Description bilateral Neiguan (PC6) and Zusanli (ST36)
Experimental Description
40 patients scheduled for elective gynecologic laparoscopic surgery, were randomly assigned to the usual care (UC) group and the EA group (n=20 each). Both groups received the routine treatment consisting of intravenous Dexamethasone (5 mg) after induction of anesthesia and intravenous Tropisetron(5 mg) before the end of the operation.
Sample Count
40
Age
18-50
Control
Std
usual care (UC) group(n=20)
Experiment
EA group(n=20)
Indicator
Postoperative Nausea and Vomiting(PONV)Numeric rating scale(NRS)Time of first flatus
Auxiliary Medication
General anaesthesia was induced with midazolam 0.05 mg/kg i.v., propofol2-3 mg/kg i.v., sufentanil 0.2-0.4μg/kg i.v., vecuronium 0.1 mg/kg i.v., and lidocaine 1 mg/kg i.v. After induction, dexamethasone 5 mg i.v. was administered. Anaesthesia was maintained with intravenous infusion of propofol, sufentanil and vecuronium. At the end of surgery, Parecoxib 40 mg i.v. was given for postoperative analgesia. Tropisetron 5 mg was administered i.v. at the end of skin closure for prophylaxis of PONV. Neostigmine 0-5 mg and atropine 0-2.5 mg were used to reverse the residual muscle relaxant effects.
Stimulation Method
EA
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
XS-998B
Nanjing Xiaosong Medical Instrument Research Institute, Nanjing , China
20-100 HZ
dense-disperse
The intensity of stimulation was adjusted at strong but comfortable level as judged by the patients.
30 min
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
0.30×40 mm
Suzhou Medical Supplies Factory Co. Ltd
-
Description The acupuncture needles used in this study were stainless steel needles (Suzhou Medical Supplies Factory Co. Ltd,0.30x40 mm, China), and electrical stimulation was applied once for 30 minutes with the dense-disperse stimulation mode (20-100 HZ) using a stimulator (XS-998B, Nanjing Xiaosong Medical Instrument Research Institute, Nanjing , China).
Anesthesia Method
GA
Clinical Trial Type
randomly
Adverse Effects
Only one participant in the EA group reported pain at the needling sites and bruising. The incident was minor, and did not require medical attention. All patients tolerated the EA treatment well.
Contraindications
Rash or local infection over the skin area of selected acupoints
Effector
In the first 6 hours after surgery, 15% and 20% of the patients experienced postoperative nausea in the EA and the UC groups, respectively. The incidences of postoperative vomiting were 5% for the EA group and 20% for the UC group. PONV reduced to zero over 12 hours in both groups and there was no statistically significant difference in PONV between the two groups at any time point. The EA group rated their postoperative pain statistically significantly lower than the UC group did at 6 hours postoperative (EA: 1.9 ± 0.8; UC: 2.9 ± 0.9, p = 0.001).The two groups did not differ in pain at 12 and 24 hours. The EA group had a shorter time to pass first flatus than the UC group did (EA: 20.3 hours ± 6.1; UC: 26.4 ± 5.2, p = 0.002). The common EA related adverse effects were minor, and did not require medical attention. The patients tolerated the EA treatment well. It is feasible and safe to deliver one-session EA treatment within 24 hours preoperatively to preempt postoperative pain. One-session preoperative EA may also accelerate motility of the gastrointestinal track. Properly powered studies are needed to further test the effectiveness of preoperative EA on PONV.
Effects of Electroacupuncture Administered 24hours Prior to Surgery on Postoperative Nausea and Vomiting and Pain in Patients Undergoing Gynecologic Laparoscopic Surgery: A Feasibility Study.
Abstract
OBJECTIVE: Our study aimed to investigate the feasibility and effectiveness of preoperative electroacupuncture (EA), delivered 24hours before surgery, on postoperative nausea and vomiting (PONV) and postoperative pain in patients undergoing gynecologic laparoscopic surgery. METHODS: In this randomized controlled trial, 40 patients scheduled for elective gynecologic laparoscopic surgery were randomly assigned to the usual care (UC) group and the EA group (n = 20 each). Both groups received the routine treatment consisting of intravenous dexamethasone (5mg) after induction of anesthesia and intravenous tropisetron (5mg) before the end of the operation. The patients in the EA group received EA at bilateral neiguan (PC6) and zusanli (ST36) within 24hours prior to the surgery. The incidence and severity of PONV and pain were recorded at 6hours, 12hours, and 24hours after the operation. Time to first flatus passage was also recorded. Bonferroni-corrected independent sample t-tests were used to analyze the data. RESULTS: In the first six hours after surgery, 15% and 20% of the patients experienced postoperative nausea in the EA and the UC groups, respectively. The incidences of postoperative vomiting were 5% for the EA group and 20% for the UC group. PONV reduced to zero over 12hours in both groups and there was no statistically significant difference in PONV between the two groups at any time point. The EA group rated their postoperative pain statistically significantly lower than the UC group did at six hours postoperative (EA: 1.9 +/- .8; UC: 2.9 +/- .9, P = .001). The two groups did not differ in pain at 12 and 24hours. The EA group had a shorter time to pass first flatus than the UC group did (EA: 20.3hours +/- 6.1; UC: 26.4 +/- 5.2, P = .002). The common EA-related adverse effects were minor, and did not require medical attention. The patients tolerated the EA treatment well. CONCLUSION: It is feasible and safe to deliver one-session EA treatment within 24hours preoperatively to preempt postoperative pain. One-session preoperative EA may also accelerate motility of the gastrointestinal track. Properly powered studies are needed to further test the effectiveness of preoperative EA on PONV."
Souce
Explore (NY). 2017 Sep-Oct;13(5):313-318. doi: 10.1016/j.explore.2017.06.002. Epub 2017 Jun 30.
