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Park MS, Park WS, Nam D, Min SY, Chae S. Efficacy of electroacupuncture in preventing nausea and vomiting after thyroidectomy: A prospective randomized controlled trial. Asian J Surg 2023; 46:3480-3484. [PMID: 36369133 DOI: 10.1016/j.asjsur.2022.10.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/16/2022] [Accepted: 10/27/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Postoperative nausea and vomiting are regarded as a serious concern after thyroidectomy. Electroacupuncture shows the potential to reduce general anesthesia-related side effects. The aim of this study was to evaluate the efficacy of electroacupuncture in preventing postoperative nausea and vomiting that commonly occurs in patients after thyroidectomy. METHODS This study was a prospective randomized controlled trial with a two-arm, patient blind structure. Sixty-four participants were randomly assigned to the acupuncture (n = 35) or control (n = 29) group. Patients in the acupuncture group received electroacupuncture and intradermal press needles. The primary endpoint was the incidence and severity of postoperative nausea and vomiting, and secondary endpoints were the length of hospital stay, pain severity, and postoperative in-hospital morbidity. RESULTS The total incidence of postoperative nausea and vomiting was 40.6% (26/64). There was no difference in the incidence between the control (10/29, 34.5%) and acupuncture (16/35, 45.7%) groups (p = 0.362). The severity of postoperative nausea and vomiting was not different between the groups (p = 0.842). Length of hospitalization and postoperative complications were not different between the groups. CONCLUSION In this randomized controlled trial, electroacupuncture treatment after thyroidectomy is safe and comparable to conventional anti-emetic therapy. TRIAL REGISTRATION Clinical Research Information Service, KCT0001782. Registered on 26 January 2016.
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Affiliation(s)
- Min-Su Park
- Department of Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Won Seo Park
- Department of Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
| | - Dongwoo Nam
- Department of Acupuncture and Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sun Young Min
- Department of Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Sumin Chae
- Department of Surgery, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
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Zhang X, Wang Q, Dong Y, Jia Y, Hou Z, Deng W, Zhang M, Mu Q, Jia H. Acupuncture-assisted anaesthesia for catheter ablation of atrial fibrillation to reduce the consumption of morphine hydrochloride and postoperative nausea and vomiting (PONV): study protocol for a randomised controlled trial. BMJ Open 2022; 12:e068318. [PMID: 36521882 PMCID: PMC9756186 DOI: 10.1136/bmjopen-2022-068318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Patients often experience postoperative nausea and vomiting (PONV) after catheter ablation of atrial fibrillation (AF) because of the use of opioids for anaesthesia and analgesia during the procedure. Some clinical trials have demonstrated that acupuncture-assisted anaesthesia (AAA) reduces opioid consumption and prevents PONV. Although several studies have been conducted on AAA, its safety and efficacy in AF catheter ablation remain unclear due to small sample sizes and a paucity of methodologically rigorous designs. Therefore, this trial was designed to evaluate the safety and efficacy of AAA in reducing PONV and morphine hydrochloride consumption during catheter ablation. METHODS This single-centre, patient-blinded, randomised, non-penetrating sham-controlled trial will be conducted in China. A total of 100 patients will be randomly assigned to the AAA and conventional anaesthesia (CA) groups in a ratio of 1:1. The patients will receive AAA or CA plus sham acupuncture during catheter ablation and will be followed up for 30 days. The primary outcomes include the total amount of morphine hydrochloride consumed during catheter ablation and PONV within the first 24 hours after the procedure. The secondary outcomes include pain, nausea and vomiting, anxiety, patient's ability to cope during catheter ablation, AF recurrence and quality of life, as assessed using the numeric rating scale. Adverse events will be recorded and their influence will be analysed at the end of the trial. DISCUSSION This study will help in evaluating the safety and efficacy of AAA applied for AF catheter ablation in reducing opioid doses during the procedure and the occurrence of PONV. ETHICS AND DISSEMINATION The study has been approved by the Medical Ethics Committee of Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine. The results of the study will be published in peer-reviewed journals and presented at conferences if possible. TRIAL REGISTRATION NUMBER ChiCTR 2100042646; Chinese Clinical Trial Registry.
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Affiliation(s)
- Xuecheng Zhang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Qi Wang
- Department of Acupuncture and Moxibustion, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yujiang Dong
- Department of Cardiology, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yuqi Jia
- College of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhihui Hou
- Department of Acupuncture and Moxibustion, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Wenqi Deng
- Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Menghe Zhang
- Department of Cardiology, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qiurun Mu
- College of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Hongling Jia
- Department of Acupuncture and Moxibustion, Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
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Xu H, Wei X, Zhang R, Li L, Zhang Z, Jia R, Zhang X, Gao X, Dong X, Pan J. The acupoint herbal plaster for the prevention and treatment of postoperative nausea and vomiting after PLIF with general anesthesia: study protocol for a multicenter randomized controlled trial. Trials 2021; 22:79. [PMID: 33482878 PMCID: PMC7821521 DOI: 10.1186/s13063-021-05037-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 01/09/2021] [Indexed: 11/10/2022] Open
Abstract
Background Postoperative nausea and vomiting (PONV) are common in posterior lumbar intervertebral fusion (PLIF) patients undergoing general anesthesia. The previous clinical observation has shown that a traditional acupoint herbal plaster (AHP) is beneficial to patients with PONV. This trial aims to assess the effect of the AHP for the prevention and treatment of PONV after PLIF in patients with general anesthesia. Methods A multicenter, parallel, randomized controlled trial (RCT) will be conducted. A total of 166 participants will be randomized to either a treatment group receiving an AHP or a control groups receiving an acupoint placebo plaster (APP) in a 1:1 ratio. The primary outcomes are the first occurrence and frequency of nausea and vomiting. The secondary outcomes include the severity grading of nausea and vomiting using a visual analog scale (VAS) measurement system, quality of life, and serological indicators. The safety evaluation is mainly about adverse events and skin reactions’ observation. Assessments will be carried out at the baseline, day 1, and day 2 (the end of the intervention). The central randomization system in the clinical trial (http://124.205.181.142:8082/xwtf/) will be used to conduct random allocation. Discussion This scientific methodology design of the trial is expected to provide clinical evidence to support the AHP for the prevention and treatment of PONV. Trial registration This study is retrospectively registered with the Chinese Clinical Trial Registry (http://www.chictr.org.cn) on 19 April 2018. ID: ChiCTR1800015768.
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Affiliation(s)
- Huiqing Xu
- Department of Anesthesiology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China
| | - Xu Wei
- Department of Scientific Research, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China
| | - Ranxing Zhang
- Department of Clinical Laboratory, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China
| | - Ling Li
- Department of Anesthesiology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China
| | - Zhijun Zhang
- Department of Anesthesiology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China
| | - Ruo Jia
- Department of Anesthesiology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China
| | - Xiaofei Zhang
- Department of Anesthesiology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, 100102, China
| | - Xiumei Gao
- Department of Anesthesiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China
| | - Xicheng Dong
- Department of Anesthesiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Junjun Pan
- TCM Characteristic Clinical Center, Wangjing Hospital, China Academy of Chinese Medical Sciences, 100102, Beijing, China.
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Elvir-Lazo OL, White PF, Yumul R, Cruz Eng H. Management strategies for the treatment and prevention of postoperative/postdischarge nausea and vomiting: an updated review. F1000Res 2020; 9. [PMID: 32913634 PMCID: PMC7429924 DOI: 10.12688/f1000research.21832.1] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 01/10/2023] Open
Abstract
Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) remain common and distressing complications following surgery. The routine use of opioid analgesics for perioperative pain management is a major contributing factor to both PONV and PDNV after surgery. PONV and PDNV can delay discharge from the hospital or surgicenter, delay the return to normal activities of daily living after discharge home, and increase medical costs. The high incidence of PONV and PDNV has persisted despite the introduction of many new antiemetic drugs (and more aggressive use of antiemetic prophylaxis) over the last two decades as a result of growth in minimally invasive ambulatory surgery and the increased emphasis on earlier mobilization and discharge after both minor and major surgical procedures (e.g. enhanced recovery protocols). Pharmacologic management of PONV should be tailored to the patient’s risk level using the validated PONV and PDNV risk-scoring systems to encourage cost-effective practices and minimize the potential for adverse side effects due to drug interactions in the perioperative period. A combination of prophylactic antiemetic drugs with different mechanisms of action should be administered to patients with moderate to high risk of developing PONV. In addition to utilizing prophylactic antiemetic drugs, the management of perioperative pain using opioid-sparing multimodal analgesic techniques is critically important for achieving an enhanced recovery after surgery. In conclusion, the utilization of strategies to reduce the baseline risk of PONV (e.g. adequate hydration and the use of nonpharmacologic antiemetic and opioid-sparing analgesic techniques) and implementing multimodal antiemetic and analgesic regimens will reduce the likelihood of patients developing PONV and PDNV after surgery.
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Affiliation(s)
| | - Paul F White
- Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.,The White Mountain Institute, The Sea Ranch, Sonoma, CA, 95497, USA.,Instituto Ortopedico Rizzoli, University of Bologna, Bologna, Italy
| | - Roya Yumul
- Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, 90048, USA.,David Geffen School of Medicine-UCLA, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90095, USA
| | - Hillenn Cruz Eng
- Department of Anesthesiology, PennState Hershey Medical Center, Hershey, PA, 17033, USA
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St. James ML, Kosanovich DL, Snyder LB, Zhao Q, Jones BG, Johnson RA. Effects of acupuncture at Pericardium-6 and Stomach-36 on nausea, sedation and gastrointestinal motility in healthy dogs administered intravenous lidocaine infusions. PLoS One 2019; 14:e0226065. [PMID: 31805134 PMCID: PMC6894766 DOI: 10.1371/journal.pone.0226065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 11/12/2019] [Indexed: 02/07/2023] Open
Abstract
The objectives of this study were to assess gastrointestinal transit times, sedation, and signs of nausea associated with intravenous lidocaine infusions in dogs following targeted acupuncture at Pericardium-6 (PC6) and Stomach-36 (ST36). In a randomized, blind crossover design, 6 healthy, adult Beagles were fed thirty 1.5 mm barium-impregnated polyethylene spheres (BIPS), then were subject to 30 minutes of: 1) no acupuncture, 2) bilateral targeted acupuncture at PC6 and ST36, or 3) bilateral non-target acupuncture at Lung-5 (LU5) and Bladder-55 (BL55). Lidocaine was immediately administered at 1 mg/kg intravenously followed by 50 μg/kg/min. BIPS were tracked radiographically; sedation and nausea were scored at baseline (Time 0) and for 11 hours during lidocaine infusions. Transit times and sedation and nausea scores were analyzed with a linear mixed-effects model; the number of BIPS at defined time points was analyzed with a piecewise linear mixed-effects model. All P values were two-sided and P < 0.05 was considered significant. Sedation and nausea scores did not differ between treatments at any time point (all P > 0.05). However, nausea scores in all groups were significantly greater at Times 5 through 7 and at Time 11 compared to Time 0 whereas sedation scores in all groups were significantly greater at Times 2 through 11 compared to Time 0 (all P < 0.05). The number of BIPs found out of the stomach, the number found in the large intestine, gastric emptying and gastrointestinal transit times did not differ between treatments (all P > 0.05). Acupuncture at PC6 and ST36 did not alleviate nausea and sedation associated with lidocaine infusions in clinically normal animals or affect gastric emptying and gastrointestinal transit.
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Affiliation(s)
- Mariko L. St. James
- Department of Surgical Sciences, University of Wisconsin, Madison, Wisconsin, United States of America
| | - DeAnna L. Kosanovich
- Department of Surgical Sciences, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Lindsey B. Snyder
- Department of Surgical Sciences, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Qianqian Zhao
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Brian G. Jones
- Antech Imaging Services, Fountain Valley, California, United States of America
| | - Rebecca A. Johnson
- Department of Surgical Sciences, University of Wisconsin, Madison, Wisconsin, United States of America
- * E-mail:
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