Abstract
Purpose
To compare the efficacy of stimulation of P6 acupoint with capsicum plaster in comparison withiv ondansetron for the prevention of postoperative nausea and vomiting (PONV). Methods: 120 patients of either sex, ASA I-II, undergoing elective middle ear surgeries under general anesthesia were included in this randomized, prospective, double-blinded and placebo-controlled study. The anesthetic technique was standardized. Patients were divided into three groups. Group I was the control group. Capsicum plaster (1 x 1 cm) was affixed at the P6 acupoint on both forearms 30 min before induction of anesthesia in patients of Group II. Patients of Groups I and III received an inactive adhesive plaster at the same site. Ondansetron 4 mgiv was given to patients of Group III at the end of surgery and the rest of the patients received a placebo. The plasters were removed six hours after transferring the patients to the postoperative unit. Criteria were fixed for the administration of rescue antiemetics (ondansetron 4 mgiv). PONV and the requirement for rescue antiemetics were recorded by a blinded observer.
Results
The incidence of PONV and the requirement for rescue antiemetics were significantly lower in both the acustimulation and ondansetron groups at six hours. At 24 hr there was a reduction in the requirement for rescue medication in the ondansetron group. Conclusion: Stimulation of the P6 acupoint with capsicum plaster is an effective method for prevention of PONV after middle ear surgery and its efficacy is comparable to ondansetron for the first six hours after surgery.
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Objectif
Comparer l’efficacité de la stimulation de l’acupoint P6 avec un emplâtre de Capsicum et l’administration iv d’ondansétron pour la prévention des nausées et vomissements postopératoires (NVPO).
Méthode
Cent vingt hommes et femmes, d’état physique ASA I-II, devant subir une opération de l’oreille moyenne sous anesthésie générale, ont participé à l’étude randomisée, prospective, à double insu et contrôlée par placebo. La technique anesthésique a été normalisée. Les patients ont été répartis en trois groupes. Le groupe I était le groupe témoin. Un emplâtre de Capsicum (1 x 1 cm) a été appliqué à l’acupoint P6 sur les deux avant-bras 30 min avant l’induction de l’anesthésie chez les patients du groupe II. Les patients des groupes I et III ont reçu un emplâtre adhésif inactif au même site. Une dose de 4 mg d’ondansétron iv a été administrée aux patients du groupe III à la fin de l’opération et le reste des patients a reçu un placebo. Les emplâtres ont été enlevés six heures après le transfert à l’unité des soins postopératoires. Les critères ont été fixés pour l’administration d’antiémétiques de secours (4 mg d’ondansétron iv). Les NVPO et les demandes d’antiémétiques ont été notées par un observateur neutre.
Résultats
à six heures, l’incidence de NVPO et les demandes d’antiémétiques étaient significativement plus basses avec l’acustimulation et l’ondansétron. à 24 h, il y a eu une réduction des demandes de médicaments de secours chez ceux qui avaient reçu l’ondansétron.
Conclusion
La stimulation de l’acupoint P6 avec un emplâtre de Capsicum est aussi efficace que l’ondansétron pendant les six premières heures postopératoires pour prévenir les NVPO après une opération de l’oreille moyenne.
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Misra, M.N., Pullani, A.J. & Mohamed, Z.U. Prevention of PONV by acustimulation with capsicum plaster is comparable to ondansetron after middle ear surgery. Can J Anesth 52, 485–489 (2005). https://doi.org/10.1007/BF03016527
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DOI: https://doi.org/10.1007/BF03016527