Background and Goal of Study: The primary purpose of this study was to test the efficacy of several neuromuscular monitoring modes at the P6 acupuncture point in preventing postoperative nausea and vomiting (PONV).
Materials and Methods: In this prospective, double-blind, randomized, placebo-controlled trial, 264 women undergoing laparoscopic hysterectomy were evaluated for PONV. Neuromuscular blockade was monitored by acceleromyography with 1 Hz single twitch (ST) over the ulnar nerve (n = 54, control), and ST (n = 52), train-of-four (TOF) (n = 53), double-burst stimulation (DBS) (n = 53), or tetanus (n = 52) over the median nerve.
Results and Discussion: The incidence of PONV (P = 0.022), the number of requests for patient-controlled analgesia (PCA) (P = 0.009), and total PCA volume (P = 0.042) 6 h after tetanic stimulation were significantly reduced the in the treatment group compared to the control group. Overall, patients in the tetanus group were more satisfied with their management of PONV compared to patients in the control group.
Conclusion(s): Tetanic stimulation applied to the P6 acupuncture point can reduce PONV after laparoscopic hysterectomy compared to ST stimulation of the ulnar nerve, resulting in a greater degree of patient satisfaction. Neither ST, TOF, nor DBS stimulation applied to the P6 acupuncture point significantly affected PONV.