Acupuncture in the Management of Postoperative Nausea and Vomiting in Patients Receiving Morphine via a Patient-Controlled Analgesia System

1996 ◽  
Vol 14 (1) ◽  
pp. 2-5 ◽  
Author(s):  
Paul McConaghy ◽  
David Bland ◽  
Hilary Swales
Keyword(s):  
Postoperative Nausea ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Visual Analogue Score ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Patient Controlled Analgesia ◽  
Randomised Controlled ◽  
To Receive ◽  
Single Blind

This single-blind, randomised, controlled trial was undertaken to assess the efficacy of acupuncture (ACP) at the PC.6 (Neiguan) point in the management of established postoperative nausea and vomiting (PONV) in patients receiving parenteral morphine via a Patient-Controlled Analgesia System (PCAS). Eighty patients were recruited on the first postoperative day and 30 were treated with ACP after developing PONV lasting more than 10min. Patients were randomly allocated to receive ACP bilaterally at either PC.6 or at a dummy point near the elbow, with manual stimulation for a total of 4min. Only patients with no knowledge of ACP antiemesis were studied, and each patient was thus unaware of the group to which they were allocated. Patients treated with PC.6 ACP had a greater mean improvement in their visual analogue score for nausea (p<0.05). All patients in the PC.6 group improved their score by 20% or more, while only one third in the control group did so (p<0.001). In the PC.6 group 53% of patients did not require any further antiemetic while receiving PCAS morphine. All patients in the control group required further antiemetic treatment (p<0.001). No adverse effects were recorded.

scholarly journals Intradermal thumbtack needle buried Neiguan (P6) point for prevention of postoperative nausea and vomiting in patients undergoing craniotomy: study protocol for a randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032417
Author(s):  
Jian-qin Lv ◽  
Chengwei Wang ◽  
Yi Yang ◽  
Yu Li ◽  
Tian-hao Xu ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
General Anaesthesia ◽  
Postoperative Nausea ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Patient Satisfaction Score ◽  
Randomised Controlled

IntroductionPostoperative nausea and vomiting (PONV) is among the most common adverse reactions following anaesthesia and surgery. Recent clinical studies have reported that the average incidence is about 30%, while in patients specifically undergoing neurosurgery, the incidence can be as great as 73%. Studies also suggest that its occurrence increases the risk of intracranial haematoma and haemorrhage. The objective of this study is to evaluate the effectiveness of intradermal thumbtack needle buried Neiguan (pericardium 6 (P6)) point therapy in the prevention of PONV in patients undergoing craniotomy under general anaesthesia.Methods and analysisThis is a single-centre, three-arm, randomised controlled trial. 180 participants are randomly assigned to either an acupuncture, intradermal thumbtack needle or control group in a 1:1:1 ratio. The P6 of the acupuncture group is punctured at both sides perpendicularly to a depth of 20 mm. Needles are retained for 30 min and stimulated every 10 min to maintain the de qi. The therapy includes two treatments; the acupuncture is administered immediately after and 24 hours after surgery. For the intradermal thumbtack needle group, the intradermal thumbtack needle is quickly inserted into the skin and embedded at P6 acupoints bilaterally. Patients and their families are asked to press the needlepoint with the onset of nausea, vomiting, bloating, pain and other reported discomforts. The needle is replaced after 24 hours. The therapy is administered immediately after and 24 hours after surgery. For the control group, no intervention is carried out. The incidence of PONV within 48 hours after craniotomy across the three groups is observed. Other observations include: (1) assessment of nausea score (severity of nausea) and pain score (visual analogue scale) 0–2, 2–6, 6–24 and 24–48 hours after craniotomy under general anaesthesia; (2) assessment of total rescue antiemetic dosage 0–48 hours after craniotomy under general anaesthesia; (3) length of hospital stay and (4) patient satisfaction score with PONV management. We will perform all statistical analysis following the intention-to-treat principle.Ethics and disseminationEthics approval has been granted by the Bioethics Subcommittee of the West China Hospital, Sichuan University: the approval number is 2018 (number 231). Results will be expected to be published in peer-reviewed journals.Trial registration numberChiCTR1800017173

scholarly journals Is Infusion of Subhypnotic Propofol as Effective as Dexamethasone in Prevention of Postoperative Nausea and Vomiting Related to Laparoscopic Cholecystectomy? A Randomized Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Mine Celik ◽  
Aysenur Dostbil ◽  
Mehmet Aksoy ◽  
Ilker Ince ◽  
Ali Ahiskalioglu ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Control Group ◽  
Double Blind ◽  
Significant Difference ◽  
Group D

Background. Postoperative nausea and vomiting (PONV) is one of common complications in patients undergoing laparoscopic cholecystectomy (LC). Aim of this study was to compare the efficacy of subhypnotic (1 mg/kg/h) infusion of propofol with dexamethasone on PONV in patients undergoing LC.Methods. A total of 120 patients were included in this randomized, double-blind, placebo-controlled study. Patients were randomly assigned to 3 groups; patients of group dexamethasone (group D) were administrated 8 mg dexamethasone before induction of anesthesia, patients of group propofol (group P) were infused to subhypnotic (1 mg/kg/h) propofol during operation and patients of group control (group C) were applied infusion of 10% intralipid. The incidence of PONV and needs for rescue analgesic and antiemetic were recorded in the first 24 h postoperatively.Results. In the 0–24 h, the incidence of PONV was significantly lower in the group D and group P compared with the group C (37.5%, 40%, and 72.5%, resp.). There was no significant difference in the incidence of PONV and use of antiemetics and analgesic between group D and group P.Conclusion. We concluded that infusion of propofol 1 mg/kg/h is as effective as dexamethasone for the prevention of PONV during the first 24 hours after anesthesia in patients undergoing LC.

scholarly journals PONV

2015 ◽  
Vol 22 (10) ◽  
pp. 1232-1236
Author(s):  
M. Azeem ◽  
Zia Ullha ◽  
Ahsan Nasim ◽  
M.A. Cheema
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Single Dose ◽  
Controlled Trial ◽  
Randomized Study ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Dose Administration ◽  
Medical University ◽  
To Receive

Background: Postoperative nausea and vomiting is reduced if inj Dexamethasoneis given preoperatively in patient undergoing Laparoscopic Cholecystectomy. The aim of thisprospective randomized, controlled trial was to look into effectiveness of dexamethasone beforesurgery may improve nausea, vomiting after surgery in patients undergoing laparoscopiccholecystectomy. Study Design: Prospective randomized study. Setting: Department of Surgery,King Edward Medical University, Lahore - Pakistan. Period: Nov 2010 to April 2012. Methods: 138Patients with Laparoscopic Cholecystectomy were randomized to receive 08 mg Dexamethasone(n=66) or placebo (n=72) intravenously before surgery. Seven patients were excluded on accountof already on steroid treatment due to various reason. Vomiting and nausea were seen in next 24hours after operation. Dexamethasone has minimal side effect after single dose administration. Sixpatients (12%) has nausea and vomiting in treatment group while 26 (47%) in the control group(p<0.001). Patient having dexamethasone, five (10%) need antiemitics as compare to 24 (44%)of those receiving placebo (p<0.001). Conclusion: Single dose of Inj Dexamethasone givenpreoperatively reduce nausea and vomiting markedly in Laparoscopic Cholecystectomy and maybe routinely used in Laparoscopic procedure.

scholarly journals Droperidol Reduces Postoperative Nausea and Vomiting and Supports the Continuation of Intravenous Patient-Controlled Analgesia with Fentanyl

2020 ◽  
Vol 23 ◽  
pp. 220-230
Author(s):  
Ikkou Hirata ◽  
Masahiro Iwamoto ◽  
Hiroki` Matsui ◽  
Hiromi Yoshinuma ◽  
Ryohkan Funakoshi
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Postoperative Nausea ◽  
Pain Treatment ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Patient Controlled Analgesia ◽  
Secondary Endpoints ◽  
The Impact

PURPOSE: To examine the impact of adding droperidol to fentanyl-based intravenous patient-controlled analgesia (IVPCA) on the discontinuation of IVPCA use due to postoperative nausea and vomiting (PONV). METHODS: Patients who underwent surgeries other than abdominal surgeries and used IVPCA between April 2014 and March 2018 were selected. Patients using IVPCA with fentanyl alone were compared to patients using droperidol added to IVPCA. Patients were allocated to one of two groups depending on the drug used for IVPCA: 1) control group, fentanyl alone; 2) droperidol group, droperidol with fentanyl. The primary endpoint was the discontinuation of IVPCA due to PONV. Secondary endpoints included PONV within 48 hours after surgery, the number of antiemetics used, pain score, and adverse effects. Propensity score matching was used to control the differences in clinical features among patients. RESULTS: Among the 793 patients initially enrolled in this study, 145 were excluded via propensity score matching; 364 of the remaining patients received IVPCA supplemented with droperidol. Propensity score matching showed that discontinuation of IVPCA due to PONV was significantly decreased in the droperidol group compared to the control group (P = 0.01). Further, compared with the control group, the droperidol group had reduced nausea up to 24 hours after surgery (P < 0.01), and the number of vomiting episodes and use of antiemetics decreased within 12 hours after surgery (P < 0.01). CONCLUSIONS: The addition of droperidol to IVPCA is associated with a decrease in PONV, as well as the improved continuation of pain treatment with fentanyl-based IVPCA, similar to IVPCA with morphine. However, it is necessary to monitor the side effects of this treatment.

scholarly journals Adding dexmedetomidine to morphine-based analgesia reduces early postoperative nausea in patients undergoing gynecological laparoscopic surgery: A randomized controlled trial

2019 ◽  
Author(s):  
Huai Jin Li ◽  
Shan Liu ◽  
Zhiyu Geng ◽  
Xue Ying Li
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Nausea ◽  
Controlled Trial ◽  
High Risk Patient ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Control Group ◽  
Loading Dose ◽  
Double Blind

Abstract Background: Few studies have investigated the effect of dexmedetomidine on postoperative nausea and vomiting (PONV) in patients underwent gynecological laparoscopic surgery. We investigated if adding dexmedetomidine to a morphine-based patient-controlled analgesia (PCA) could decrease the incidence of PONV in this high-risk patient population. Methods: In this prospective, randomized, double-blind and placebo-controlled study, 122 patients underwent gynecological laparoscopic surgery were assigned into two groups. Patients in the dexmedetomidine group (Group Dex) received a loading dose of dexmedetomidine 0.4μg/kg before the end of surgery, followed by morphine 0.5mg/ml plus dexmedetomidine 1μg/ml for postoperative i.v. PCA. Patients in the control group (Group Ctrl) received normal saline before the end of surgery, followed by morphine 0.5mg/ml alone for postoperative i.v. PCA. PCA pump was programmed as followed: bolus dose 2ml, lockout interval 8 minutes and background infusion at a rate of 1ml/h. The primary outcome was the incidence of nausea and vomiting within the first postoperative 24 hours. Results: Although there were no significant differences in regard to the total incidence of PONV (41.0% vs 52.5%, P=0.204), PONV score, time to first onset of PONV, or the need for rescue antiemetics within the first postoperative 24 hr between the two groups, the incidence of nausea and total PONV during the first 2h period was significantly lower in the Group Dex than in the Group Ctrl (9.8% vs 24.6%, P=0.031 and 0.031, respectively). More patients in Group Dex were over sedated or had bradycardia during the PACU compared with Group Ctrl (P=0.040 and 0.036, respectively). Conclusion: Adding dexmedetomidine to morphine-based PCA with a loading dose might reduce the incidence of early postoperative nausea but not total PONV within 24h after surgery in patients undergoing gynecological laparoscopic surgery.

scholarly journals Incidence of postoperative nausea and vomiting is not increased by combination of low concentration sevoflurane and propofol compared with propofol alone in patients undergoing laparoscopic gynecological surgery

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Yuka Uchinami ◽  
Satoshi Takikawa ◽  
Fumiki Takashima ◽  
Yosuke Maeda ◽  
Satoki Nasu ◽  
...  
Keyword(s):  
Postoperative Nausea ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Gynecological Surgery ◽  
Intravenous Anesthesia ◽  
Low Concentration ◽  
Number Of Patients ◽  
Prospective Randomized Controlled Trial ◽  
To Receive

Abstract Background The incidence of postoperative nausea and vomiting (PONV) is higher in patients receiving volatile anesthetics than those receiving total intravenous anesthesia (TIVA) with propofol. However, it is unclear whether its incidence is increased when a low concentration of sevoflurane is used in combination with propofol. Methods This prospective, randomized, controlled trial enrolled women undergoing laparoscopic gynecological surgery. Patients were randomly assigned to receive general anesthesia either with propofol alone (group P) or with 0.8% sevoflurane and propofol (group SP, n = 36, each group) for maintenance of anesthesia. The incidence of PONV and the number of patients who required antiemetics were compared. Results There were no differences in the incidence of PONV and the number of patients who required antiemetics between the P and SP groups. Conclusions A combination of 0.8% sevoflurane and propofol to maintain anesthesia does not increase the incidence of PONV compared with TIVA with propofol. Trial registration UMIN-CTR UMIN000023647, registered 14 August 2016.

Sign in / Sign up

Export Citation Format

Share Document