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Randomized trial of acupuncture with antiemetics for reducing postoperative nausea in children

Christine S Martin1, Sarah E Deverman1, Daniel C Norvell2

  • 1Department of Anesthesia and Perioperative Medicine, Division of Pediatric Anesthesia, Oregon Health & Science University, Portland, Oregon.

Acta Anaesthesiologica Scandinavica
|November 7, 2018
PubMed

Insights

Acupuncture at the P6 point reduced nausea in children after tonsillectomy during early recovery. However, it did not significantly lower the overall incidence of postoperative nausea and vomiting (PONV) within 24 hours.

Area of Science:

  • Anesthesiology
  • Integrative Medicine
  • Pediatric Surgery

Background:

  • Postoperative nausea and vomiting (PONV) is a frequent complication following pediatric tonsillectomy.
  • Acupuncture at the pericardium 6 (P6) point has shown efficacy in preventing PONV in adults.
  • The study investigated the effectiveness of P6 acupuncture in pediatric PONV prevention.

Purpose of the Study:

  • To evaluate if intraoperative acupuncture at the P6 point, combined with standard antiemetics, is superior to antiemetics alone in preventing PONV in children undergoing tonsillectomy.
  • To assess the impact of P6 acupuncture on nausea, retching, and emesis during early postoperative recovery and up to postoperative day 1.

Main Methods:

  • A randomized double-blind trial involving 161 children aged 3-9 years undergoing tonsillectomy.
  • Participants received either bilateral P6 acupuncture plus antiemetics (ondansetron and dexamethasone) or antiemetics alone.
  • PONV incidence, severity, and need for additional antiemetics were recorded during PACU recovery (phases I and II) and via follow-up calls on postoperative day 1 (POD 1).

Main Results:

  • The incidence of PONV during PACU recovery (phases I and II) was significantly lower in the acupuncture group (7.0%) compared to the control group (34.7%).
  • This reduction was primarily driven by decreased nausea in the acupuncture group (5.0% vs 24.0%), with no significant difference in vomiting.
  • No significant difference in overall PONV incidence was observed between the groups within the first 24 hours post-surgery (36.1% vs 49.3%).

Conclusions:

  • Intraoperative acupuncture at the P6 point, when added to antiemetics, effectively reduces nausea during early postoperative recovery in children undergoing tonsillectomy.
  • Acupuncture did not demonstrate a significant impact on the overall incidence of PONV within 24 hours post-surgery.
  • P6 acupuncture may be a beneficial adjunct therapy for managing early postoperative nausea in pediatric surgical patients.
Abstract

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