Electroacupuncture on PC6 Prevents Opioid-Induced Nausea and Vomiting after Laparoscopic Surgery

Objective： To investigate the treatment time dependence of electroacupuncture （EA） on Neiguan （PC6） for preventing postoperative nausea and vomiting （PONV）. Methods： One hundred and seventy-eight patients, who had received intravenous patient-controlled analgesia （PCA） with Fentanyl, were assigned randomly to three groups using random numbers： a pre-operative EA group （PrEA）, a post-operative EA group （PoEA）, and a non-acupuncture control group （NC）. An anesthetist evaluated the incidence and severity of nausea and vomiting for 48 h after surgery blindly. The main outcomes were severity and freguency of PONV, which were measured with a self-reported questionnaire and a confirmation from the anesthetist. The data were analyzed with ANOVA and Z-test. Results： The incidence of nausea and vomiting was significantly lower in the PrEA group than the NC group during 48 h after surgery （P〈0.01, P〈0.05）. The incidence of vomiting was also significantly lower in the PrEA group than the PoEA group （P〈0.05）. The PoEA subjects evidenced no significant differences compared with the NC subjects in terms of the incidence of nausea and vomiting （P〈0.05）. The severity of nausea was significantly lower in the PrEA group than in the NC and PoEA groups （P〈0.05）. Conclusions： EA on PC6 is effective in the prevention of PONV, and pre-operative acupuncture is more effective than post-operative acupuncture.

Effect of transcutaneous electroacupuncture at Neiguan(PC 6) on refractory vomiting in patients in intensive care unit

OBJECTIVE: To observe the effect of transcutaneous electroacupuncture(TEA) at Neiguan(PC 6) on refractory vomiting in critically ill patients in intensive care(ICU) setting.METHODS: Ten patients admitted in ICU and presenting vomiting refractory to one or more antiemetic drugs were prospectively included in the study. TEA was applied at acupoint of Neiguan(PC6) during 30 min with a neuromuscular transmission monitor(single-twitch stimulation with 1 Hz at a constant current of 10 m A). Nausea and Vomiting were evaluated at the following intervals: immediately after 30 min of TEA at Neiguan(PC 6),30 min-6h and 6-24 h. The presence of nausea and/or vomiting throughout the observational period was defined as the primary end point.RESULTS: The presence of nausea or vomiting throughout the observational period was 10% at the end of TEA, 40% between 30 min and 6 h, and50% between 30 min and 24 h(P < 0.001, P = 0.01 and P = 0.03 vs pre-TEA, respectively). There were no complications or side effects related to TEA.CONCLUSION: TEA at Neiguan(PC 6) seems effective in reducing refractory vomiting in the patients in ICU setting, even if larger trials are needed to define optimal modalities.

揿针针刺内关穴、合谷穴对骨科手术患者术后疼痛及恶心呕吐的影响

目的:观察揿针针刺内关穴、合谷穴对骨科手术患者术后疼痛及恶心呕吐的影响。方法:入组的60例患者均为2018年11月至2019年9月江苏省连云港市中医院骨伤科住院手术治疗的患者,采用随机数字表法分为揿针组和对照组,每组30例。两组患者在手术后给予地佐辛注射液静脉自控镇痛,对照组在镇痛泵中同时配伍托烷司琼,揿针组术后另给予揿针针刺内关、合谷穴,两组镇痛泵均留置48 h。记录两组患者VAS评分、镇痛泵的有效按压次数、恶心呕吐发生情况、患者对术后镇痛的总体满意度。结果:揿针组术后12 h、24 h、48 h VAS评分低于对照组,差异有统计学意义(P<0.05);揿针组术后48 h镇痛泵有效按压次数低于对照组,差异具有统计学意义(P<0.05);两组术后48 h发生恶心呕吐例数比较,差异无统计学意义(P>0.05);揿针组满意度为90.0%、对照组满意度为83.4%,揿针组高于对照组,差异具有统计学意义(P<0.05)。结论:揿针针刺内关穴、合谷穴对术后镇痛有协同作用,可减少恶心呕吐的发生。

不同频率电针对腹腔镜手术病人术后恶心呕吐的影响

目的:评价采用不同频率电针刺激双侧内关穴对全身麻醉腹腔镜手术病人术后发生恶心与呕吐的影响,探讨理想电针参数。方法:将全身麻醉下行腹腔镜手术的女性病人120例随机分为4组:2Hz电针治疗组(A组)、2Hz/100Hz电针治疗组(B组)、100Hz电针治疗组(C组)和对照组(D组),每组30例。各组均接受相同麻醉处理方案,A、B、C 3组病人均在常规药物麻醉开始前半小时针刺双侧内关穴,得气后连接HANS-200A电针仪,频率分别为2Hz、2Hz/100Hz、100Hz,手术结束后停止电针刺激。D组不予电针。观察记录各组病人手术结束后生命体征、术后恶心与呕吐的发生情况及术后恶心与呕吐的严重程度分级。结果:各组病人术后1h心率、平均动脉压(MAP)、指脉氧饱和度、呼吸频率差异无统计学意义(均P>0.05);B组病人术后恶心呕吐发生率明显低于A、C、D组[10.0%(3/30)vs 30.0%(9/30)、36.7%(11/30)、53.3%(16/30),均P<0.01];B组病人术后恶心呕吐严重程度明显低于其他3组(均P<0.01)。结论:2Hz/100Hz电针可有效减少行全身麻醉腹腔镜手术病人术后恶心呕吐发生率,减低病人恶心呕吐的严重程度。