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Acupuncture and postoperative vomiting in day-stay paediatric patients
K L Schwager1, D B Baines, R J Meyer
1Department of Anaesthesia, New Children's Hospital, Sydney, N.S.W.
Insights
Acupuncture point stimulation at P6 and Li4 did not significantly reduce postoperative vomiting in children undergoing day-stay surgery. Vomiting incidence remained similar between stimulated and control groups over 24 hours.
Area of Science:
- Pediatric Anesthesiology
- Complementary and Alternative Medicine
- Surgical Outcomes
Background:
- Acupuncture point P6 stimulation is recognized for preventing nausea and vomiting in adults.
- Limited comparative research exists on its efficacy in pediatric populations.
- Postoperative nausea and vomiting (PONV) is a common concern in pediatric surgery.
Purpose of the Study:
- To evaluate the effectiveness of transcutaneous electrical stimulation of acupuncture points P6 and Li4 in reducing postoperative vomiting in children.
- To compare the incidence of vomiting between stimulated and control groups in pediatric day-stay surgery.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving 84 unpremedicated pediatric patients undergoing circumcision or herniotomy/orchidopexy.
- Patients received either transcutaneous stimulation of P6 and Li4 or a placebo (no stimulation).
- Vomiting incidence was monitored for 24 hours postoperatively across different recovery phases.
Main Results:
- No statistically significant difference in the overall incidence of postoperative vomiting was observed between the stimulated group and the control group (P = 0.909).
- No significant differences were found in vomiting rates within the recovery ward, day-stay ward, or at home.
- Vomiting was most frequent within the first four hours post-surgery and more prevalent in the day-stay ward.
Conclusions:
- Transcutaneous stimulation of acupuncture points P6 and Li4 is not effective in reducing postoperative vomiting in pediatric patients undergoing day-stay surgery.
- Further research may be needed to explore alternative or adjunct interventions for PONV in this population.
Abstract:
The stimulation of the acupuncture point P6 has been used to prevent nausea and vomiting in the adult population. It has, however, been subject to limited comparative evaluation in children. We proposed that stimulation of P6 and the analgesic point Li4 would reduce the incidence of postoperative vomiting. Eighty-four unpremedicated paediatric patients having day-stay surgery (circumcision or herniotomy/orchidopexy) were included in a randomized, double-blind, placebo-controlled study of transcutaneous stimulation of P6 and Li4, or no stimulation. The incidence of vomiting was recorded for 24 hours postoperatively. There was no statistically significant difference in total postoperative vomiting in those patients who were stimulated, compared with the control group (P = 0.909), or between any group for postoperative vomiting in the recovery ward, day-stay ward or at home. For all groups, vomiting was more common within the first four hours and more likely to occur in the day-stay ward.