穴位按压腕带联合托烷司琼对乳腺癌根治术患者术后早期恢复质量的影响

目的评价穴位按压腕带联合托烷司琼对乳腺癌根治术患者术后恶心呕吐(PONV)以及早期恢复质量的影响。方法择期全麻下行乳腺癌根治术患者75例,年龄35~68岁,ASAⅠ或Ⅱ级。采用随机数字表法将患者分为三组:穴位按压腕带组(A组,25例)、托烷司琼组(B组,25例)、穴位按压腕带联合托烷司琼组(C组,25例)。A组:麻醉诱导前30 min,患者双侧前臂内关穴放置穴位按压腕带直至术后24 h。B组:手术结束前30 min静脉注射托烷司琼6 mg。C组:麻醉诱导前30 min,患者双侧前臂内关穴放置穴位按压腕带直至术后24 h;手术结束前30 min静脉注射托烷司琼6 mg。三组均接受全凭静脉麻醉。观察并记录拔管即刻、拔管即刻~术后6 h、术后6~24 h时间段恶心呕吐发生情况及严重程度。分别于术前1 d、术后1 d采用Qo R-40量表对患者进行分项评估。结果与A、B组比较,C组拔管即刻~术后6 h PONV发生率明显降低(P0.05),且术后24 h恶心呕吐分级明显降低(P0.05)。术后1 d C组身体舒适度评分、情绪状态评分和疼痛评分明显高于A、B组(P0.05或P0.01),Qo R-40总评分明显高于A、B组(P0.01)。结论穴位按压腕带联合托烷司琼能降低术后恶心呕吐发生率及严重程度,提高乳腺癌根治术患者术后早期恢复质量。     

加巴喷丁术前用药在开腹子宫切除术后镇痛效应的Meta分析

目的系统评价加巴喷丁术前用药对开腹子宫切除术患者术前用药的效果及安全性。方法电子检索PubMed、Cochrane、Embase、Ovid、Springer Link、Web of Science、CNKI、万方、维普等数据库,收集2000~2016年发表的加巴喷丁术前用药的随机对照试验(randomized controlled trial,RCT)文献,按Cochrane指导手册的方法选择文献、提取资料及评价研究质量后,采用RevMan5.3软件进行Meta分析。结果共纳入10篇RCT文献,共计609例患者。Meta分析结果显示,与对照组比较,加巴喷丁组术后24h阿片类麻醉药物的累积用量明显减少(WMD=-8.83mg,95%CI-12.70~-4.97,P0.001);VAS评分无明显降低(WMD=-7.70mm,95%CI-18.22~2.82,P=0.15);呕吐的发生率明显降低(RR=0.49,95%CI 0.35~0.69,P0.001)。两组术后24h内恶心的发生率(RR=0.73,95%CI 0.45~1.17,P=0.19)和嗜睡的发生率(RR=2.08,95%CI0.62~6.92,P=0.23)差异无统计学意义。结论开腹子宫切除术的患者加巴喷丁术前用药能够有效地降低阿片类麻醉药物的累积用量,减少呕吐的发生率,而对术后疼痛、恶心以及嗜睡无明显影响。     

椎管内麻醉与全身麻醉对关节置换术效果的Meta分析

目的通过Meta分析的方法评价椎管内麻醉与全身麻醉对关节置换术的效果。方法计算机检索Pubmed、Web of Science、Cochrane Library、中国知网、中国生物医学数据库,检索中华系列杂志相关文献,收集所有评价椎管内麻醉与全身麻醉对关节置换术效果的随机对照试验(RCT),筛选出符合的文献,并严格评价纳入研究的方法学质量。统计学软件采用Cochrane协作网提供的RevMan 5.3。结果最终纳入21篇符合标准的RCT,共包含1 874例患者。Meta合并分析显示:与全身麻醉比较,椎管内麻醉可明显减少关节置换术术中出血量(WMD=-97.52ml,95%CI=-173.60~-21.44,P=0.01),明显降低关节置换术深静脉血栓发生率(RR=0.68,95%CI=0.48~0.95,P=0.02)、肺栓塞发生率(RR=0.58,95%CI=0.35~0.91,P=0.03)、术后恶心呕吐发生率(RR=0.74,95%CI=0.60~0.92,P=0.008)。亚组分析显示,未使用抗凝药时椎管内麻醉可明显降低深静脉血栓发生率(RR=0.51,95%CI=0.38~0.69,P0.001)和肺栓塞发生率(RR=0.34,95%CI=0.18~0.65,P=0.001)。结论椎管内麻醉在关节置换术中可有效改善患者术中情况,降低术后不良反应发生率。     

前锯肌平面阻滞减轻胸腔镜术后阿片类药物镇痛所致恶心呕吐的meta分析

目的评价前锯肌平面阻滞(serratus anterior plane block,SAPB)用于减轻胸腔镜术后阿片类药物所致恶心呕吐的有效性和安全性。方法计算机检索PubMed、Ovid、Cochrane Library、ISI Web of knowledge、中国生物医学文献数据库(CBM)、中文科技期刊全文数据库(VIP)、中国期刊全文数据库(CNKI)及万方数据库中SAPB用于胸腔镜术后镇痛的随机对照试验(RCT),对照组为注入安慰剂或不阻滞,检索时间均从建库至2019年12月。2位研究者按照纳入标准筛选文献、提取资料,2位评价员独立对纳入文献的质量进行评价,采用RevMan5.3进行meta分析。结果纳入12个RCT共703例患者。在有效性方面,与对照组相比,SAPB组术后各时点静息状态、运动状态下疼痛视觉模拟评分(Visual Analogue Scale,VAS)降低,差异有统计学意义;在安全性方面,与对照组相比,SAPB组术后恶心呕吐发生率较低,差异有统计学意义(RR=0.36,95%CI:0.20～0.65,P=0.0006),SAPB组术后24 h吗啡累积使用量较少,差异有统计学意义(MD=-1.51,95%CI:-1.93～-1.10,P0.00001)。结论 SAPB能够降低胸腔镜术后恶心呕吐发生率,减少术后阿片类镇痛药物的使用,用于胸腔镜术后镇痛安全有效。     

穴位敷贴加穴位按摩防治全麻术后恶心呕吐

目的探讨穴位敷贴加穴位按压防治全麻术后患者恶心呕吐的疗效,为防治全麻术后恶心呕吐提供有效方法。方法将外科全麻术后患者随机分为对照组(69例)和观察组(72例),对照组行常规治疗护理,观察组采用足三里、内关穴敷贴加按压防治术后恶心呕吐。结果两组术后24h恶心呕吐程度比较,差异有统计学意义(P<0.01)。结论穴位敷贴加穴位按摩防治外科全麻术后恶心呕吐疗效确切;操作简便、价廉、不良反应少,提高了患者的舒适度。     

术前持续服用抗血小板药物对颈动脉内膜剥脱术术后出血影响的Meta分析

目的采用Meta分析比较颈动脉内膜剥脱术(carotid endarterectomy,CEA)患者术前持续服用抗血小板药物对术后出血的影响。方法检索Pubmed、Cochrane Library、Embase数据库、中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方数据库和维普期刊网,时间从建库至2017年2月。收集所有关于术前服用抗血小板药物与CEA术后出血的随机对照试验(RCT)研究。采用Cochrane协作网系统评价法评价文献质量,采用RevMan 5.3软件对收集患者资料进行Meta分析评价。结果最终纳入4篇RCT,共514例患者,其中安慰剂组256例,干预组258例。所有结局指标各项研究结果无异质性(P0.1,I250%),采用固定效应模型分析。CEA术前持续服用抗血小板药物可明显降低CEA术后脑卒中风险(RR=0.30,95%CI 0.11~0.83,P=0.02)。两组术后30d(RR=0.23,95%CI 0.04~1.32,P=0.1)及1年全因死亡率(RR=0.49,95%CI 0.24~1.02,P=0.06)、大出血发生率(RR=1.40,95%CI 0.54~3.59,P=0.49)和出血并发症发生率(RR=1.02,95%CI0.15~6.96,P=0.98)及TIA发生率(RR=1.08,95%CI 0.47~2.49,P=0.86)差异无统计学意义。结论颈动脉内膜剥脱术前持续服用阿司匹林不增加术后出血并发症风险,但可明显降低术后脑卒中风险。     

择期腹腔镜胆囊切除术预防性使用抗生素的作用Meta分析

目的:评价预防性使用抗生素在择期腹腔镜胆囊切除术中的作用。方法:检索相关数据库,收集在2003年1月—2014年12月期间公开发表的关于预防性使用抗生素在择期腹腔镜胆囊切除术的随机对照试验(RCT),按纳入排除标准进行文献筛选、资料提取和方法学质量评价后,采用Rev Man 5.2.10软件进行Meta分析。结果:最终共纳入9篇RCT研究,共2 316例患者,其中预防组1 165例,对照组1 151例。Meta分析结果显示,预防组与对照组比较,术后总感染率(RR=0.98,95%CI=0.59~1.61)、表浅切口感染率(RR=0.82,95%CI=0.48~1.41)及胆汁培养阳性率(RR=0.82,95%CI=0.64~1.05)差异均无统计学意义(均P0.05);在纳入包含糖尿病及胆绞痛的RCT中,总感染率及表浅切口感染率差异无统计学意义(均P0.05)。结论:择期腹腔镜胆囊切除术预防性使用抗生素不能降低术后感染的发生率,但该结论仍需多中心、大样本、前瞻性RCT研究验证。     

经胸封堵术与直视修补术治疗室间隔缺损的系统评价与Meta分析

目的比较经胸微创封堵与开胸直视修补治疗室间隔缺损的疗效。方法计算机检索Pub Med、EMbase、The Cochrane Library、VIP、CNKI、CBM、Chinese Clinical Trial Register、Clinical Trials.gov及万方数据库,检索时间为建库至2016年7月31日。筛选满足纳入标准的文献,提取数据并评价文献质量,采用Rev Man 5.0和Stata 14.0进行Meta分析。结果 11篇文献满足纳入标准,其中5篇随机对照试验(RCT),6篇队列研究,共2 504例患儿。RCT的Meta结果显示两种手术成功率差异无统计学意义(RR=0.99,95%CI 0.96~1.03,P=0.70);队列研究发现经胸封堵组的手术成功率低于直视修补组(OR=0.21,95%CI 0.08~0.55,P=0.002)。RCT和队列研究的结果一致发现经胸微创封堵组相对于开胸直视修补组,手术时间(RCT MD=–79.38,95%CI–95.00~–63.76,P0.000 01;队列研究MD=–66.26,95%CI–71.20~–61.31,P0.000 01),住院时间(RCT MD=–2.10,95%CI–2.65~–1.55,P0.000 01;队列研究MD=–3.99,95%CI–6.03~–1.94,P=0.000 1)均缩短,且需输血例数也减少(RCT RR=0.04,95%CI 0.01~0.11,P0.000 01;队列研究OR=0.01,95%CI 0.00~0.13,P=0.001)。RCT和队列研究结果均发现经胸封堵术能降低术后心律失常发生率(RCT RR=0.20,95%CI 0.13~0.32,P0.000 01;队列研究OR=0.46,95%CI 0.31~0.67,P0.000 1)。RCT发现经胸封堵术会增加瓣膜反流风险(RR=1.45,95%CI1.07~1.96,P=0.02);队列研究提示经胸封堵术能降低瓣膜反流发生率(OR=0.43,95%CI 0.20~0.92,P=0.03)。RCT和队列研究均未发现两组间术后残余分流发生率差异有统计学意义(RCT RR=0.96,95%CI 0.57~1.62,P=0.89;队列研究OR=0.52,95%CI 0.12~2.25,P=0.38)。结论经胸微创封堵治疗室间隔缺损能缩短患者手术时间、住院时间,减少术中术后的输血例数和术后心律失常的发生。对于合适的室间隔缺损患者,经胸微创封堵术优于开胸直视修补术。     

围术期经皮穴位电刺激对术后胃肠功能影响的Meta分析

目的：系统评价经皮穴位电刺激（TEAS）促进术后胃肠功能恢复的效果。
方法：计算机检索中国知网、万方、维普、Embase、PubMed等数据库,纳入有关TEAS对术后胃肠功能影响的随机对照试验（RCT）,采用Cochrane系统评价手册5.1推荐的RCT质量评价工具进行方法学质量评价。采用RevMan 5.3、Stata 15进行Meta分析。
结果：共纳入34篇RCTs,患者3 593例,TEAS组1 781例,非TEAS组1 812例。与非TEAS组比较,TEAS组术后24 h内恶心发生率（RR=0.46,95%CI 0.36～0.59,P<0.001）、术后24 h内呕吐发生率（RR=0.47,95%CI 0.37～0.59,P<0.001）明显降低,术后肠鸣音恢复时间（MD=-6.42 h,95%CI -8.53～-4.32 h,P<0.001）、术后首次肛门排气时间（MD=-8.72 h,95%CI-10.64～-6.80 h,P<0.001）、术后首次排便时间（MD=-11.83 h,95%CI -14.67～-8.98 h,P<0.001）明显缩短。
结论：TEAS可促进术后胃肠功能恢复,明显降低术后24 h内恶心、呕吐发生率,缩短术后首次肛门排气、排便时间。     

昂丹司琼预防麻醉后寒战有效性和安全性的Meta分析

目的评价昂丹司琼预防麻醉后寒战的有效性和安全性。方法计算机检索Cochrane Library、PubMed、Embase、CNKI、万方、维普等数据库,检索时间为建库至2018年8月,纳入以昂丹司琼预防麻醉后寒战为研究目的,研究组为昂丹司琼,对照组为生理盐水或哌替啶或曲马多的随机对照试验,采用RevMan 5.3对数据进行Meta分析,根据不同对照组、不同麻醉方式及不同剂量进行亚组分析。结果共纳入16项研究,1 443例受试者。有效性方面,研究组寒战发生率明显低于生理盐水组(RR=0.42,95%CI 0.35～0.51,P0.001);与哌替啶组(RR=0.68,95%CI 0.44～1.05,P=0.09)及曲马多组(RR=2.07,95%CI 0.90～4.75,P=0.09)差异无统计学意义;在3个不同麻醉方式亚组(RR=0.44,95%CI 0.36～0.54,P0.001),2个不同剂量亚组(RR=0.41,95%CI 0.34～0.49,P0.001)中,研究组寒战发生率明显低于生理盐水组。安全性方面,研究组术后恶心呕吐发生率明显低于生理盐水组(RR=0.27,95%CI 0.16～0.46,P0.001)。结论昂丹司琼可有效预防麻醉后寒战的发生,其效果与哌替啶、曲马多相当,并且可明显减少术后恶心呕吐的发生。     

Acupressure wristbands do not prevent postoperative nausea and vomiting after urological endoscopic surgery

PURPOSE: To evaluate the efficacy of acupressure wristbands in the prevention of postoperative nausea and vomiting (PONV). METHODS: Two hundred ASA I-II patients undergoing elective endoscopic urological procedures were included in a randomized, prospective, double blind, placebo-controlled study. Spherical beads of acupressure wristbands were placed at the P6 points in the anterior surface of both forearms in Group I patients (acupressure group, n = 100) whereas, in Group 2 (control group, n = 100) they were placed inappropriately on the posterior surface. The acupressure wristbands were applied 30 min before induction of anesthesia and were removed six hours postoperatively. Anesthesia was induced with thiopental and maintained with nitrous oxide and oxygen, fentanyl, isoflurane and vecuronium. The tracheas were extubated on the operation table after patients received neostigmine and atropine. Post operative nausea and vomiting were evaluated separately as none, mild, moderate or severe at the time of patient's arrival in PACU, then at six hours and twenty-four hours after surgery by a blinded observer. RESULTS: In the acupressure group, 25 patients had PONV compared with 29 patients in the control group (P = NS). CONCLUSION: Application of acupressure wristbands at the P6 of both forearms 30 min before induction of anesthesia did not decrease the incidence of PONV in patients undergoing endoscopic urological procedures.     

Korean hand acupressure reduces postoperative nausea and vomiting after gynecological laparoscopic surgery

To investigate the effectiveness of prophylactic Korean hand acupressure in the prevention of postoperative vomiting in women scheduled for minor gynecological laparoscopic surgery, we conducted a double-blinded, randomized, placebo-controlled study. In one group (n = 40), acupressure was performed 30 min before the induction of anesthesia by using special acupressure seeds, which were fixed onto the Korean hand acupuncture point K-K9 and remained there for at least 24 h. The second group (n = 40) functioned as the Placebo group. The treatment groups did not differ with regard to demographics, surgical procedure, or anesthetic administered. In the Acupressure group, the incidence of nausea and vomiting was significantly less (40% and 22.5%) than in the Placebo group (70% and 50%). We conclude that Korean hand acupressure of the acupuncture point K-K9 is an effective method for reducing postoperative nausea and vomiting in women after minor gynecological laparoscopic surgery. IMPLICATIONS: This randomized study was performed to investigate the antiemetic effect of the Korean hand acupuncture point K-K9. Acupressure of K-K9 reduces the incidence of postoperative nausea and vomiting in female patients after minor gynecological laparoscopic surgery.     

Effect and placebo effect of acupressure (P6) on nausea and vomiting after outpatient gynaecological surgery

BACKGROUND: Acupuncture and acupressure have previously been reported to possess antiemetic effect. We wanted to investigate the "true" and placebo effect of acupressure in prevention of postoperative nausea and vomiting (PONV). PATIENTS AND METHODS: Sixty women undergoing outpatient minor gynaecological surgery were entered into a double-blind and randomised study. One group received acupressure with bilateral stimulation of P6 (A), a second group received bilateral placebo stimulation (P) and a third group received no acupressure wrist band and served as a reference group (R). PONV was evaluated as number of patients with complete response (no PONV), nausea only or vomiting. In addition, the need for rescue antiemetic medication and nausea after 24 h was registered. RESULTS: Complete response was obtained in 11, 11 and 9 patients in groups, A, P and R, respectively. Nine, 7 and 6 patients had nausea before discharge home, and 1, 1 and 8 patients were nauseated (8 vs 1 patient: P < 0.05) 24 h after operation in A, P and R groups, respectively. When compared to placebo acupressure (2 patients vomited and 5 needed rescue), significantly (P < 0.05) fewer needed rescue antiemetic medication after acupressure at P6 (no vomiting or rescue medication). When compared to the observation group (5 vomited and 4 needed rescue antiemetics), significantly fewer vomited after acupressure (P < 0.05) CONCLUSION: In patients undergoing brief gynaecological surgery, placebo effect of acupressure decreased nausea after 24 h but vomiting and need of rescue antiemetics was reduced only by acupressure with the correct P6 point stimulation.     

Acupressure for intrathecal narcotic-induced nausea and vomiting after caesarean section

In this randomized double-blind trial we investigated the effect of acupressure on the incidence of nausea and vomiting after caesarean section under spinal anaesthesia with added intrathecal morphine. Parturients wore either acupressure or placebo wristbands during surgery and postoperatively for at least 10 h. There was no significant difference overall between the two groups in the incidence of intra- or postoperative nausea or vomiting/retching. Demand for antiemetic medication was also similar in the two groups. However, in the sub-group of parturients who gave a previous history of postoperative nausea or vomiting, there was a statistically significant reduction in both postoperative nausea and vomiting/retching in the acupressure group. Further investigations are needed to see whether acupressure may be an effective non-pharmacological, non-invasive treatment for a common problem in this sub-group of patients.     

P6 acupressure does not prevent emesis during spinal anesthesia for cesarean delivery

Nausea and vomiting are major adverse effects during spinal anesthesia for cesarean delivery. Stimulation of the P6 (Neiguan) acupoint is a traditional Chinese acupuncture technique used for effective antiemetic purposes. In this study, we evaluated the antiemetic effect of P6 acupressure in parturients during spinal anesthesia for cesarean delivery. In a randomized, double-blind, controlled trial, 110 parturients scheduled for elective cesarean delivery were enrolled in the study. Thirty minutes before initiation of spinal anesthesia, parturients were randomized to acupressure bands or placebo bands bilaterally on the P6 acupoint and nausea and vomiting were observed over the study period. There were no statistically significant differences in maternal characteristics. Incidence rates for intraoperative nausea were 64% (acupressure group) and 71% (control group) (P = 0.416), with an incidence of intraoperative vomiting of 22% (acupressure group) and 27% (control group) (P = 0.506). The results suggest that prophylactic use of acupressure bands bilaterally on the P6 acupoint failed to prevent nausea and vomiting during spinal anesthesia for cesarean delivery.     

Acupressure and prevention of nausea and vomiting during and after spinal anaesthesia for caesarean section

The efficacy of acupressure at the P6 point in the prevention of nausea and vomiting during and after Caesarean section was studied. A double- blind, randomized controlled study of acupressure vs placebo was designed. Ninety-four patients scheduled for Caesarean section were included. The anaesthetic technique and postoperative analgesia were standardized. The use of acupressure reduced the incidence of nausea or vomiting from 53% to 23% compared with placebo (95% confidence interval (CI) 0.34-0.25; P = 0.002) during the operation and from 66% to 36% compared with placebo (95% CI 0.34-0.19; P = 0.003) after the operation. Other variables were similar between the groups.      

The use of nonpharmacologic techniques to prevent postoperative nausea and vomiting: a meta-analysis.

We assessed the efficacy of nonpharmacologic techniques to prevent postoperative nausea and vomiting (PONV) by systematic review. These studies included acupuncture, electroacupuncture, transcutaneous electrical nerve stimulation, acupoint stimulation, and acupressure. Of the 24 randomized trials retrieved by a search of articles indexed on the MEDLINE and EMBASE databases (1980-1997), 19 were eligible for meta-analysis. The primary outcomes were the incidence of nausea, vomiting, or both 0-6 h (early efficacy) or 0-48 h (late efficacy) after surgery. The pooled relative risk (RR) and numbers needed to treat (NNT) were calculated. In children, no benefit was found. Some results in adults were significant. Nonpharmacologic techniques were similar to antiemetics in preventing early vomiting (RR = 0.89 [95% confidence interval 0.47-1.67]; NNT = 63 [10-infinity]) and late vomiting (RR = 0.80 [0.35-1.81]; NNT = 25 [5-infinity]) in adults. Nonpharmacologic techniques were better than placebo at preventing early nausea (RR = 0.34 [0.20-0.58]; NNT = 4 [3-6]) and early vomiting in adults (RR = 0.47 [0.34-0.64]; NNT = 5 [4-8]). Nonpharmacologic techniques were similar to placebo in preventing late vomiting in adults (RR = 0.81 [0.46-1.42]; NNT = 14 [6-infinity]). Using nonpharmacologic techniques, 20%-25% of adults will not have early PONV compared with placebo. It may be an alternative to receiving no treatment or first-line antiemetics. IMPLICATIONS: This systematic review showed that nonpharmacologic techniques were equivalent to commonly used antiemetic drugs in preventing vomiting after surgery. Nonpharmacologic techniques were more effective than placebo in preventing nausea and vomiting within 6 h of surgery in adults, but there was no benefit in children.     

Effect of P-6 acupressure on prevention of nausea and vomiting after epidural morphine for post-Cesarean section pain relief

Background: Nausea and vomiting are important side effects following administration of epidural morphine for post-Cesarean section pain relief. Stimulation of the P-6 (Neiguan) acupoint is a traditional Chinese acupuncture modality used for antiemetic purpose; it has been found to be effective. The aim of this study was to evaluate the antiemetic effect of P-6 acupressure in parturients given epidural morphine for post-Cesarean section pain relief.
Method: In a randomized, double-blind and controlled trial, sixty parturients receiving epidural morphine for post-Cesarean section pain relief were investigated. Parturients were allocated to receive the acupressure bands or placebo bands on the P-6 acupoint bilaterally before the administration of spinal anesthesia and were observed over a 48-hour study period.
Results: The incidence of nausea and vomiting was significantly decreased from 43% and 27% in the control group, to 3% and 0% in the acupressure group, respectively ( P <0.05).
Conclusion: The results demonstrate that prophylactic use of acupressure bands bilaterally on the P-6 acupoint can significantly reduce incidence of nausea and vomiting after epidural morphine for post-Cesarean section pain relief.     

Acupressure and the prevention of nausea and vomiting after laparoscopy

The efficacy of currently available antiemetics remains poor. Concern with their side effects and the high cost of the newer drugs has led to renewed interest in non-pharmacological methods of treatment. We have studied the efficacy of acupressure at the P6 point in the prevention of nausea and vomiting after laparoscopy, in a double-blind, randomized, controlled study of acupressure vs placebo. We studied 104 patients undergoing laparoscopy and dye investigation. The anaesthetic technique and postoperative analgesia were standardized. Failure of treatment was defined as the occurrence of nausea and/or vomiting within the first 24 h after anaesthesia. The use of acupressure reduced the incidence of nausea or vomiting from 42% to 19% compared with placebo, with an adjusted risk ratio of 0.24 (95% CI 0.08-0.62; P = 0.005). Other variables were similar between groups.      

P6 acupressure increases tolerance to nauseogenic motion stimulation in women at high risk for PONV

PURPOSE: In a previous study we noticed that P6 acupressure decreased postoperative nausea and vomiting (PONV) more markedly after discharge. As motion sickness susceptibility is increased by, for example, opioids we hypothesized that P6 acu-pressure decreased PONV by decreasing motion sickness susceptibility. We studied time to nausea by a laboratory motion challenge in a group of volunteers, during P6 and placebo acupressure. METHODS: 60 women with high and low susceptibilities for motion sickness participated in a randomized and double-blind study with an active P6 acupressure, placebo acupressure, and a control group (n = 20 in each group). The risk score for PONV was over 50%. The motion challenge was by eccentric rotation in a chair, blindfolded and with chin to chest movements of the head. The challenge was stopped when women reported moderate nausea. Symptoms were recorded. RESULTS: Mean time to moderate nausea was longer in the P6 acu-pressure group compared to the control group. P6 acupressure = 352 (259-445), mean (95% confidence interval) in seconds, control = 151 (121-181) and placebo acupressure = 280 (161-340); (P = 0.006). No difference was found between P6 and placebo acupressure or placebo acupressure and control groups. Previous severity of motion sickness did not influence time to nausea (P = 0.107). The cumulative number of symptoms differed between the three groups (P < 0.05). Fewer symptoms were reported in the P6 acupressure compared to the control group P < 0.009. Overall, P6 acupressure was only marginally more effective than placebo acupressure on the forearms. CONCLUSION: In females with a history of motion sickness P6 acu-pressure increased tolerance to experimental nauseogenic stimuli, and reduced the total number of symptoms reported.