Study On The Effect Of Press Needle Combined With Palonosetron On Preventing Nausea And Vomiting After Gynecological Laparoscopic Surgery

Objective:To investigate the prevention and treatment effect of press needle stimulation at Neiguan and Zusanli points combined with palonosetron intravenous injection on postoperative nausea and vomiting(PONV)after gynecological laparoscopic surgery,so as to provide basis for clinical application.Methods:90 patients undergoing gynecological laparoscopic surgery under Intravenous Inhalation Combined with general anesthesia were randomly divided into three groups: palonosetron group(P group),press needle acupoint stimulation group(Q group),press needle acupoint stimulation combined with palonosetron group(PQ group),30 cases in each group.In group P,palonosetron 0.25 mg was slowly intravenously injected 30 min before anesthesia induction,and bilateral Neiguan and Zusanli needling were performed(the needle body of the pressing needle was removed,and the same operation was performed when it was stuck at the same acupoint);in group Q,bilateral Neiguan and Zusanli needling were performed 30 min before anesthesia induction;in group PQ,palonosetron 0.25 mg was performed 30 min before anesthesia induction The selection and application of pressing points were performed by the same trained anesthesiologist.All patients were connected with patient-controlled intravenous analgesia(PCIA)before leaving the operating room.The incidence and intensity of PONV at 3,6,12,18 and 24 hours after the patients returned to the ward,the first exhaust time and defecation time after the operation were observed and recorded.PONV intensity was evaluated according to the degree of nausea visual analog scale(NVAS).Results:1.There was no significant difference in age,BMI,ASA grade,operation time and anesthesia time among the three groups(P> 0.05).2.There was significant difference in the total vomit intensity among the three groups within 24 hours(P<0.05).After pairwise comparison,the vomit intensity of PQ group was lower than that of P group and Q group(that is,there was no difference between P group and Q group).Compared with the three groups at each time point,there was no significant difference at 3 h(P>0.05);there was significant difference at 6 h,12 h,18 h and 24 h(P<0.05);after pairwise comparison,the vomiting intensity of PQ group at 6h,12 h,18 h and 24 h was less than that of P group and Q group(that is,there was no difference between P group and Q group at each time point).3.There was a significant difference in the total number of vomiting within 24 hours among the three groups(P<0.05).After pairwise comparison,the number of vomiting in PQ group was less than that in P group and Q group(that is,there was no difference between P group and Q group).There was no significant difference between the three groups at 3 h(P>0.05);there was significant difference at 6 h,12 h,18 h and 24 h(P<0.05).After pairwise comparison,the vomiting times of PQ group at 6 h,12 h,18 h and24 h were less than those of P group and Q group(that is,there was no difference between P group and Q group at each time point).4.The difference of postoperative exhaust time among the three groups was statistically significant(P<0.05).After pairwise comparison,the postoperative exhaust time of group Q and PQ was less than that of group P,with statistical significance(P<0.05),but there was no significant difference between group Q and PQ(P>0.05).5.The difference of defecation time among the three groups was statistically significant(P<0.05).After the operation,the defecation time of group Q and PQ was less than that of group P,with statistical significance(P<0.05).There was no significant difference between group Q and PQ(P>0.05).Conclusion:It is worthy of clinical promotion that pressing needle stimulation of Neiguan and Zusanli combined with palonosetron can significantly reduce the intensity and frequency of PONV after gynecological laparoscopic surgery,shorten the postoperative exhaust time and defecation time,improve the postoperative comfort of patients,accelerate the recovery of gastrointestinal function,and promote postoperative rehabilitation.