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The effect of acupuncture on postoperative nausea and vomiting after pediatric tonsillectomy: A meta-analysis and
Hwang Cheol Shin1, Jong Seung Kim2,3, Sang Kyi Lee1
1Department of Anesthesiology and Pain Medicine, Chonbuk National University, Jeonju.
Insights
Acupuncture effectively reduces postoperative nausea and vomiting (PONV) in children after tonsillectomy. This method is a cost-effective alternative to traditional antiemetic drugs, offering significant relief from PONV symptoms.
Area of Science:
- Pediatric Surgery
- Integrative Medicine
- Pain Management
Background:
- Tonsillectomy is a common pediatric surgery with significant risks of postoperative nausea and vomiting (PONV).
- Traditional antiemetic drugs like ondansetron can be costly and have side effects.
- Effective and safe PONV prevention is crucial for pediatric patients undergoing tonsillectomy.
Purpose of the Study:
- To evaluate the antiemetic efficacy of acupuncture for preventing PONV in pediatric tonsillectomy patients.
- To compare acupuncture's effectiveness against conventional antiemetic drug therapies.
Main Methods:
- A systematic literature search was conducted across MEDLINE, Embase, and Cochrane databases up to July 2015.
- Eight studies (4 RCTs, 3 prospective cohorts, 1 pilot study) were included in the meta-analysis.
- Quality assessment used the Newcastle-Ottawa scale and Cochrane risk of bias tool.
Main Results:
- Meta-analysis of eight studies showed a significant reduction in PONV incidence with acupuncture compared to control groups (Risk Ratio 0.77).
- Acupuncture at the PC6 (neiguan) acupoint demonstrated a significantly lower risk ratio for PONV prevention than conventional drug therapy.
Conclusions:
- Acupuncture at PC6 is an effective and economical treatment for preventing PONV following pediatric tonsillectomy.
- While further RCTs are warranted, acupuncture presents a promising alternative to standard antiemetic treatments.
Objectives/Hypothesis:
Tonsillectomy is one of the most frequently performed pediatric surgical procedures worldwide. The complications of this procedure include postoperative nausea and vomiting (PONV) and pain; therefore, both the treatment and prevention of PONV are important. Classical antiemetics include drug therapies such as ondansetron, which are undesirable because they often carry a high cost and several side effects. Therefore, in this study we aimed to evaluate the antiemetic effect of acupuncture after pediatric tonsillectomy.
Methods:
We searched for eligible articles that reported on the antiemetic effects of acupuncture after tonsillectomy using the three databases, MEDLINE, Embase, and Cochrane, through July 2015. We included full-length original articles with adequate data for evaluating the antiemetic effects on pediatric tonsillectomy in the form of a relative ratio. The Newcastle-Ottawa scale was used to assess the quality of case control and cohort studies, and the Cochrane risk of bias tool was employed for randomized controlled trials (RCTs).
Results:
The search identified 415 publications. After screening, we selected eight articles for review (4 RCTs, 3 prospective cohorts, and 1 pilot study). A meta-analysis of acupuncture in pediatric tonsillectomy revealed that the number of patients with PONV was significantly reduced with acupuncture compared to the control group, with a risk ratio of 0.77 (95% confidence interval: 0.63-0.94, P < 0.05).
Conclusion:
When acupuncture at PC6 (neiguan) was used to prevent PONV after pediatric tonsillectomy, the risk ratio was significantly lower compared to that of conventional drug therapy. Although further randomized controlled trials are needed, acupuncture at PC6 is considered an economic and effective treatment for emesis after pediatric tonsillectomy. Laryngoscope, 126:1761-1767, 2016.
