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Acupressure at acupoint P6 for prevention of postoperative nausea and vomiting: a randomised clinical trial

Majholm, Birgitte; Møller, Ann M

European Journal of Anaesthesiology (EJA): June 2011 - Volume 28 - Issue 6 - p 412–419
doi: 10.1097/EJA.0b013e32833f6f42
Acupressure and TENS

Background and objective Postoperative nausea and vomiting causes discomfort in many patients despite both antiemetic prophylactics and improved anaesthetic techniques. Stimulation of acupoint P6 is described as an alternative method for prophylaxis of postoperative nausea and vomiting.

In a randomised, double-blinded study, we aimed to investigate the effect of P6 acupoint stimulation on the incidence of postoperative nausea and vomiting within 24 h postoperatively with an acupressure wristband: Vital-Band.

Methods One hundred and thirty-four healthy, non-smoking women scheduled for breast surgery were randomised either to P6 stimulation or to sham control. Wristbands were applied and covered with a dressing before induction of anaesthesia. Follow-up was carried out three times within 24 h postoperatively. Primary outcomes were postoperative nausea and/or vomiting.

Results One hundred and twelve patients completed the study. There were no statistically significant differences in the incidence of nausea [P6 stimulation, 35.1% (95% confidence interval, CI 22.7–47.5%) versus sham control, 43.1% (95% CI 29.5–56.7%; P = 0.433)] or vomiting [P6 stimulation, 25.9% (95% CI 14.6–37.2%) versus sham control, 26.9% (95% CI 14.8–39.0%; P = 1.000)]. Approximately, one third of the patients reported side effects caused by the wristband, for example, redness, swelling and tenderness.

Conclusion We did not find the Vital-Band effective in preventing either nausea or vomiting after operation in women undergoing breast surgery.

From the Copenhagen University Hospital, Herlev, Denmark

Published online 21 January 2011

Correspondence to Birgitte Majholm, MD, Trial Unit, Department of Anaesthesiology, Copenhagen University Hospital, Herlev, Herlev Ringvej 75, DK-2730 Herlev, Denmark Tel: +45 44 88 35 95; fax: +45 44 88 37 24; e-mail: Birmaj01@heh.regionh.dk

The results of this study have been presented in abstract form at the annual meeting of Danish Anaesthesiologists in Copenhagen, Denmark; 13–15 November 2008.

This article is accompanied by the following Invited Commentary:

♦ Streitberger K, Kranke P. Evidence for the efficacy of acupressure for preventing post-operative nausea and vomiting: an ongoing debate. Eur J Anaesthesiol 2011; 28:396–398.

© 2011 European Society of Anaesthesiology