The effect of acupuncture on postoperative pain, nausea and vomiting after pediatric tonsillectomy: a systematic review

Pouy, Somaye; Etebarian, Abolfazl; Azizi-Qadikolaee, Ali; Saeidi, Solmaz

doi:10.1515/ijamh-2018-0285

Cited by 10 publications

(6 citation statements)

References 38 publications

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“…PONV has a high incidence in pediatric patients, especially for tonsillectomy and strabismus surgery (40)(41)(42). Recent studies had shown that PONV could lead to several adverse consequences, such as dehydration, electrolyte imbalance, and the wound dehiscence (43,44).…”

Section: Discussionmentioning

confidence: 99%

The Safety of Propofol Versus Sevoflurane for General Anesthesia in Children: A Meta-Analysis of Randomized Controlled Trials

Zhao

Feng²,

Liu³

et al. 2022

Front. Surg.

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BackgroundPropofol and sevoflurane are the most used anesthetics for pediatric surgery. Emergence agitation, postoperative nausea and vomiting and postoperative pain are the primary adverse effect of these general anesthetics. Many clinical studies had compared the safety of propofol and sevoflurane in pediatric surgery, but the results were controversial.ObjectivesTo evaluate the evidence surrounding the safety of propofol versus sevoflurane for general anesthesia in children.MethodsDatabases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data and Vip Data were searched to collect relevant articles. Trials were strictly selected according to previously defined inclusion and exclusion criteria. RevMan 5.3 software was used for meta-analyses.ResultsTwenty randomized controlled trials recruiting 1,550 children for general anesthesia were included, with overall low-moderate methodological quality. There was evidence that compared with sevoflurane anesthesia, propofol anesthesia significantly decreased the incidence of emergence agitation (OR = 4.99, 95% CI, 3.67–6.80; P < 0.00001), postoperative nausea and vomiting (OR = 1.91, 95% CI, 1.27–2.87; P = 0.002) and postoperative pain (OR = 1.72, 95% CI, 1.11–2.64; P = 0.01) in children. However, patients who received sevoflurane tended to have shorter times to eye opening (MD = −2.58, 95% CI, −2.97– −2.19; P < 0.00001) and times to extubation (MD = −1.42, 95% CI, −1.81– −1.02; P < 0.00001).ConclusionsThis review reveals that the children who received propofol anesthesia had the lower risks of emergence agitation, postoperative nausea and vomiting and postoperative pain when compared with sevoflurane anesthesia. But the children who received sevoflurane recovered slightly faster than those received propofol. Considering the limitations of the included studies, better methodological quality and large controlled trials are expected to further quantify the safety of propofol and sevoflurane for general anesthesia in children.

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Section: Discussionmentioning

confidence: 99%

The Safety of Propofol Versus Sevoflurane for General Anesthesia in Children: A Meta-Analysis of Randomized Controlled Trials

Zhao

Feng²,

Liu³

et al. 2022

Front. Surg.

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“…In the pediatric population, acupuncture, electroacupuncture, and laser acupuncture at the P-6 acupoint have all been used to prevent POV after tonsillectomy and/or adenoidectomy, hernia repair, circumcision, orchidopexy, chemotherapy, and strabismus procedures 321, [350][351][352][353][354][355][356][357][358][359][360][361][362] . However, there are other studies that used these modalities in both adults and children with negative results [363][364][365][366] .…”

Section: Nonpharmacologic Therapies For Ponv and Pdnvmentioning

confidence: 99%

“…Acupoints such as Laogong (PC8), Waiguan (SJ5), Zusanli (ST36), Hegu (LI4), and Quchi (LI11) can be used for reducing PONV as well 338 – 349 . In the pediatric population, acupuncture, electroacupuncture, and laser acupuncture at the P-6 acupoint have all been used to prevent POV after tonsillectomy and/or adenoidectomy, hernia repair, circumcision, orchidopexy, chemotherapy, and strabismus procedures 321 , 350 – 362 . However, there are other studies that used these modalities in both adults and children with negative results 363 – 366 .…”

Section: Nonpharmacologic Therapies For Ponv and Pdnvmentioning

confidence: 99%

Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review

et al. 2020

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Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) remain common and distressing complications following surgery. The routine use of opioid analgesics for perioperative pain management is a major contributing factor to both PONV and PDNV after surgery. PONV and PDNV can delay discharge from the hospital or surgicenter, delay the return to normal activities of daily living after discharge home, and increase medical costs. The high incidence of PONV and PDNV has persisted despite the introduction of many new antiemetic drugs (and more aggressive use of antiemetic prophylaxis) over the last two decades as a result of growth in minimally invasive ambulatory surgery and the increased emphasis on earlier mobilization and discharge after both minor and major surgical procedures (e.g. enhanced recovery protocols). Pharmacologic management of PONV should be tailored to the patient’s risk level using the validated PONV and PDNV risk-scoring systems to encourage cost-effective practices and minimize the potential for adverse side effects due to drug interactions in the perioperative period. A combination of prophylactic antiemetic drugs with different mechanisms of action should be administered to patients with moderate to high risk of developing PONV. In addition to utilizing prophylactic antiemetic drugs, the management of perioperative pain using opioid-sparing multimodal analgesic techniques is critically important for achieving an enhanced recovery after surgery. In conclusion, the utilization of strategies to reduce the baseline risk of PONV (e.g. adequate hydration and the use of nonpharmacologic antiemetic and opioid-sparing analgesic techniques) and implementing multimodal antiemetic and analgesic regimens will reduce the likelihood of patients developing PONV and PDNV after surgery.

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“…Others have studied the therapeutic effect of acupuncture following tonsillectomy, vascular surgery, childbirth, irritable bowel disease and colonoscopy. 18 –20,25 –28 In this study, the most common region of pain was the back (21%). Of note, Federman et al 11 observed a higher rate of chronic musculoskeletal back conditions (40%).…”

Section: Discussionmentioning

confidence: 66%

Battlefield acupuncture appears to be an effective therapy for pain management

2021

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Introduction: The Department of Defense has been training primary care providers in battlefield acupuncture (BFA), a subtype of auricular acupuncture, as an adjunct therapy for pain management. Methods: The objective of this study was to evaluate the effectiveness and safety of BFA for pain management in an outpatient Internal Medicine clinic staffed by resident physicians. The target population for this single-center prospective cohort study were military beneficiaries at a medical treatment facility located at the Wright-Patterson Air Force Base. Participants who met inclusion criteria were treated with BFA in addition to routine standard care for pain (n = 69). The control group was composed of participants who received routine standard care only without BFA (n = 27). Pain was assessed by a self-reported pain scale (0–10) at the time of encounter, immediately after BFA (for the intervention group), then at 24 and 48 h afterwards. Results: Mean pain for the intervention group decreased from 5.45 before BFA to 3.29 immediately following BFA to 2.21 at 24 h and to 2.10 at 48 h (p < 0.001). Thus, at all three post-treatment time points, mean decrease in pain surpassed a two-point reduction, deemed to be a clinically important difference. The BFA group had a greater reduction in pain compared to the no intervention group at 24 h (3.14 vs 0.59, p < 0.001) and at 48 h (3.26 vs 0.96, p < 0.001). Four intervention group participants (6%) reported an adverse reaction (three with pain at the insertion site) or complication (one with superficial infection). Conclusion: BFA provided by Internal Medicine residents appears to be a safe and effective adjunct therapy for pain management in an outpatient setting, but requires further validation by randomized controlled trials.

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The effect of acupuncture on postoperative pain, nausea and vomiting after pediatric tonsillectomy: a systematic review

Cited by 10 publications

References 38 publications

The Safety of Propofol Versus Sevoflurane for General Anesthesia in Children: A Meta-Analysis of Randomized Controlled Trials

The Safety of Propofol Versus Sevoflurane for General Anesthesia in Children: A Meta-Analysis of Randomized Controlled Trials

Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review

Battlefield acupuncture appears to be an effective therapy for pain management

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