ST36 acupoint injection with anisodamine for postoperative nausea and vomiting in female patients after bariatric surgery: a prospective, randomized controlled trial

Abstract

Background The use of multimodal pharmacological prophylactic regimes has decreased postoperative nausea and vomiting (PONV) in general but it still occurs in over 60% of female patients after bariatric surgery. This study aimed to evaluate the efficacy of ST36 acupoint injection with anisodamine in prevention of PONV among female patients after bariatric surgery. Methods Ninety patients undergoing laparoscopic sleeve gastrectomy were randomly allocated to anisodamine or control group at the ratio of 2:1. Anisodamine or normal saline was injected into Zusanli (ST36) bilaterally after induction of general anesthesia. The incidence and severity of PONV were assessed during the first 3 postoperative days and at 3 months. The quality of early recovery of anesthesia, gastrointestinal function, sleep quality, anxiety, depression, and complications were also evaluated. Results Baseline and perioperative characteristics were comparable between two groups. In the anisodamine group, 25 patients (42.4%) experienced vomiting within postoperative 24 h compared with 21 (72.4%) in the control group (relative risk 0.59; 95% confidence interval 0.40–0.85). Time to first rescue antiemetic was 6.5 h in anisodamine group, and 1.7 h in the control group (P = 0.011). Less rescue antiemetic was required during the first 24 h in the anisodamine group (P = 0.024). There were no differences in either postoperative nausea or other recovery characteristics. Conclusions The addition of ST36 acupoint injection with anisodamine significantly reduced postoperative vomiting without affecting nausea in female patients with obesity undergoing laparoscopic sleeve gastrectomy.

Effect of Zusanli Acupoint Injection with Anisodamine on Postoperative Recovery Quality of Patients Undergoing Bariatric Surgery

“…These results suggest that ST36 acupoint injection not only improves the quality of postoperative recovery but also that the pharmacological effect of anisodamine enhances this therapeutic impact. Interestingly, another study found that ST36 acupoint injection without or with anisodamine had no effect on the early recovery in the hospital and quality of life after discharge [ 10 ]. The difference in the results of our analyses may be due to the inconsistency in the gender of the patients involved in the study.…”

“…In recent years, ST36 acupoint injection of anisodamine has received increasing attention as a new therapeutic approach [ 9 ]. Studies have shown that ST36 acupoint injection of anisodamine has a good effect in improving PONV and other clinical adverse symptoms [ 10 ]. Therefore, the purpose of this study was to explore the effect of acupoint injection of anisodamine at ST36 on the quality of early recovery after bariatric surgery, in order to provide reference for clinical practice.…”

A Review on the Chemical Properties, Plant Sources, Anti‐shock Effects, Pharmacokinetics, Toxicity, and Clinical Applications of Anisodamine

“…It is proven that the incorporation of ST36 acupoint injection with anisodamine yielded a significant reduction in postoperative vomiting among female patients with obesity who underwent laparoscopic sleeve gastrectomy, while not exerting any discernible impact on nausea. [82] In addition, Wang et al conducted a study demonstrating that the administration of anisodamine via acupoint injection can treat intractable hiccups following a stroke, and iacupoint injection of anisodamine combined with chlorpromazine produces superior outcomes for patients with intractable hiccups after stroke, while also exhibiting a high level of safety and potential for clinical application. [83] Numerous studies have demonstrated that the co-administration of anisodamine with conventional drug therapy yields enhanced therapeutic outcomes.…”