Acupressure and the prevention of nausea and vomiting after laparoscopy

Abstract

The efficacy of currently available antiemetics remains poor. Concern with their side effects and the high cost of the newer drugs has led to renewed interest in non-pharmacological methods of treatment. We have studied the efficacy of acupressure at the P6 point in the prevention of nausea and vomiting after laparoscopy, in a double-blind, randomized, controlled study of acupressure vs placebo. We studied 104 patients undergoing laparoscopy and dye investigation. The anaesthetic technique and postoperative analgesia were standardized. Failure of treatment was defined as the occurrence of nausea and/or vomiting within the first 24 h after anaesthesia. The use of acupressure reduced the incidence of nausea or vomiting from 42% to 19% compared with placebo, with an adjusted risk ratio of 0.24 (95% CI 0.08-0.62; P = 0.005). Other variables were similar between groups.

Acupressure and ondansetron for postoperative nausea and vomiting after laparoscopic cholecystectomy

“…30 Acupuncture and acupressure at the P6 point is associated with mixed clinical results. Harmon, 4 Stein, 21 Fan, 31 and Dundee 27,32,33 have observed a decrease in the incidence of PONV after P6 stimulation. The important component of this treatment includes the timing of stimulation 31,34 and correct point location.…”

Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting

“…There were 10 types of P6 acupoint stimulation: needle acupuncture (Dundee 1986;Dundee 1989;Sharma 2007;Streitberger 2004;Yentis 1992); infiltration of dextrose (Tavlan 1996;Wang 2002;Yang 1993); semipermanent needles (Andrzejowski 1996); electrical stimulation of needles (Amir 2007;Dundee 1989;Ho 1989;Rusy 2002); transcutaneous electrical nerve stimulation (Fassoulaki 1993;Gan 2004;Habib 2006;Ho 1989); laser stimulation (Butkovic 2005;Schlager 1998); an acu-stimulation device (White 2002;Zarate 2001); and acupressure (Agarwal 2000;Agarwal 2002;Alkaissi 1999;Alkaissi 2002;Allen 1994;Barsoum 1990;Duggal 1998;Ferrara-Love 1996;Gieron 1993;Harmon 1999;Harmon 2000;Ho 1996;Klein 2004;Lewis 1991;Samad 2003;Schultz 2003;Turgut 2007). Two studies used conventional peripheral nerve stimulation (Arnberger 2007;Liu 2008).…”

“…Allocation sequence was generated using a computer-generated random numbers table (Agarwal 2000;Arnberger 2007;Gan 2004;Harmon 1999;Ho 1996;Klein 2004;Misra 2005;White 2002;Zarate 2001), a table of random numbers (Agarwal 2002;Duggal 1998;Liu 2008;Samad 2003;Schultz 2003), a block design procedure (Rusy 2002), and a yoking randomization based on a computer-generated list (Wang 2002). Four of the 40 trials reported adequate allocation concealment (Arnberger 2007;Gan 2004;Schultz 2003;Streitberger 2004).…”

“…No side effects were observed for patients receiving acupuncture (Dundee 1986;Dundee 1989;Sharma 2007); acupressure, in several trials (Agarwal 2000;Agarwal 2002;Gieron 1993;Harmon 1999;Ho 1996;Klein 2004;Lewis 1991); or transcutaneous electro-acupoint stimulation by a peripheral nerve stimulator (Liu 2008). Haematomas occurred in one patient in the acupuncture group and in two patients in the placebo acupuncture group (Streitberger 2004).…”

Acupressure wristbands do not prevent postoperative nausea and vomiting after urological endoscopic surgery

“…1 The incidence of PONV may be as high as 60-70% which is influenced by various factors in the perioperative period including patient characteristics. [2][3][4][5][6] The medications used to alleviate PONV may be associated with side effects varying from lethargy, restlessness, tachycardia and extrapyramidal symptoms.…”