Perioperative Acupuncture and Postoperative Acupressure Can Prevent Postoperative Vomiting following Paediatric Tonsillectomy Or Adenoidectomy: A Pragmatic Randomised Controlled Trial

Abstract

Objective To investigate the effectiveness of acupuncture and acupressure as supplements to standard treatment for postoperative vomiting in children undergoing tonsillectomy and/or adenoidectomy. Methods A pragmatic, open, block-randomised controlled trial. The results were analysed according to the intention-to-treat principle. The study was conducted without extra resources in a normal setting at the day-surgery department of Lovisenberg Diakonale Hospital in Oslo. 154 children with an American Society of Anesthesiologists grade 1-2, weighing at least 10 kg, were included. Children with concomitant gastrointestinal diseases, emesis or antiemetic treatment <24 h preoperatively, rash or local infection over the actual acupuncture points were excluded together with patients whose parents' informed consent could not be obtained. The intervention group received acupuncture at pericardium 6 bilaterally, at a depth of approximately 0.7 cm with a median of 21 min during anaesthesia, followed by acupressure wristbands for 24 h and standard treatment. The control group received standard treatment. The primary end point was the occurrence of vomiting or retching during 24 h postoperatively. Results Children in the acustimulation group experienced less retching and vomiting than the control group-46.8% versus 66.2% (p=0.015). The effect of acustimulation was specifi cally pronounced in girls and children aged 1-3 years. Conclusion This trial indicates the effectiveness of acustimulation as an adjunct to standard treatment. The results should encourage and promote the implementation of acustimulation for postoperative vomiting in children undergoing adenoidectomy or tonsillectomy.

Acupuncture in ambulatory anesthesia: a review

“…[52][53][54][55][56][57][58][59][60] One study found acupuncture partly effective for pain, 61 and one study found acupressure effective for vomiting, but not nausea.…”

“…Four studies reported the need for rescue medication 52,61,62 64,66 and five reported adverse events. 37,53,57,59,63 Discomfort and treatment satisfaction were reported twice. 37,59,60,62 Resumption to normal activity, complete response, emergence agitation, parent satisfaction, and recovery time were reported once each.…”

“…37,53,57,59,63 Discomfort and treatment satisfaction were reported twice. 37,59,60,62 Resumption to normal activity, complete response, emergence agitation, parent satisfaction, and recovery time were reported once each. 53,58,60,62 Characteristics of the acupuncture and acupressure studies are presented in Tables 1 and 2.…”

“…59 For maintenance anesthesia, ten studies used volatile anesthetics, 52,[54][55][56]58,60,[62][63][64][65] four studies used intravenous anesthetics, 57,59,61,66 a multicenter study included both volatile and intravenous anesthetics, 37 and in one study anesthesia was not specified. 53 The studies encompassed a range of types of surgery, including strabismus surgery, tonsillectomy, and laparoscopic cholecystectomy.…”

“…58 One study reported on acupuncture applied to the PC6 acupoint to treat sore throat due to intubation. 56 Acupuncture or acupressure was initiated before the induction of anesthesia in seven studies, 52,53,55,62,[64][65][66] during anesthesia in five studies, 37,56,[58][59][60] and postoperatively in three studies. 54,57,61 One study tested both preoperative and perioperative acupuncture.…”