A Randomized Controlled Trial Comparing the Efficacy of P6 Acupuncture Plus Ondansetron versus Ondansetron or P6 Acupuncture in the Prevention of Nausea and Vomiting after Bupivacaine-Morphine Spinal Anesthesia

Abstract

Objective: To compare P6 acupuncture plus ondansetron with either ondansetron or P6 acupuncture in the prevention of postoperative nausea and vomiting (PONV) in patients submitted to spinal anesthesia. Methods: A randomized controlled trial was performed with 90 patients undergoing orthopedic surgery under spinal anesthesia with bupivacaine, 15 to 17.5 mg, and morphine, 100 μg. They were assigned to one of the three groups: Group Ondansetron (n = 30), patients were given ondansetron, 8 mg intravenously, before spinal block was performed; Group P6 acupuncture (n = 30), patients were subjected to bilateral electrical stimulation of P6 acupoint for 30 minutes before anesthesia; and Group P6 acupuncture plus ondansetron (n = 30), the exact combination of the groups Ondansetron and P6 acupuncture. Results: In the post anesthesia care unit, the incidence of nausea and vomiting ranged from 13.3% to 26.7% and from 6.7% to 13.3%, respectively, with no significant differences among groups (p > 0.05). Ondansetron group had the highest incidence of nausea (73.3%) (p < 0.001) and vomiting (43.3%) (p < 0.001) at the ward from 0 to 24 hours, followed by P6 acupuncture (33.3% and 26.7%) and P6 acupuncture plus ondansetron groups (16.0% and 0%). Conclusion: Preoperative stimulation of P6 acupoint in combination with ondansetron has higher efficacy than either P6 acupoint stimulation or the administration of

Effects of Preoperative Acupuncture on Prevention of Nausea and Vomiting and Plasma Serotonin Values in the Hysterectomy Postoperative Period: a Randomized Clinical Trial

“…As described in a study published by our research group, PC6 is a point on the anterior surface of the forearm between the palmaris longus and the carpi radialis flexor tendons. It extends for a distance two times wider than the distance between the thumb interphalangeal joint and the distal wrist crease (almost four centimeters from the distal wrist crease) [11]. The needle is inserted into the skin perpendicularly until a sensation of pain, distension, and, at times, electrical sensation radiates to the fingers [16][17][18].…”

“…Acupuncture has been considered effective in the treatment of PONV when used before the induction of general anesthesia, as a single technique or combined with conventional antiemetics. The stimulation of the pericardium point 6 (PC6, Neiguam) is frequently used for treatment of PONV, anxiety, and motion sickness [11]. Needle insertion in the region of the PC6 point has been proven to be safe with no adverse effects and does not reach the level of the underlying muscle fascia [12].…”

“…Needle insertion in the region of the PC6 point has been proven to be safe with no adverse effects and does not reach the level of the underlying muscle fascia [12]. Studies have shown that digital pressure on the PC6 point is also effective in the treatment of PONV [11,13].…”

Effectiveness of the Use of Acupressure Wristband at Neiguan Point (P6) Towards Postoperative Nausea Vomiting (PONV) in Orthopedic Surgical Patients

“…Terhitung sebanyak 30% hingga 80% terjadi pada pasien yang berisiko tinggi (Pierre & Whelan, 2013). PONV terjadi sebagai salah satu efek samping dari pemberian anestesi, dilaporkan satu dari empat pasien yang menjalani operasi mengalami PONV (Yin et al, 2017) . Beberapa pasien melaporkan bahwa nausea dan vomiting setelah operasi dirasakan lebih buruk bila dibandingkan dengan nyeri setelah operasi (Porter & Gyawali, 2012).…”

“…Penanganan secara farmakologis telah dilakukan untuk mengatasi PONV. Beberapa regimen antiemetik telah digunakan, namun belum ada satupun yang mampu mencegah PONV hingga mencapai nol (Yin et al, 2017). Selain dengan farmakolis, diperlukan penanganan dengan cara non farmakologis salah satunya melalui acupressure (Dastgir, 2014).…”