two NTMs are needed for one patient. OBJECTIVE:The objective of this study was to examine the efficacy of unilateral electrical stimulation of HT7 using an NTM to prevent EA in children. DESIGN:Prospective, double-blinded, randomized clinical trial. SETTING:Kanagawa Children's Medical Centre, Yokohama, Japan. PATIENTS:One hundred children (ages 18-96 months) with ASA-PS I or II, who were scheduled to undergo inguinal hernia repair or orchiopexy under sevoflurane anaesthesia. INTERVENTION:Patients were randomly assigned to one of the following two groups: (1) HT7 group: unilateral (right side) stimulation of the HT7 acupuncture point using a single-twitch electrical stimulus (1 Hz, 50 mA) throughout the surgery, and (2) control group: electrodes alone were attached to the HT7 point on the right side; an electrical stimulus was not applied. MAIN OUTCOME MEASURES:The primary outcome was the incidence of EA evaluated using the pediatric anaesthesia emergence delirium (PAED) scale. The secondary outcomes were the incidence of EA evaluated using Aono's scale, the severity of EA, PACU stay duration, and postoperative pain. RESULTS:There was no statistical difference between the incidence of EA in the HT7 and the control group (28.0% and 24.0%, respectively; P > 0.99). The risk ratio was 1.17 (95% confidence interval: 0.60-2.27). CONCLUSIONS:We observed that there was no effect of unilateral single-twitch electrical stimulation to the HT7 on the incidence of EA, contrary to the findings with bilateral HT7 stimulation.
Effects of P6 stimulation on postoperative nausea and vomiting in laparoscopic cholecystectomy patients.
Carr Karen L,Johnson Faith E,Kenaan Charbel A,Welton John M
Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
PURPOSE:Postoperative nausea and vomiting (PONV) remains one of the most common postsurgical complications after anesthesia and surgery. Pericardium 6 (P6) stimulation is believed to prevent PONV and is a potential adjunctive treatment with pharmacologic agents. The purpose of this study was to compare the effects of P6 stimulation on PONV occurrence to a control group not receiving the P6 stimulation in sequential female patients undergoing laparoscopic cholecystecomy at a community hospital in central Florida between November 2010 and March 2013. DESIGN:This study is a double-blinded randomized controlled trial. METHODS:PONV was measured on admission to the postanesthesia care unit (PACU), at 30 and 60 minutes, at discharge from the PACU to home and at two points at home up to 6 hours and between 6 and 24 hours. FINDINGS:Of the 56 total patients, those in the P6 group (n = 26) had statistically significant lower incidence of PONV, 0%, vs 14.3% in the control group (n = 27; P < .05) on admission to the PACU, but at all other time points, there was no significant difference in PONV. Thirty-one percent of the patients in the P6 group had PONV in PACU or at home compared with 51.9% in the control group. CONCLUSIONS:The results of the study demonstrate that the use of P6 stimulation in the perioperative arena is clinically meaningful; however, more research is needed with a larger sample size.
Randomized controlled trial of acupuncture to prevent emergence delirium in children undergoing myringotomy tube placement.
Martin Christine S,Yanez N David,Treggiari Miriam M,Piper Lisa,Cusick Jordan,Lalwani Kirk
BACKGROUND:Myringotomy tube placement is a pediatric procedure frequently performed under inhalational anesthesia without intravenous line placement. Emergence delirium is common following sevoflurane anesthesia, and can lead to patient harm and escalation of nursing care. Our goal was to determine if intraoperative acupuncture, compared to standard of care, reduces emergence delirium in children undergoing myringotomy tube placement. METHODS:Single center, randomized, controlled trial at a university hospital, including children ages 1-6 years with ASA physical status 1-3 scheduled for myringotomy tube placement. Participants were stratified based on midazolam premedication and randomized to intraoperative acupuncture (AC, N.=49) or standard anesthesia care (SC, N.=50). Acupuncture needles were placed in bilateral Heart 7 (HT7) and ear Shen Men points after anesthesia induction. A blinded observer in the PACU assessed emergence delirium using the Pediatric Anesthesia Emergence Delirium (PAED) scale. Endpoints were highest PAED score in the recovery room and post-discharge agitation and sleep quality. RESULTS:Patient baseline characteristics were similar between treatment groups. With midazolam premedication, the highest PAED score was 11.6 in patients receiving AC and 12.0 for SC. Without midazolam premedication, the highest PAED was 11.8 in patients receiving AC and 10.7 for SC. The overall PAED score difference between AC and SC groups was 0.33 (95% CI -1.5, 2.2, P=0.723). CONCLUSIONS:Intraoperative acupuncture at HT7 and ear Shen Men did not reduce PAED scores after myringotomy tube placement. Based on these data, it is therefore unlikely that a larger study of the same design would demonstrate a significant effect of intraoperative acupuncture on emergence delirium after brief sevoflurane anesthesia. However, other acupuncture points or techniques could be considered.
Randomized trial of acupuncture with antiemetics for reducing postoperative nausea in children.
Martin Christine S,Deverman Sarah E,Norvell Daniel C,Cusick Jordan C,Kendrick Angela,Koh Jeffrey
Acta anaesthesiologica Scandinavica
BACKGROUND:Postoperative nausea and vomiting (PONV) is common after tonsillectomy in children. There is evidence that perioperative acupuncture at the pericardium 6 (P6) point is effective for preventing PONV in adults. Our goal was to determine if intraoperative acupuncture at the P6 point, in addition to usual antiemetics, is more effective than antiemetics alone in preventing PONV in children. METHODS:In a randomized double-blind trial, 161 children age 3 through 9 years undergoing tonsillectomy with or without adenoidectomy were randomized to either bilateral acupuncture at P6 plus antiemetics (n = 86) or antiemetics only (n = 75). All participants received ondansetron 0.15 mg/kg and dexamethasone 0.25 mg/kg, up to 10 mg. The presence of nausea, retching, emesis and administration of additional antiemetics were recorded during phases I and II of PACU recovery. Follow-up calls occurred on postoperative day 1 (POD 1). RESULT:During phase I and II recovery, the incidence of PONV was significantly less with acupuncture than without (7.0% vs 34.7%, RR: 0.2, 95% CI: 0.09-0.46; P < 0.001). The difference in PONV was driven by less nausea in the acupuncture group (5.0% vs 24.0%), with no difference in vomiting between the two groups. In the first 24 hours, PONV occurred in 36.1% with acupuncture and 49.3% without; these values did not differ significantly (P = 0.09). CONCLUSIONS:Children receiving acupuncture plus antiemetic therapy had less risk of developing nausea during phase I and II recovery, but there was no difference in PONV on POD 1. Acupuncture may reduce nausea in the PACU, even when combined with antiemetics.