Clinical Observation Of Acupuncture To Prevent Postoperative Nausea And Vomiting After Craniotomy

Objective:This study is based on the concept of "patient-centered" multidisciplinary integrated and accelerated rehabilitation surgery services.A prospective randomized controlled trial design was used to explore the efficacy and patterns of acupuncture pre-treatment in the prevention of post-craniotomy nausea and vomiting.A comparison of the advantages and disadvantages of acupuncture and acupuncture needles was conducted to provide a new method of intervention for the prevention of post-craniotomy nausea and vomiting.Methods:The subjects who met the inclusion and exclusion criteria were divided into 60 cases in the conventional group,60 cases in the acupuncture group and 60 cases in the milli-acupuncture group using a randomized controlled trial.The conventional group was treated with the conventional treatment protocol for accelerated rehabilitation surgery,the acupuncture group was treated with acupuncture on top of the conventional treatment for accelerated rehabilitation surgery,and the milliacupuncture group was treated with milliacupuncture on top of the conventional treatment for accelerated rehabilitation surgery.The incidence and severity of vomiting,nausea and the frequency of combined postoperative medications were used as the effect indicators in four postoperative periods:0~2 hours,2~6 hours,6~24 hours and 24~48 hours.The clinical efficacy pattern and safety of the interventions were evaluated using dizziness,stagnant needles,bent needles,broken needles,haematoma,severe pain and local infection as safety indicators.Results:1.Baseline status: There was no statistically significant difference between the three groups in terms of demographic characteristics,surgical site,risk factors associated with postoperative nausea and vomiting,and information related to surgery and anaesthesia(P > 0.05).2.Analysis of efficacy indicators:(1)Incidence of vomiting:(1)There was a statistically significant difference between the three groups in the incidence of vomiting from 0 to 2 hours after the procedure(P < 0.05).There was a statistically significant difference in the incidence of vomiting between the milli-needle group and the conventional group(P < 0.05);there was no statistically significant difference in the incidence of vomiting between the snap-needle group and the conventional group,and between the milli-needle group and the snap-needle group(P >0.05).(2)There was a statistically significant difference between the three groups in the incidence of vomiting between 2 and 6 hours after the procedure(P < 0.05).The difference between the two groups was statistically significant(P<0.05);the difference in the incidence of vomiting between the milli-needle and conventional groups and between the milli-needle and milli-needle groups was not statistically significant(P > 0.05).(3)There was no statistically significant difference between the three groups in the incidence of vomiting in the time periods of 6 to 24 hours after surgery and 24 to 48 hours after surgery(P > 0.05).(2)Incidence of nausea:(1)There was a statistically significant difference between groups in the incidence of nausea in the three groups from 2 to 6 hours after the procedure(P < 0.05).There was a statistically significant difference in the incidence of nausea between the snap-needle and conventional groups(P < 0.05);there was no statistically significant difference in the incidence of nausea between the milli-needle and conventional groups and between the milli-needle and snap-needle groups(P > 0.05).(2)There was no statistically significant difference between the three groups in the incidence of nausea in the three time periods of 0~2 hours,6~24 hours and 24~48 hours fter surgery(P > 0.05).(3)Severity of nausea: There was no statistically significant difference between the three groups in terms of nausea scores at the four post-operative time periods(P > 0.05).(4)Combined medication: There was no statistically significant difference in the frequency of combined medication among the three groups at the four post-operative time periods(P > 0.05).3.Safety: There was no statistically significant difference between the three groups in terms of safety(P > 0.05).Conclusion:1.Acupuncture at the Neiguan point has a preventive effect on post-operative nausea and vomiting after neurosurgical craniotomy.2.Both milli-needle and snap-needle stimulation of the Neiguan acupuncture point had a better preventive effect on post-operative nausea and vomiting after craniotomy than the conventional interventions in accelerated rehabilitation surgery alone.3.The preventive effect of milli-acupuncture at the Neiguan point on postoperative vomiting was more pronounced between 0 and 2 hoursafter surgery.The prevention of postoperative nausea and vomiting was more pronounced between 2 and 6 hours after surgery when the acupuncture points were buried with snapping needles.The prophylactic effect of snapping needles and milli-needle acupuncture on postoperative nausea and vomiting was comparable in all four time periods after surgery.4.Both milli-needle acupuncture and snap-needle buried acupuncture have good clinical efficacy,high safety and few adverse effects.However,the snap-acupuncture needle has the characteristics of long duration of acupuncture effect,high comfort and more convenient operation,and its feasibility of clinical promotion may be superior.