Acupuncture in the prevention of postoperative nausea and vomiting

Abstract

SummaryThe efficacy of intra-operative acupuncture at the PC6 point in the prevention of postoperative nausea or vomiting was studied. A double-blind randomised controlled study of acupuncture versus placebo was performed in 81 patients scheduled for day case gynaecological laparoscopic surgery. Failure of treatment was defined as the occurrence of nausea or vomiting prior to or within 24 h of discharge. The use of acupuncture reduced the incidence of postoperative nausea or vomiting in hospital from 65% to 35% compared with placebo and after discharge from 69% to 31% compared with placebo.

Chinese Medicine and Biomodulation in Cancer Patients—Part Two

“…Innovative single-blind RCTs have since confirmed these results [260][261][262] and led to a consensus statement from the U.S. National Institutes of Health that "acupuncture is a proven effective treatment modality for nausea and vomiting" 263 . A threearm RCT comparing conventional modern antiemetics (such as the 5-hydroxytryptamine 3 receptor antagonists), electroacupuncture, and the combination of antiemetic drugs and acupuncture clearly demonstrated that the combination arm was the most effective for preventing nausea and vomiting 264 .…”

Acupuncture modulates mechanical responses of smooth muscle produced by transmural nerve stimulation in gastric antrum of genetically hyperglycemic rats

“…The effects of acupuncture also vary depending on the points where it is applied, with site specific inhibitory or stimulatory effects of acupuncture on gastric motility being noted (Kametani et al, 1979;Sato et al, 1993). The PC-6 point at the wrist and the ST-36 point on the hind limb are the common loci used for the acupuncture treatment of gastric symptoms such as nausea and vomiting (Al-Sadi et al, 1997), suggesting that acupuncture at these points may stimulate gastric motility. In contrast, application of acupuncture to the abdomen has been used for the treatment of abdominal pain (Diehl, 1999;Gu, 1992), suggesting that the application of acupuncture to this point may inhibit gastric motility and reduce gastrospasm.…”

A reply

“…Because a primary outcome was not defined a priori, positive results are difficult to interpret as they might be due to multiple testing. On the other side, in this cited study as well as in another recent study with positive results [3], acupuncture was performed after induction of anaesthesia. This seems not to be an optimal treatment condition according to the further discussion of Lee.…”

“…A combination of other points, e.g. ST36, ST40, CV12, could better reflect everyday practice and recently studies adopted such approaches [3,4]. Second, recent trials with positive results in this area had a longer stimulation duration and the needles were maintained postoperatively [3,5].…”