Electroacupuncture Prophylaxis of Postoperative Nausea and Vomiting following Pediatric Tonsillectomy with or without Adenoidectomy

Abstract

Perioperative P6 electroacupuncture in awake patients significantly reduced the occurrence of nausea compared with the sham and control groups, but it did not significantly reduce the incidence or number of episodes of emesis or the use of rescue antiemetics. Sham acupuncture may exacerbate the severity but not the incidence of emesis. The efficacy of P6 acupuncture for PONV prevention is similar to commonly used pharmacotherapies. Its appropriate role in prevention and treatment of PONV requires further study.

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

“…Most trials recruited healthy adults undergoing elective surgery. Seven trials recruited children (Butkovic 2005;Lewis 1991;Rusy 2002;Schlager 1998;Shenkman 1999;Wang 2002;Yentis 1992). One trial recruited both children and adults (Amir 2007).…”

“…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).…”

“…Unclear There was no description about side effects of therapy in the trial, but in the correspondence (Rusy 2002) the authors wrote "There were no noted muscle contractions or patients who complained of paresthesias during the study".…”

“…For example, P6 acupoint stimulation significantly reduced the risk of PONV in some studies (Amir 2007;Butkovic 2005;Ho 1996;Rusy 2002;Turgut 2007;Wang 2002) but not in others (Agarwal 2000;Allen 1994;Barsoum 1990;Misra 2005;Shenkman 1999). One systematic review (Vickers 1996), using a 'vote counting' approach, suggested that acupuncture may not be effective in the prevention of PONV.…”