Taiwanese Journal of Obstetrics and Gynecology
Volume 44, Issue 3 , Pages 242-246, September 2005

Effect of Auricular Acupressure Therapy for the Prevention of Postoperative Nausea and Vomiting After Gynecological Surgery

  • Pei-Shan Tsai

      Affiliations

    • Department of Anesthesiology, Mackay Memorial Hospital, Hsinchu, Taiwan
  • ,
  • Kun-Yi Lin

      Affiliations

    • Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Hsinchu, Taiwan

Department of Anesthesiology, Mackay Memorial Hospital, Taipei, Hsinchu, Taiwan

Received 8 January 2005; received in revised form 10 January 2005; accepted 11 January 2005.

Article Outline

Summary 

Objective

Postoperative nausea and vomiting (PONV) is still a troubling problem in patients who undergo gynecological surgery, especially in patients using morphine for patient-controlled analgesia (PCA). In this study, we investigated whether auricular acupressure therapy reduced the incidence of PONV.

Materials and Methods

A total of 150 female patients (ASA I-II, aged 18-65 years) scheduled to undergo myomectomy or hysterectomy were enrolled in this double-blind, placebo-controlled study and randomly assigned to one of three groups. In groups I and II, we taped seeds of Wangbuliuxing onto auricular points (two sets of four) and asked patients to compress these points four times a day. Group III acted as the control group.

Results

Data were available for 124 patients. The incidence of PONV in group I was significantly decreased in the first 2 days (day 1: 16%; day 2: 12%) compared with group II (day 1: 42%, p = 0.021; day 2: 32%, p = 0.048) and group III (day 1: 40%, p = 0.030; day 2: 35%, p = 0.023).

Conclusion

Auricular acupressure therapy at the shenmen, jiaogan, wei, and pizhixia points prevented PONV after gynecological surgery with PCA.

Key Words:  auricular acupressure therapy , patient-controlled analgesia , postoperative nausea and vomiting

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Pierre S , Corno G , Benais H , Apfel CC . A risk score-dependent antiemetic approach effectively reduces postoperative nausea and vomiting-a continuous quality improvement initiative . Can J Anaesth . 2004;51:320–325
  2. Sun R , Klein KW , White PF . The effect of timing of ondansetron administration in outpatients undergoing otolaryngologic surgery . Anesth Analg . 1997;84:331–336
  3. Graczyk SG , McKenzie R , Kallar S , et al.   Intravenous dolasetron for the prevention of postoperative nausea and vomiting after outpatient laparoscopic gynecologic surgery . Anesth Analg . 1997;84:325–330
  4. Wilson AJ, Diemunsch P, Lindeque BG, Scheinin H, Helbo-Hansen HS, Kroeks MV, et al. Single-dose i.v. granisetron in the prevention of postoperative nausea and vomiting . Br J Anaesth . 1996;76:515–518
  5. Cieslak GD , Watcha MF , Phillips MB , Pennant JH . The dose-response relation and cost-effectiveness of granisetron for the prophylaxis of pediatric postoperative emesis . Anesthesiology . 1996;85:1076–1085
  6. Mikawa K , Takao Y , Nishina K , Shiga M , Maekawa N , Obara H . Optimal dose of granisetron for prophylaxis against postoperative emesis after gynecological surgery . Anesth Analg . 1997;85:652–656
  7. Simpson K , Spencer CM , McClellan KJ . Tropisetron: an update of its use in the prevention of chemotherapy-induced nausea and vomiting . Drugs . 2000;59:1297–1315
  8. Henzi I , Walder B , Tramer MR . Dexamethasone for the prevention of postoperative nausea and vomiting: a quantitative systematic review . Anesth Analg . 2000;90:186–194
  9. Liu K , Hsu CC , Chia YY . The effect of dose of dexamethasone for antiemesis after major gynecological surgery . Anesth Analg . 1999;89:1316–1318
  10. Wang JJ , Ho ST , Lee SC , Liu YC , Ho CM . The use of dexamethasone for preventing postoperative nausea and vomiting in females undergoing thyroidectomy: a dose-ranging study . Anesth Analg . 2000;91:1404–1407
  11. Wang JJ , Ho ST , Tzeng JI , Tang CS . The effect of timing of dexamethasone administration on its efficacy as a prophylactic antiemetic for postoperative nausea and vomiting . Anesth Analg . 2000;91:136–139
  12. Domino KB , Anderson EA , Polissar NL , Posner KL . Comparative efficacy and safety of ondansetron, droperidol, and metoclopramide for preventing postoperative nausea and vomiting: a meta-analysis . Anesth Analg . 1999;88:1370–1379
  13. Fortney JT , Gan TJ , Graczyk S , et al.   A comparison of the efficacy, safety, and patient satisfaction of ondansetron versus droperidol as antiemetics for elective outpatient surgical procedures. S3A-409 and S3A-410 Study Groups . Anesth Analg . 1998;86:731–738
  14. Henzi I , Sonderegger J , Tramer MR . Efficacy, dose-response, and adverse effects of droperidol for prevention of postoperative nausea and vomiting . Can J Anaesth . 2000;47:537–551
  15. Kim Y , Kim CW , Kim KS . Clinical observations on postoperative vomiting treated by auricular acupuncture . Am J Chin Med . 2003;31:475–480
  16. Wang SM , Kain ZN . P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting in children . Anesthesiology . 2002;97:359–366
  17. Kotani N , Hashimoto H , Sato Y , et al.   Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses . Anesthesiology . 2001;95:349–356
  18. Windle PE , Borromeo A , Robles H , Ilacio-Uy V . The effects of acupressure on the incidence of postoperative nausea and vomiting in postsurgical patients . J Perianesth Nurs . 2001;16:158–162
  19. Alkaissi A , Stalnert M , Kalman S . Effect and placebo effect of acupressure (P6) on nausea and vomiting after outpatient gynaecological surgery . Acta Anaesthesiol Scand . 1999;43:270–274
  20. al Sadi M , Newman B , Julious SA . Acupuncture in the prevention of postoperative nausea and vomiting . Anaesthesia . 1997;52:658–661
  21. Schwager KL , Baines DB , Meyer RJ . Acupuncture and post-operative vomiting in day-stay paediatric patients . Anaesth Intensive Care . 1996;24:674–677
  22. Dundee JW , Ghaly RG , Bill KM , Chestnutt WN , Fitzpatrick KT , Lynas AG . Effect of stimulation of the P6 antiemetic point on postoperative nausea and vomiting . Br J Anaesth . 1989;63:612–618
  23. Lee A , Done ML . The use of nonpharmacologic techniques to prevent postoperative nausea and vomiting: a meta-analysis . Anesth Analg . 1999;88:1362–1369
  24. Abbate S . Chinese Auricular Acupuncture . Boca Raton, FL: CRC Press; 2004;
  25. Watcha MF , White PF . Postoperative nausea and vomiting. Its etiology, treatment, and prevention . Anesthesiology . 1992;77:162–184
  26. Chung A , Bui L , Mills E . Adverse effects of acupuncture. Which are clinically significant? . Can Fam Physician . 2003;49:985–989
  27. White A . A cumulative review of the range and incidence of significant adverse events associated with acupuncture . Acupunct Med . 2004;22:122–133
  28. Col C , Soran A , Col M . Can postoperative abdominal wound dehiscence be predicted? . Tokai J Exp Clin Med . 1998;23:123–127
  29. Temes R , Feteiha M , Mapel D , Crowell R , Ketai L , Wernly J . Esophageal rupture after regional anesthesia: report of two cases . J Clin Gastroenterol . 1999;28:360–363
  30. Brauer RB , Liebermann-Meffert D , Stein HJ , Bartels H , Siewert JR . Boerhaave's syndrome: analysis of the literature and report of 18 new cases . Dis Esophagus . 1997;10:64–68
  31. Nanji GM , Maltby JR . Vomiting and aspiration pneumonitis with the laryngeal mask airway . Can J Anaesth . 1992;39:69–70
  32. Apfel CC , Laara E , Koivuranta M , Greim CA , Roewer N . A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers . Anesthesiology . 1999;91:693–700

PII: S1028-4559(09)60146-7

doi:10.1016/S1028-4559(09)60146-7

Taiwanese Journal of Obstetrics and Gynecology
Volume 44, Issue 3 , Pages 242-246, September 2005