The efficiency of the acupressure in prevention of the chemotherapy-induced nausea and vomiting

Effects of PC6 acupressure on acute and delayed nausea and vomiting induced by chemotherapy in patients with malignant neoplasm: a meta-analysis

OBJECTIVE

Evaluating the intervention effect of PC6 acupressure on chemotherapy-induced acute, delayed nausea, and vomiting in malignant tumor patients.

METHOD

Eleven databases had been retrieved from January 2010 through January 2022. The published meta-analysis literature was hand-searched, and the language was limited to English and Chinese. The protocol of this meta-analysis was registered with PROSPERO (registration number: CRD42022323693). Two reviewers independently selected relevant eligible articles, extracted data, and evaluated the risk of bias. Meta-analysis was statistically analyzed using software RevMan 5.3.

RESULT

Ten randomized controlled trials with 975 patients were included. Only two studies were assessed as high quality; eight studies were evaluated as moderate. Meta-analysis showed that compared with the control group, PC6 acupressure reduced the occurrence number of acute (SMD = -0.39,95CI (-0.73, -0.05) P = 0.02), delayed (SMD = -0.51, 95% CI (-0.96, -0.05) P = 0.03) nausea and acute (SMD = -0.42,95% CI (-0.79, -0.06) P = 0.02), delayed (SMD = -0.37, 95% CI (-0.77, 0.03) P = 0.07) vomiting; it reduced the severity of acute (SMD = -0.34, 95% CI (-0.57, -0.11) P = 0.004), delayed (SMD = -0.79, 95% CI (-1.33, -0.25) P = 0.004) nausea and acute (SMD = -0.51, 95% CI (-0.79, -0.23) P = 0.0004), delayed (SMD = -0.50, 95% CI (-0.84, -0.17) P = 0.003) vomiting, while it did not reduced the experience time on acute and delayed CINV.

CONCLUSION

The meta-analysis shows the effectiveness of PC6 acupressure in preventing and treating nausea and vomiting. Large, high-quality, well-designed randomized controlled trials are needed in the future to determine the efficacy of PC6 acupressure on chemotherapy-induced nausea and vomiting.

Acupuncture in chemotherapy-induced dysgeusia (AcuDysg): study protocol of a randomised controlled trial

INTRODUCTION

Dysgeusia is a common side effect of chemotherapy in patients with cancer, but to date, there is no effective treatment. Many patients with cancer request complementary medicine treatment in addition to their cancer treatments, and acupuncture is highly accepted for patients with cancer; however, evidence regarding the effectiveness of acupuncture for dysgeusia is scarce.The study investigates the effectiveness of an additional dysgeusia-specific acupuncture plus self-acupressure intervention compared with supportive acupuncture plus self-acupressure intervention alone for chemotherapy-induced dysgeusia in patients with cancer.

METHODS AND ANALYSIS

This is a multicentre, randomised, controlled and two-armed parallel-group, single-blind trial involving 130 patients. Both groups will receive eight sessions of acupuncture treatment over a period of 8 weeks and will be trained to perform self-acupressure (eLearning combined with therapist instruction) at predefined acupressure points once a day during the whole treatment period. Patients in the control group will receive supportive routine care acupuncture and self-acupressure treatment only; in addition to this treatment, the intervention group will receive the dysgeusia-specific acupuncture and acupressure within the same treatment session. The primary outcome is the perceived dysgeusia over 8 weeks, measured weekly after the acupuncture treatment. Secondary outcomes include the indices from the objective taste and smell test, weight loss, perceived dysgeusia, fatigue, distress, nausea and vomiting, odynophagia, xerostomia and polyneuropathy, as well as quality of life at the different time points.

ETHICS AND DISSEMINATION

The study has been approved by the Cantonal Ethics Committee (CEC) (Kanton Zürich Kantonale Ethikkommission) (approval no. KEK-ZH-Nr. 2020-01900). The results will be submitted to a peer-reviewed journal for publication.

TRIAL REGISTRATION NUMBERS

DRKS00023348, SNCTP000004128.

The Effects of Acupressure in the Prevention of Nausea and Vomiting Related to Chemotherapy in Children: A Randomized Double-Blinded Placebo-Controlled Study

Background: Acupressure is known to be a nursing intervention used to prevent chemotherapy-induced nausea and vomiting in children. Methods: This study was conducted to evaluate and compare the effectiveness of manual and wristband acupressure in the prevention of chemotherapy-induced nausea and vomiting in children. This double-blinded and placebo-controlled study was conducted with 44 children aged between 5 and 18 years receiving chemotherapy in a university hospital's pediatric oncology clinic. Children were randomized into groups using a 2 × 2 factorial design: (a) The child who was given manual acupressure before the first chemotherapy was given placebo manual acupressure before the next chemotherapy; (b) the same child who was administered wristband acupressure before the first chemotherapy was administered placebo wristband acupressure before the next chemotherapy. After all interventions, the severity and number of episodes of nausea and vomiting and additional antiemetic needs in the children were monitored for 24 h. Results: In both groups, the severity and number of nausea and vomiting were lower according to their own placebo groups. Manual and wristband acupressure were effective in reducing the severity and number of nausea and vomiting, but manual acupressure was more effective in reducing the severity and number of nausea and vomiting in comparison to wristband acupressure (p < .05). No statistically significant difference was found between the groups regarding additional antiemetic drug use. Discussion: In this study, manual and wristband acupressure were determined to be effective in reducing the severity and number of nausea and vomiting related to chemotherapy.

High Feasibility and Safety, but Negligible Efficacy of Acupressure for Treating Nausea in Cancer Patients Admitted to the Palliative Care Unit: A Pilot Study

Management of nausea is an important dimension of palliative care. The first choice for treating nausea is antiemetics, but their efficacy is inadequate. Acupressure intervention for nausea in cancer patients has been studied as a non-pharmacological therapy, and appears to have had some effect. However, such a therapy has not been well reviewed in patients with terminal cancer. The purpose of this study was to clarify the feasibility of acupressure intervention and examine its safety and preliminary efficacy. We recruited cancer patients that fulfilled the eligibility criteria and were admitted to the palliative care unit, from August 2018 to February 2019, in Tohoku University Hospital, Japan. We conducted a longitudinal assessment of acupressure intervention in a single arm. We identified the patient's research accomplishments and evaluated possible fainting due to the vagal reflex and symptom severity. Descriptive statistics were used to calculate the completion rate for the feasibility and Wilcoxon signed-rank tests to compare the average of continuous variables for the safety and efficacy. Twelve patients participated in this study and completed the procedure. Their average age was 70 years (SD = 9.3), and the most common primary cancer sites were the rectum and pancreas. The blood pressure and pulse rate did not drop sharply. Four patients exhibited decreased nausea but there was no statistically significant difference (P = 0.5). We suggested that acupressure has high feasibility and safety, as an intervention for patients with terminal cancer. However, no significant differences were observed regarding its effect on nausea.

Effect of Music Therapy with Periorbital Massage on Chemotherapy-Induced Nausea and Vomiting In Gastrointestinal Cancer: A Randomized Controlled Trail

Introduction: Music and massage therapy are among the approaches of complementary medicine. Patients with cancer have been hugely encouraged in recent years to use complementary medicine to relieve chemotherapy-induced nausea and vomiting. The present study was conducted to determine the effect of music and periorbital massage therapy on chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancers.

Methods: The present single-blind clinical trial study was conducted on 60 patients with gastrointestinal cancer undergoing chemotherapy who were randomly assigned to control and music plus massage therapy groups. Two interventions were concurrently carried out on patients in music plus massage therapy group while receiving chemotherapy medication, but the control group received no intervention. Rhodes questionnaire was used to assess nausea and vomiting before and 24 hours after chemotherapy. Data were analyzed using descriptive and analytical statistical tests (Chi-square and t-tests).

Results: Music plus periorbital massage therapy significantly reduced nausea and vomiting in patients undergoing chemotherapy compared to the control group.

Conclusion: According to the results, using music plus periorbital massage improves nausea and vomiting in patients undergoing chemotherapy, and can be considered as a complementary medicine method in conjunction with other medicinal therapies to relieve symptoms of patients with cancer.

Effectiveness of acupressure on the experience of nausea and vomiting among patients receiving chemotherapy

The study was conducted for a period of six weeks among 40 cancer patients selected by purposive sampling to explore the impact of acupressure on nausea and vomiting for patients receiving chemotherapy. Data were gathered using a semi-structured interview schedule, semi-structured questionnaire and Rhodes' index of nausea, vomiting and retching. The research design was a quasi experimental 'post-test only, control group design'. Data analysis was done using descriptive and inferential statistics involving frequency, percentage, Chi square and independent 't' test. Results of the study showed that the subjects in the experimental group experienced mild (65%) to moderate (35%) nausea and vomiting, whereas the subjects in the control group experienced moderate (35%) to severe (65%) nausea and vomiting, t (38)= 2.693, 8.270, 8.401 respectively for days 1, 2 and 3; p < 0.05). The results point to the fact that acupressure is effective in reducing nausea and vomiting among patients receiving chemotherapy.

Acupressure bands do not improve chemotherapy-induced nausea control in pediatric patients receiving highly emetogenic chemotherapy: A single-blinded, randomized controlled trial

BACKGROUND

Chemotherapy-induced nausea and vomiting remain common, distressing side effects of chemotherapy. It has been reported that acupressure prevents chemotherapy-induced nausea in adults, but it has not been well studied in children.

METHODS

In this multicenter, prospective, randomized, single-blind, sham-controlled trial, the authors compared acute-phase nausea severity in patients ages 4 to 18 years who were receiving highly emetic chemotherapy using standard antiemetic agents combined with acupressure wrist bands, the most common type of acupressure, versus sham bands. Patients wore acupressure or sham bands continuously on each day of chemotherapy and for up to 7 days afterward. Chemotherapy-induced nausea severity in the delayed phase and chemotherapy-induced vomiting control in the acute and delayed phases also were compared.

RESULTS

Of the 187 patients randomized, 165 contributed nausea severity assessments during the acute phase. Acupressure bands did not reduce the severity of chemotherapy-induced nausea in the acute phase (odds ratio [OR], 1.33; 95% confidence limits, 0.89-2.00, in which an OR <1.00 favored acupressure) or in the delayed phase (OR, 1.23; 95% CL, 0.75-2.01). Furthermore, acupressure bands did not improve daily vomiting control during the acute phase (OR, 1.57; 95% CL, 0.95-2.59) or the delayed phase (OR, 0.84; 95% CL, 0.45-1.58). No serious adverse events were reported.

CONCLUSIONS

Acupressure bands were safe but did not improve chemotherapy-induced nausea or vomiting in pediatric patients who were receiving highly emetic chemotherapy. Cancer 2018;124:1188-96. © 2017 American Cancer Society.

Antiemetics: American Society of Clinical Oncology Clinical Practice Guideline Update

Purpose

To update the ASCO guideline for antiemetics in oncology.

Methods

ASCO convened an Expert Panel and conducted a systematic review of the medical literature for the period of November 2009 to June 2016.

Results

Forty-one publications were included in this systematic review. A phase III randomized controlled trial demonstrated that adding olanzapine to antiemetic prophylaxis reduces the likelihood of nausea among adult patients who are treated with high emetic risk antineoplastic agents. Randomized controlled trials also support an expanded role for neurokinin 1 receptor antagonists in patients who are treated with chemotherapy.

Recommendation

Key updates include the addition of olanzapine to antiemetic regimens for adults who receive high-emetic-risk antineoplastic agents or who experience breakthrough nausea and vomiting; a recommendation to administer dexamethasone on day 1 only for adults who receive anthracycline and cyclophosphamide chemotherapy; and the addition of a neurokinin 1 receptor antagonist for adults who receive carboplatin area under the curve ≥ 4 mg/mL per minute or high-dose chemotherapy, and for pediatric patients who receive high-emetic-risk antineoplastic agents. For radiation-induced nausea and vomiting, adjustments were made to anatomic regions, risk levels, and antiemetic administration schedules. Rescue therapy alone is now recommended for low-emetic-risk radiation therapy. The Expert Panel reiterated the importance of using the most effective antiemetic regimens that are appropriate for antineoplastic agents or radiotherapy being administered. Such regimens should be used with initial treatment, rather than first assessing the patient’s emetic response with less-effective treatment. Additional information is available at www.asco.org/supportive-care-guidelines and www.asco.org/guidelineswiki .

Contemporary acupressure therapy: Adroit cure for painless recovery of therapeutic ailments

Since time immemorial, complementary and alternative medicines (CAM) have played a significant role in human health care. CAM is known to have a strong reputation and reliability within every culture to provide basic health care treatment for patients. CAM acts as a better therapeutic option in human being for treating various diseases and improving quality of life with apt consideration to the economic aspects. Acupressure, one of the known CAM, originated in ancient China is based on the principal of acupoints activation across the meridians which correct the imbalance between Qi. Activation of specific points on the meridians is known to facilitate reduction of pain at the local sites. It also reduces the pain from other body parts. This review outlines various types, devices and mechanisms involved in the acupressure treatment.

Investigation of Nausea and Vomiting in Cancer Patients Undergoing Chemotherapy

Nausea and vomiting are the most important problems in patients undergoing chemotherapy, despite the recent improvements in the administration of antiemetic drugs. Through a review of the literature, we found that there are several nursing researches focusing on the effectiveness of interventions for the treatment of nausea and vomiting in cancer patients. The purpose of this study was to investigate the symptom of nausea and vomiting in patients undergoing chemotherapy. The study also investigated the impact of nausea and vomiting on patients' ability to respond to daily activities. The study is descriptive; the sample included patients with different types of cancer and receiving chemotherapy. The inclusion criteria were: the histological diagnosis of cancer, the administration of chemotherapy and the knowledge of the Greek language. The questionnaires used were: the MASCC (vomiting questionnaire), the Memorial Symptom Assessment Scale and the scale of functional assessment of cancer therapy. Data collection took place in oncological hospitals of Thessaloniki and Athens in Greece. For statistical analysis we used the statistical package SPSS 15.0.

The effect of acupressure application on chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer

OBJECTIVE

The purpose of this study was to determine the effect of acupressure applied to the pericardium 6 (P6 or neiguan) acupuncture point on chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer.

METHOD

The study was conducted using a quasi-experimental model with a control group. It included a total of 64 patients with stages 1-3 breast cancer who received cycle two and more advanced chemotherapy in an ambulatory chemotherapy unit. There were 32 patients in the experimental group and 32 patients in the control group. Acupressure was applied to the P6 acupuncture point of patients in the experimental group with the help of a wristband. A Patient Information Form, the Beck Anxiety Inventory, and the Index of Nausea, Vomiting and Retching were employed to collect the data.

RESULTS

It was determined that the mean nausea, vomiting, and retching scores, the total (experience, occurrence, and distress) scores, and the mean anxiety scores for patients to whom acupressure was applied at the P6 acupuncture point were statistically significantly lower compared with the scores of patients in the control group.

SIGNIFICANCE OF RESULTS

The efficacy of applying acupressure was demonstrated. We determined that applying acupressure at the P6 point is effective in decreasing chemotherapy-induced nausea, vomiting, and anxiety in patients with breast cancer. Further research with more subjects is needed.

Effect of acupressure on post-operative nausea and vomiting in cesarean section: a randomised controlled trial

BACKGROUND

Because of potential side effects of chemical treatments and in order to decrease the risk of nausea and vomiting in post-operative patients, there is a necessary requirement for some alternative therapeutic methods such as Acupressure.

AIM

The present randomized clinical trial study aimed to compare the effects of Acupressure and Metoclopramide on postoperative nausea and vomiting in Caesarean Sections.

SETTING AND DESIGN

The patients who were subjected to caesarean surgeries, who were referred to the Ilam Mustafa Hospital in the west of Iran, were enrolled in this randomised clinical trial study.

MATERIAL AND METHODS

Totally, 102 patients who were selected for elective Caesarean Section were included in this study. Patients were randomly assigned to one of three groups, with 34 cases in each group. All groups were matched for effective factors on nausea and vomiting in inclusion and exclusion criteria. The control group did not receive any intervention, the second group received 10 mg Metoclopramide intravenously, immediately prior to anaesthesia induction and in the third group, Acupressure bands were applied at the P6 points on both wrists, 15 minutes before anaesthesia induction. Intra-operative and post-operative emetic episodes were recorded by a trained investigator. The patients who experienced nausea were evaluated on a linear numeric scale which ranged from 0 (no) to 10 (severe). Statistics and Results: The incidence of nausea and vomiting in postoperative periods was lower in Metoclopramide and Acupressure groups as compared that in the control group. The frequency of anti-emetic which was used was significantly higher in control group as compared to those in the other groups (p<0.001). No side effects or complications were caused by any intervention.

CONCLUSION

In parturients who underwent caesarean deliveries which were performed under spinal anaesthesia in this study, use of Metoclopramide and Acupressure was found to be equally effective for reducing emetic symptoms (nausea, retching, and vomiting).