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Effect of acupuncture on nausea and/or vomiting during and after cesarean section in comparison with ondansetron

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Abstract

Purpose

Acupuncture has been used for the management of postoperative nausea and vomiting (PONV). This study compared the effect of electrical acustimulation with ondansetron for preventing intraoperative and postoperative emetic symptoms and improving patient satisfaction.

Methods

After gaining ethical approval, 450 parturients scheduled for elective cesarean delivery were randomly allocated to receive either electrical stimulation using P6 acupoint (pericardium 6) bilaterally for 30 min before spinal anesthesia (group III; n = 150), or 4 mg ondansetron 30 min before spinal anesthesia (group II; n = 150), or placebo (group II; n = 150). Nausea and vomiting were evaluated and recorded intraoperatively and postoperative for 24 h by an independent anesthetist.

Results

The three groups were not significantly different with respect to intraoperative ephedrine dose and duration of surgery. Nausea and vomiting occurred statistically significantly less often in the active treatment groups (II, III) during operation and for 6 h postoperatively. There was no statistically significant difference between the groups in the incidence of nausea and vomiting from 6 to 24 h postoperatively. Patient satisfaction with PONV control was higher with the active treatment groups compared with group I.

Conclusion

Electrical acustimulation is comparable to ondansetron in prevention of PONV during and after cesarean delivery under spinal anesthesia and in improving patient satisfaction.

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References

  1. Watcha MF, White PF. Postoperative nausea and vomiting: its etiology, treatment, and prevention. Anesthesiology. 1992;77:162–84.

    Article  PubMed  CAS  Google Scholar 

  2. Borgeat A, Ekatodramis G, Schenker CA. Postoperative nausea and vomiting in regional anesthesia: a review. Anesthesiology. 2003;98:530–47.

    Article  PubMed  Google Scholar 

  3. Coloma M, White PF, Markowitz SD, Whitten CW, Macaluso AR, Berrisford SB, Thornton KC. Dexamethasone in combination with dolasetron for prophylaxis in the ambulatory setting: effect on outcome after laparoscopic cholecystectomy. Anesthesiology. 2002;96:1346–50.

    Article  PubMed  CAS  Google Scholar 

  4. Al-Sadi M, Newman B, Julious SA. Acupuncture in the prevention of postoperative nausea and vomiting. Anesthesia. 1997;52:658–61.

    Article  CAS  Google Scholar 

  5. Chernyak GV, Sessler DI. Preoperative acupuncture and related techniques. Anesthesiology. 2005;102:1031–49.

    Article  PubMed  Google Scholar 

  6. Somri M, Vaida SJ, Sabo E, Yassain G, Gankin I, Gaitini LA. Acupuncture versus ondansetron in the prevention of postoperative vomiting: a study of children undergoing dental surgery. Anesthesia. 2001;56:927–32.

    Article  CAS  Google Scholar 

  7. Rusy LM, Hoffman GM, Weismzn SJ. Electroacupuncture prophylaxis of postoperative nausea and vomiting following pediatric tonsillectomy with or without adenoidectomy. Anesthesiology. 2002;96:300–5.

    Article  PubMed  Google Scholar 

  8. Schlager A, Offer T, Baldissera I. Laser stimulation of acupuncture point P6 reduces postoperative vomiting in children undergoing strabismus surgery. Br J Anesth. 1998;81:529–32.

    CAS  Google Scholar 

  9. Zarate E, Mingus M, White PF, Chiu W, Scuderi P, Loskota W, Daneshgari V. The use of transcutaneous acupoint electrical stimulation for preventing nausea and vomiting after laparoscopic surgery. Anesth Analg. 2001;92:629–35.

    Article  PubMed  CAS  Google Scholar 

  10. Fassoulaki A, Papilas K, Sarantopoulos C, Zotou M. Transcutaneous electrical nerve stimulation reduces the incidence of vomiting after hysterectomy. Anesth Analg. 1993;76:1012–4.

    Article  PubMed  CAS  Google Scholar 

  11. Ulett GA, Han S, Han JS. Electroacupuncture: mechanisms and clinical application. Biol Psychiatry. 1998;44:129–38.

    Article  PubMed  CAS  Google Scholar 

  12. Zhao ZQ. Neural mechanism underlying acupuncture analgesia. Prog Neurobiol. 2008;85:355–75.

    Article  PubMed  Google Scholar 

  13. Habib SS, Allen TK. P6 stimulation for the prevention of nausea and vomiting associated with cesarean delivery under neuraxial anesthesia: a systematic review of randomized controlled trials. Anesth Analg. 2008;107:1308–12.

    Google Scholar 

  14. Gan TJ, Jiao KR, Zenn M, Georgiade G. A randomized controlled comparison of electro-acupoint stimulation or ondansetron versus placebo for the prevention of postoperative nausea and vomiting. Anesth Analg. 2004;99:1070–5.

    Article  PubMed  Google Scholar 

  15. Apfel CC, Korttila K, Abdalla M, Kerger H, Turan A, Vedder I, Zernak C, Danner K, Jokela R, Pocock SJ, Trenkler S, Kredel M, Biedler A, Sessler DI, Roewer N. A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med. 2004;350:2441–51.

    Article  PubMed  CAS  Google Scholar 

  16. Streitberger K, Ezzo J, Schneider A. Acupuncture for nausea and vomiting: an update of clinical and experimental studies. Auton Neurosci. 2006;129:107–17.

    Article  PubMed  Google Scholar 

  17. Lee A, Done ML. The use of nonpharmacologic techniques to prevent postoperative nausea and vomiting: a meta-analysis. Anesth Analg. 1999;88:1362–9.

    PubMed  CAS  Google Scholar 

  18. Zou D, Chen WH, Iwakiri K, Rigda R, Tippett M, Holloway RH. Inhibition of transient lower esophageal sphincter relaxations by electrical acupoint stimulation. Am J Physiol Gastrointest Liver Physiol. 2005;289:G197–201.

    Article  PubMed  CAS  Google Scholar 

  19. Balki M, Carvalho CA. Intraoperative nausea and vomiting during cesarean section under regional anesthesia. Int J Obstet Anesth. 2005;14:230–41.

    Article  PubMed  CAS  Google Scholar 

  20. Dundee JW, Ghaly RG, Bill KM, Chestnutt WN, Fitzpatrick KT, Lynas AG. Effect of stimulation of the P6 antiemetic point on postoperative nausea and vomiting. Br J Anaesth. 1989;63:612–8.

    Article  PubMed  CAS  Google Scholar 

  21. Liu WC, Feldman SC, Cook DB, Hung DL, Xu T, Kalnin AJ, Komisaruk BR. Study of acupuncture-induced periaqueductal gray activity in humans. Neuroreport. 2004;15:1937–40.

    Article  PubMed  Google Scholar 

  22. Ho CM, Tsai HG, Chan KH, Tsai SK. P6 acupressure does not prevent emesis during spinal anesthesia for cesarean delivery. Anesth Analg. 2006;102:900–3.

    Article  PubMed  Google Scholar 

  23. Stein DJ, Birnbach DJ, Danzer BI, Kuroda MM, Grunebaum A, Thys DM. Acupressure versus intravenous metoclopramide to prevent nausea and vomiting during spinal anesthesia for cesarean section. Anesth Analg. 1997;84:342–5.

    PubMed  CAS  Google Scholar 

  24. Harmon D, Ryan M, Kelly A. Acupressure and prevention of nausea and vomiting during and after spinal anaesthesia for caesarean section. Br J Anaesth. 2000;84:463–7.

    PubMed  CAS  Google Scholar 

  25. Frigerio C, Buchwalder PA, Spertini F. Ondansetron: reasons to be restrictive. Lancet. 1996;347:1484–5.

    Article  PubMed  CAS  Google Scholar 

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Acknowledgment

The authors acknowledge Dr. Ahmed Daif, professor of anesthesia, who is pioneer of acupuncture in Mansoura University.

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Authors and Affiliations

  1. Department of Anesthesiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Alaa M. El-Deeb & Mona S. Ahmady

Authors
  1. Alaa M. El-Deeb
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  2. Mona S. Ahmady
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Correspondence to Alaa M. El-Deeb.

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El-Deeb, A.M., Ahmady, M.S. Effect of acupuncture on nausea and/or vomiting during and after cesarean section in comparison with ondansetron. J Anesth 25, 698–703 (2011). https://doi.org/10.1007/s00540-011-1198-0

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  • DOI: https://doi.org/10.1007/s00540-011-1198-0

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