[Acupuncture in anesthesia or analgesic-induced nausea and vomiting]

The most common and distressing symptoms following anesthesia and surgery are pain and emetic problems. Under most circumstances, pain causes the greater amount of suffering, particularly after major surgery, but in some instances postoperative nausea and vomiting (PONV) may be more distressing, particularly after minor surgery. In outpatient surgery, emesis may also have important economic implications, for example, admission to hospital beds because of intractable vomiting. Antimetic drugs given during the perioperative period may be associated with unwanted side effects, including sedation, hypotension and extrapyramidal reactions. Since 1986 there have been studies reporting beneficial antiemetic effects for Pe 6 stimulation on the right or both forearms in adults using either needling (acupuncture) or pressure (acupressure). The majority of these studies have investigated postoperative nausea and vomiting. But Pe 6 stimulation has also been shown to be an effective antiemetic for symptoms associated with pregnancy and chemotherapy. Although Pe 6 electro-acupuncture and acupressure are recognized as having an antiemetic effect, its inconvenient instrumentation may limit its clinical applicability. There have also been studies reporting beneficial antiemetic effects of P 6 acupoint injection with 50% glucose and acupuncture of the ear.