| BackgroundPostoperative nausea and vomiting(PONV)are a condition commonly present after anaesthesia and surgery,with the overall incidence of 40%-90%.Type of anaesthesia,type of surgery and site of operation contribute to PONV occurrence rate.Some clinical trials revealed acupuncture being effective in treating and preventing PONV.Acupuncture is often used to treat pain,and numerous studies have found it is safe compared to routine care.Many clinical studies have evaluated the efficacy of acupuncture and related methods as adjuvant treatment for postoperative analgesia.In the current literature available,we have not found any acupuncture study assessed the effect of acupuncture in preventing PONV and postoperative pain together as it is intended in this study.ObjectiveTo assess the preventive effect of acupuncture in patients undergoing surgery and if it can help reduce the onset of nausea,vomiting,and postoperative pain,as a complementary treatment to the application of preventive establishment protocols already for each procedure.MethodSetting and design:This study had been a prospective pilot trial and randomized controlled.The patients were randomly allocated into two groups:32 cases in Group A(acupuncture group)and 32 cases in Group C(control group).Study period:From April 2018 to June 2018Patients:64 patients,70%female and 30%male,undergoing laparoscopic abdominal surgery and breast surgery under general anaesthesia were enrolled.All patients selected have received the same prevention protocol for postoperative nausea and vomit(PONV)the protocol for pain and the anaesthetic procedure were the same(appendix 1,7)Interventions:In Group A(Acupuncture Group):The patients received preventive treatment for nausea,vomiting and pain,then received acupuncture at acupoints:Zusanli(ST36),Shangjuxu(ST37),Neiguan(PC6),Hegu(LI4),bilaterally,with electrical stimulation being,connected to the needless after de qi,with a sparse-dense waveform with the intensity of patients feeling a slight but not uncomfortable twitching.The electrical stimulation was applied for 30 min.Group C(Control Group):The patients received preventive treatment for nausea,vomiting and pain(Appendix 1,7)without receiving acupuncture.Outcome measurements:For measurement Nausea,we used the visual analogue scale(VAS)scale 1 to 10.Vomiting,the score was graded as 0 = no vomiting 1 = vomiting Pain,for measurements we used the visual analogue scale(VAS)scale 1 to 10.The measurements for nausea,vomiting and pain were obtained at 60 minutes after leaving the intervention,at 5 hours and 24 hours post-surgery.Statistical analysis:Excel has been used to save and manage data and perform some more simple statistical analysis.For analyse data of pain we used R,because is a very powerful statistical software.The Fisher test to compare scores between groups for a fixed time and Mac Nemar to perform comparisons between times(60 minutes,5hours and 24 hours)within groups.ResultsThe primary variable to observe was the effectiveness of acupuncture to prevent nausea at five hours after surgery.The result was that patients did not show nausea from five hours in both groups,but in the area of resuscitation,immediately after the surgery,in group A two patients presented nausea with a VAS 2 and in group C only one patient also had nausea with a VAS 2.Rescue medication was administered in all three cases.The secondary variables to study are vomiting and pain.Vomiting:neither of the two groups presented vomiting at any time.Pain:-In recovering room at 60 minutes after intervention,the VAS in group A was 1.84±1.05 and group C was 2.41±1.90.-At 5 hours after intervention,the VAS in Group A was 0.72±0.73 and Group C was1.22±1.16.-At 24 hours after intervention,the VAS in Group A was 0.25±0.44 and Group C was 0.66±0.65.Analyzing by continuous intervals,there are not baseline differences P-value 0.135 at 60 minutes but there are significant differences at 5h P-value 0.035 and at 24h P-value 0.003,in the group A with less pain.Analyzing by categorized way,there is no differences in any moment between the two groups:baseline P-value 0.074,at 5h P-value 0.113 and at 24h P-value 1.ConclusionsThe preventive medications for nausea,vomiting and pain that are given as an established protocol before operation have been very effective specifically in the sample studied.Consequently,it is difficult to show the effect of acupuncture in preventing postoperative symptoms and signs.However,this study still showed that acupuncture has the effect of reliving postoperative pain,which provides a complementary method for the routine preventive established protocol for patients. |
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