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Arslan HN, Çelik SŞ. Nonpharmacological Nursing Interventions in Postoperative Nausea and Vomiting: A Systematic Review. J Perianesth Nurs 2024; 39:142-154. [PMID: 37865902 DOI: 10.1016/j.jopan.2023.06.096] [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: 11/12/2022] [Revised: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 10/23/2023]
Abstract
PURPOSE This study aims to assess the impact of nonpharmacological nursing interventions on postoperative nausea and vomiting (PONV). DESIGN This is a systematic review. METHODS MEDLINE, Web of Science, ScienceDirect, Tübitak-ULAKBİM, and TRDizin databases were searched for the following search terms, including "Postoperative Nausea and Vomiting," "Nurse," "Nursing," and "Nonpharmacological Interventions" to identify nonpharmacological nursing interventions for PONV. A systematic review of English and Turkish articles published in the period between January 1, 2012 and June 1, 2023 was conducted. The PICOT-SD method was used to determine the compatibility of the pieces with the eligibility criteria. FINDINGS Fifty-eight of 3,874 articles obtained from databases fulfilled the eligibility criteria. This study demonstrated that acupuncture, aromatherapy, the oral intake of ginger, listening to music, education, and visits to patients decreased the incidence of nausea and vomiting and increased the quality of life. Additionally, it was found that patients' quality of life tended to improve along with reductions in postoperative complications. CONCLUSIONS The results of this study support previous findings in the literature and demonstrate that nonpharmacological nursing interventions help reduce and prevent PONV. Based on our results, we suggest that nonpharmacological nursing interventions can be employed for the management of PONV in patients undergoing surgery.
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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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Chao YL, Rau YA, Shiue HS, Yan JL, Tang YY, Yu SW, Yeh BY, Chen YL, Yang TH, Cheng SC, Hsieh YW, Huang HC, Tsai FK, Chen YS, Liu GH. Using a consensus acupoints regimen to explore the relationship between acupuncture sensation and lumbar spinal postoperative analgesia: A retrospective analysis of prospective clinical cooperation. JOURNAL OF INTEGRATIVE MEDICINE 2022; 20:329-337. [PMID: 35487866 DOI: 10.1016/j.joim.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 01/31/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This study evaluated the effectiveness of acupuncture treatment on postoperative pain in patients with degenerative lumbar spine disease, and explored the relationship between the postoperative analgesic effect of acupuncture and the sensation of acupuncture experienced by the patients. METHODS This retrospective study analyzed the medical records of 97 patients who had undergone an operation by the same surgeon due to degenerative lumbar disease. These patients were divided into acupuncture group (n = 32), patient-controlled analgesia (PCA) group (n = 27), and oral analgesia group (n = 38) according to the different postoperative analgesic methods. During their hospitalization, patients completed daily evaluations of their pain using a visual analogue scale (VAS), and injection times of supplemental meperidine were recorded. Also, the Chinese version of the Massachusetts General Hospital Acupuncture Sensation Scale (C-MASS) was used in the acupuncture group. RESULTS Each of the three treatment groups showed significant reductions in postoperative pain, as shown by reduced VAS scores. The acupuncture group, however, had less rebound pain (P < 0.05) than the other two groups. Both the acupuncture and PCA groups experienced acute analgesic effects that were superior to those in the oral analgesia group. In addition, the higher the C-MASS index on the second day after surgery, the lower the VAS score on the fourth day after surgery. There was also a significant difference in the "dull pain" in the acupuncture sensation. CONCLUSION The results demonstrated that acupuncture was beneficial for postoperative pain and discomfort after simple surgery for degenerative spinal disease. It is worth noting that there was a disproportionate relevance between the patient's acupuncture sensation and the improvement of pain VAS score.
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Affiliation(s)
- Yen-Lin Chao
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Yi-Ai Rau
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Hong-Sheng Shiue
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, China
| | - Jiun-Lin Yan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, China; Department of Neurosurgery, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan, China
| | - Yuan-Yun Tang
- Department of Traditional Chinese Medicine, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital, New Taipei 236, Taiwan, China
| | - Shao-Wen Yu
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Bo-Yan Yeh
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Yen-Lung Chen
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Tsung-Hsien Yang
- Department of Traditional Chinese Medicine, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital, New Taipei 236, Taiwan, China
| | - Shu-Chen Cheng
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Yi-Wen Hsieh
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Hsin-Chia Huang
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Fu-Kuang Tsai
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China
| | - Yu-Sheng Chen
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, China
| | - Geng-Hao Liu
- Division of Acupuncture and Moxibustion, Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China; School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan, China; Sleep Center, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan, China.
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Zhu J, Li S, Wu W, Guo J, Wang X, Yang G, Lu Z, Ji F, Zou R, Zheng Z, Zheng M. Preoperative electroacupuncture for postoperative nausea and vomiting in laparoscopic gynecological surgery: a randomized controlled trial. Acupunct Med 2022; 40:415-424. [PMID: 35229627 DOI: 10.1177/09645284221076517] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: We aimed to evaluate the effectiveness and safety of preoperative electroacupuncture (EA) on the incidence of postoperative nausea and vomiting (PONV), and severity of postoperative pain, in gynecological patients undergoing laparoscopic surgery. The effects of EA administered at different preoperative time points were compared. Methods: A total of 413 patients undergoing elective laparoscopic gynecological surgery were randomly allocated into 4 groups receiving EA the day before surgery (Group Pre, n = 103), 30 min before (Group 30, n = 104) or both (Group Comb, n = 103), or usual care alone (Group Usual, n = 103). All acupuncture groups had usual care. The incidence of PONV and pain at 24 h were primary outcomes. Secondary outcomes included the severity of postoperative nausea, vomiting and pain, requirement for antiemetic medication and quality of recovery (QoR)-15 scores after surgery. Results: There were significant differences between the four groups in nausea and vomiting incidence (0–24 h), postoperative antiemetic use (0–48 h), and postoperative pain (0–6 h), with the EA groups recording the lowest levels. Regarding primary outcomes, incidence of nausea and vomiting at 6-24 h was 28/11/18/11% (p = 0.003) 23/5/8/9% (p < 0.001), respectively, for Groups Usual/Pre/30/Comb. Accordingly, EA reduced the incidence of nausea and vomiting at 6-24 h by 61/34/60% and 79/65/61% for Groups Pre/30/Comb, respectively. Regarding secondary outcomes, incidence of nausea and vomiting at 0-6 h was 20/9/11/7% (p = 0.013) and 17/7/9/6% (p = 0.021), respectively, for Groups Usual/Pre/30/Comb. Rescue antiemetics at 0–6 h were required by 18/4/11/4% (p = 0.001) in Groups Usual/Pre/30/Comb. The mean numerical rating scale (NRS) pain score (0–10) at 0–6 h was significantly different between groups (2.45/1.89/2.01/1.97 for Groups Usual/Pre/30/Comb, p = 0.024). There were no significant differences between the three EA-treated groups. Conclusion: In gynecological patients undergoing laparoscopic surgery and treated with multimodal antiemetic methods, one session of preoperative EA may be a safe adjunctive treatment for PONV prophylaxis. Optimal timing of EA requires further verification. Trial registration number: ChiCTR-INR-16010035 (Chinese Clinical Trial Registry).
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Affiliation(s)
- Juan Zhu
- Department of Anesthesiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Sha Li
- Department of Anesthesiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenzhong Wu
- Department of Acupuncture, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Guo
- Department of Anesthesiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiaoqiu Wang
- Department of Acupuncture, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Guang Yang
- Department of Anesthesiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhigang Lu
- Key Laboratory of Acupuncture and Medicine Research of Ministry of Education, College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, China
| | - Fangbing Ji
- Department of Anesthesiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Rong Zou
- Department of Anesthesiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhen Zheng
- Discipline of Chinese Medicine, School of Health and Biomedical Sciences, World Health Organization Collaborating Centre for Traditional Medicine, RMIT University, Melbourne, VIC, Australia
| | - Man Zheng
- Department of Anesthesiology, The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Zheng XZ, Xiong QJ, Liu D, Wei K, Lai Y. Effectiveness of Acupuncture Therapy on Postoperative Nausea and Vomiting After Gynecologic Surgery: A Meta-Analysis and Systematic Review. J Perianesth Nurs 2021; 36:564-572. [PMID: 34404603 DOI: 10.1016/j.jopan.2020.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/13/2020] [Accepted: 12/26/2020] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim of this study was to evaluate the effectiveness and safety of acupuncture therapy (AT) on postoperative nausea and vomiting (PONV) after gynecologic surgery (GS). DESIGN A meta-analysis using a systematic search strategy was performed. METHODS A comprehensive literature search of all published randomized controlled trials or prospective cohort studies assessing the effectiveness of AT on PONV in patients undergoing GS was conducted in three databases: PubMed, EMBASE, and Cochrane Library. The incidence of PONV, the use of rescue antiemetics, and side effects of AT were analyzed using the Review Manager 5.3 software. FINDINGS Nine randomized controlled trials and one prospective cohort study identified in the literature search from database inception (1966) to December 31, 2019, including 1,075 participants were included in the present study. AT significantly reduced the risk of developing postoperative nausea and postoperative vomiting by 48% (relative risk = 0.52; 95% confidence interval, 0.44 to 0.61; P < .00001) and 42% (relative risk = 0.58; 95% confidence interval, 0.49 to 0.68; P < .00001), respectively. No significant differences in the incidence of side effects such as bleeding and needle pain were observed between groups (P = .54). AT was also associated with a lower rate of rescue antiemetic usage (P < .00001) and a higher degree of satisfaction with postoperative recovery (P < .0001). Moreover, the optimal therapeutic effect of AT on preventing PONV was achieved when the treatment time was controlled within 30 minutes and transcutaneous acupoint electrical stimulation was applied. CONCLUSION AT is an effective and safe physical therapy for the prophylaxis of PONV in patients undergoing GS.
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Affiliation(s)
- Xiao-Zhuo Zheng
- Anesthesiology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiu-Ju Xiong
- Anesthesiology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Dan Liu
- Anesthesiology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ke Wei
- Anesthesiology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Yuan Lai
- Anesthesiology Department, Affiliated Hospital of Chongqing Three Gorges Medical College, Chongqing, China
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Ding N, Li L, Zhu X, Huang X, Wang L, Yue R. Acupuncture for patients with glucagon-like peptide-1 receptor agonists-induced nausea and vomiting: A systematic review protocol. Medicine (Baltimore) 2020; 99:e20343. [PMID: 32481324 PMCID: PMC7249859 DOI: 10.1097/md.0000000000020343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 04/21/2020] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The glucagon-like peptide-1 receptor agonists (GLP-1 RAs) class agent has grown rapidly in the last decade due to its effects on lowering HbA1c and weight and the low possibility of hypoglycemia. However, GLP-1 RAs are not devoid of adverse effects among which nausea and vomiting rank first, which reduce adherence to treatment. Accumulated evidences proved that acupuncture can properly treat nausea and vomiting caused by various reasons. The study aims at assessing the safety and effectiveness exhibited by acupuncture treatment for patients with nausea and vomiting induced by GLP-1 RAs. METHODS AND ANALYSIS Articles that have been identified via electronically searching databases of MEDLINE, Nature, PubMed, the Cochrane Library, WorldSciNet, EMbase, Science Online, AMED, China National Knowledge Infrastructure, the Wanfang Databse and China Biology Medicine Disc and the Chongqing VIP Chinese Science and Technology Periodical Database from their inception of to December 31, 2019 will be incorporated into the systematic review. The review only adopts Chinese and English. It will also pay attention to searching resources of qualified studies, relevant conference proceedings, potential reference list, as well as related system reviews. Two researchers will take charge of completing the selection of research, the extraction of data as well as the assessment of research quality independently. A random- or fixed-effects model will be employed to synthesize data combining the heterogeneity test. The primary outcomes will be nausea and vomiting, seen from the objective and self-reported assessment. Data analysis will be performed via the RevMan 5 software, and GRADE will help to assess the evidence level. The heterogeneity level will determine whether the random-effects model or the fixed-effects model will be used. The 2 categories will adopt risk ratio (RR) or odds ratio (OR) and 95% confidence interval (CI). Continuous variables will adopt the weighted mean difference or standardized mean difference and 95% CI. Meta-analysis will not be conducted if no assessment, like subgroup analysis, is able to explain existing meaningful heterogeneity. The subgroup analysis shall carefully consider each subgroup in certain case. ETHICS AND DISSEMINATION The systematic review does not involve the evaluation of patients' individual information or patients' right; thus, there is no need to gain the approval from ethical institution. The article will be published in journals reviewed by peers and present at related conference.Registration: Open Science Framework (OSF) Preregistration. 2020, April 8. osf.io/3fgu8.
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Affiliation(s)
- Ning Ding
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Linzhi Li
- Hospital of Chengdu University of Traditional Chinese Medicine
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xinyun Zhu
- Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaoying Huang
- Hospital of Chengdu University of Traditional Chinese Medicine
| | - Lizhen Wang
- Hospital of Chengdu University of Traditional Chinese Medicine
| | - Rensong Yue
- Hospital of Chengdu University of Traditional Chinese Medicine
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Hullender Rubin L, Veleber S. Hospital-Based Acupuncture Integration: Access, Reimbursement, and Implementation. J Altern Complement Med 2020; 26:356-359. [PMID: 32401620 DOI: 10.1089/acm.2020.0133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Lee Hullender Rubin
- Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Susan Veleber
- Department of Integrative Oncology, Seattle Cancer Care Alliance, Seattle, WA, USA
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Harvie A, Steel A, Wardle J. Traditional Chinese Medicine Self-Care and Lifestyle Medicine Outside of Asia: A Systematic Literature Review. J Altern Complement Med 2019; 25:789-808. [PMID: 31274332 DOI: 10.1089/acm.2018.0520] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background: Chinese medicine, when applied as a whole system of care, traditionally incorporates self-care techniques and patient understanding as key aspects of patient recovery and health maintenance. Objectives: This review aims to explore the literature to date on Traditional Chinese Medicine (TCM) self-care in settings outside of Asia, beyond the sole application of t'ai chi or qigong, to consider simple self-care techniques as health care interventions that may be generalized to a wider population. Design: AMED, CINAHL, EMBASE, PubMed, and MEDLINE databases were searched for articles from inception to July 2018. Studies were included, which were undertaken in settings outside of Asia and/or Asian communities, and were excluded if they solely examined t'ai chi or qigong. Results: Findings of the included studies (n = 37) were categorized into four key areas in relation to the TCM self-care component evaluated: self-acupressure, self-acupuncture, self-moxibustion, and the adoption of prescribed lifestyle, diet, and exercise advice based on a TCM diagnosis. The studies included randomized clinical trials, case studies, hospital audits, and qualitative evaluations. The studies assessed TCM self-care in relation to a wide range of health conditions, with the majority of studies concluding positive findings. Conclusion: This review draws attention to the potential role of TCM self-care techniques, in settings outside of Asia, beyond the sole practices of t'ai chi and qigong, as an adjunct to health maintenance and recovery. Only tentative conclusions can be drawn from the existing research, however, due to variability across studies in reporting transparency and the overall low number of studies retrieved. Further research is warranted.
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Affiliation(s)
- Alaia Harvie
- 1Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Amie Steel
- 1Faculty of Health, University of Technology Sydney, Sydney, Australia.,2Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jon Wardle
- 1Faculty of Health, University of Technology Sydney, Sydney, Australia.,2Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Yilmaz Sahin S, Iyigun E, Can MF. Effect of acupressure application to the P6 acupoint before laparoscopic cholecystectomy on postoperative nausea-vomiting: A randomized controlled clinical study. Int J Nurs Stud 2018; 87:40-48. [PMID: 30053681 DOI: 10.1016/j.ijnurstu.2018.07.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 07/12/2018] [Accepted: 07/16/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Nausea and vomiting are common postoperative complications that occur within the first 24 h in adults. Clinical practice guidelines and a Cochrane review recommend stimulating the P6 acupoint to prevent or reduce postoperative nausea and vomiting. However, there are currently no standards and optimal timing is not known. OBJECTIVES The purpose of this study was to evaluate the effect of acupressure application on the P6 acupoint, using acupressure wristbands, in the prevention of postoperative nausea and vomiting and the antiemetic drug requirement in patients who had high postoperative nausea and vomiting risk related to laparoscopic cholecystectomy. DESIGN This was a longitudinal, randomized controlled clinical study. SETTINGS The study was conducted in the general surgery department of a training and research hospital (105 beds), from March 2015 to March 2016. PARTICIPANTS A total of 111 female patients who underwent laparoscopic surgery were divided into three groups of 37, using a block randomization method. METHODS Training on acupressure wristband use was provided to the intervention group and an acupressure wristband with a plastic cap was placed at the P6 acupoint. A wristband with the same appearance as the acupressure wristband, but without a cap, was used in the placebo group. No intervention was used in the control group. The wristband was placed approximately one hour before the surgery and removed six hours after the surgery in both the intervention and placebo groups. The data were collected at the 2nd, 6th, and 24th postoperative hours. RESULTS The application of the acupressure wristband to the P6 acupoint in patients who underwent laparoscopic cholecystectomy was found to be more effective in decreasing the severity of nausea at the 2nd postoperative hour and the nausea incidence at 2-6 h, postoperatively, when compared to the placebo group (p < 0.05). However, there was no statistically significant difference between the intervention group and the control group. Therefore, acupressure application to the P6 acupoint was not found to be clinically effective in decreasing postoperative vomiting, antiemetic drug requirement, and in decreasing pain, anxiety, or the need for analgesic drugs (p > 0.05). CONCLUSIONS We did not find the stimulation of the P6 acupoint with an acupressure wristband to be clinically effective in reducing postoperative nausea and vomiting or antiemetic drug requirement in patients who underwent laparoscopic cholecystectomy.
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Affiliation(s)
- Sibel Yilmaz Sahin
- University of Health Sciences, Gülhane Faculty of Nursing, Department of Surgical Nursing, Ankara, Turkey.
| | - Emine Iyigun
- University of Health Sciences, Gülhane Faculty of Nursing, Department of Surgical Nursing, Ankara, Turkey.
| | - Mehmet Fatih Can
- University of Health Sciences, Gülhane Training and Research Hospital, Department of General Surgery, Ankara, Turkey.
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Birch S, Lee MS, Alraek T, Kim TH. Overview of Treatment Guidelines and Clinical Practical Guidelines That Recommend the Use of Acupuncture: A Bibliometric Analysis. J Altern Complement Med 2018; 24:752-769. [PMID: 29912569 DOI: 10.1089/acm.2018.0092] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION As positive evidence emerges for the use of an intervention to treat a health problem, the intervention gradually becomes incorporated into treatment guidelines (TGs) or clinical practice guidelines (CPGs) that are related to that health problem. To assess whether this general hypothesis can apply to acupuncture, 96 health problems were identified for which positive conclusions in systematic reviews and meta-analyses regarding the effectiveness of acupuncture have been made and then searched for TGs or CPGs that have recommended the use of acupuncture. METHODS Through August 31, 2017, searches were performed in relevant medical databases and Google using "treatment guideline," "clinical practice guideline," and the names of the 96 medical conditions as search terms. A "snow-balling" search approach was adopted. All positive recommendations were added into the registry. RESULTS A total of 1311 publications were found that recommended using acupuncture published between 1991 and 2017. The number per year reached 50 in 2005 and 100 in 2009. In addition, 2189 positive recommendations were found for the use of acupuncture. Of these, 1486 were related to 107 pain indications and 703 were related to 97 nonpain indications. These recommendations were made by a wide range of groups, such as government health institutions, national guideline, and medical specialty groups. The recommendations came from around the world but were especially abundant in North America, Europe, and Australasia. DISCUSSION AND CONCLUSION Considerably more recommendations were found for the use of acupuncture than are known within the acupuncture or medical communities. A trend by year was also found; a rise in the number of positive statements about acupuncture was typically followed by a rise in the number of recommendations of acupuncture. Thus, the recommendations followed the emergent evidence for acupuncture. Better implementation plans need to be developed for the CPG/TG recommendations about acupuncture to be more effective/efficient.
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Affiliation(s)
- Stephen Birch
- 1 Department of Health Sciences, Kristiania University College , Oslo, Norway
| | - Myeong Soo Lee
- 2 Clinical Medicine Division, Korea Institute of Oriental Medicine , Daejeon, Republic of South Korea
| | - Terje Alraek
- 1 Department of Health Sciences, Kristiania University College , Oslo, Norway .,3 Department of Community Medicine, Faculty of Medicine, National Research Centre in Complementary and Alternative Medicine, UiT The Arctic University of Norway , Tromso, Norway
| | - Tae-Hun Kim
- 4 Korean Medicine Clinical Trial Center, Korean Medicine Hospital, Kyung Hee University , Seoul, Republic of Korea
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12
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Abstract
BACKGROUND Acupuncture treatment has been used in China for >2500 years, and at present it is used worldwide as a form of analgesia in patients with acute and chronic pain. Furthermore, acupuncture is regularly used not only as a single anesthetic technique but also as a supplement or in addition to general anesthesia (GA). OBJECTIVES The aim of this systematic review and meta-analysis was to assess the level of evidence for the clinical use of acupuncture in addition to GA in patients undergoing craniotomy. DESIGN This is a systematic review of randomized controlled trials with meta-analyses. DATA SOURCES The literature search (PubMed, Cochrane Library, and Web of Science) yielded 56 citations, published between 1972 and March 01, 2015. No systematic review or meta-analyses on this topic matched our search criteria. Each article of any language was assessed and rated for the methodological quality of the studies, using the recommendation of the Oxford Centre for Evidence Based Medicine. Ten prospective randomized controlled clinical trials with a total of 700 patients were included. ELIGIBILITY CRITERIA Included in the meta-analysis were studies that involved any craniotomy under GA compared with a combination of GA and acupuncture. Exclusion criteria were no acupuncture during surgery, no GA during surgery, only postoperative data available, animal studies, and low grade of evidence. RESULTS The use of acupuncture significantly reduced the amount of volatile anesthetics during surgery (P<0.001) and led to faster extubation time (P=0.001) and postoperative patient recovery (P=0.003). In addition, significantly reduced blood levels of the brain tissue injury marker S100β 48 hours after operation (P=0.001) and occurrence of postoperative nausea and vomiting (P=0.017) were observed. No patient studied suffered from awareness. CONCLUSIONS The analysis suggests that the complementary use of acupuncture for craniotomy has additional analgesic effects, reduces the needed amount of volatile anesthetic, reduces the onset of postoperative nausea and vomiting, and might have protective effects on brain tissue. Our findings may stimulate future randomized controlled trials to provide definitive recommendations.
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Acupuncture for Nausea and Vomiting. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00111-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Asmussen S, Przkora R, Maybauer DM, Fraser JF, Sanfilippo F, Jennings K, Adamzik M, Maybauer MO. Meta-Analysis of Electroacupuncture in Cardiac Anesthesia and Intensive Care. J Intensive Care Med 2017; 34:652-661. [PMID: 28569130 DOI: 10.1177/0885066617708558] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Acupuncture treatment has been employed in China for over 2500 years and it is used worldwide as analgesia in acute and chronic pain. Acupuncture is also used in general anesthesia (GA). The aim of this systematic review and meta-analysis was to assess the efficacy of electroacupuncture (EA) in addition to GA in patients undergoing cardiac surgery. METHODS We searched 3 databases (Pubmed, Cochrane Library, and Web of Science-from 1965 until January 31, 2017) for randomized controlled trials (RCTs) including patients undergoing cardiac surgery and receiving GA alone or GA + EA. As primary outcomes, we investigated the association between GA + EA approach and the dosage of intraoperative anesthetic drugs administered, the duration of mechanical ventilation (MV), the postoperative dose of vasoactive drugs, the length of intensive care unit (ICU) and hospital stay, and the levels of troponin I and cytokines. RESULTS The initial search yielded 477 citations, but only 7 prospective RCTs enrolling a total of 321 patients were included. The use of GA + EA reduced the dosage of intraoperative anesthetic drugs (P < .05), leading to shorter MV time (P < .01) and ICU stay (P < .05) as well as reduced postoperative dose of vasoactive drugs (P < .001). In addition, significantly lower levels of troponin I (P < .01) and tumor necrosis factor α (P < .01) were observed. CONCLUSION The complementary use of EA for open-heart surgery reduces the duration of MV and ICU stay, blunts the inflammatory response, and might have protective effects on the heart. Our findings stimulate future RCT to provide definitive recommendations.
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Affiliation(s)
- Sven Asmussen
- 1 Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Knappschaftskrankenhaus, Ruhr-University Bochum, Bochum, Germany.,2 Departments of Anesthesiology and Epidemiology and Biostatistics, The University of Texas Medical Branch, Galveston, TX, USA.,3 Critical Care Research Group, Prince Charles Hospital, The University of Queensland, Brisbane, Queensland, Australia
| | - Rene Przkora
- 2 Departments of Anesthesiology and Epidemiology and Biostatistics, The University of Texas Medical Branch, Galveston, TX, USA.,4 Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Dirk M Maybauer
- 2 Departments of Anesthesiology and Epidemiology and Biostatistics, The University of Texas Medical Branch, Galveston, TX, USA.,5 Department of Cardiothoracic Anaesthesia and Critical Care, St George's Hospital, London, UK
| | - John F Fraser
- 3 Critical Care Research Group, Prince Charles Hospital, The University of Queensland, Brisbane, Queensland, Australia
| | - Filippo Sanfilippo
- 6 Department of Anesthesia and Intensive Care, IRCCS-ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo, Italy.,7 Department of Anaesthesiology and Intensive Care, Philipps University, Marburg, Germany
| | - Kristofer Jennings
- 2 Departments of Anesthesiology and Epidemiology and Biostatistics, The University of Texas Medical Branch, Galveston, TX, USA
| | - Michael Adamzik
- 1 Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Knappschaftskrankenhaus, Ruhr-University Bochum, Bochum, Germany
| | - Marc O Maybauer
- 2 Departments of Anesthesiology and Epidemiology and Biostatistics, The University of Texas Medical Branch, Galveston, TX, USA.,3 Critical Care Research Group, Prince Charles Hospital, The University of Queensland, Brisbane, Queensland, Australia.,5 Department of Cardiothoracic Anaesthesia and Critical Care, St George's Hospital, London, UK.,8 Cardiothoracic Anaesthesia and Intensive Care, Central Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary, University of Manchester, UK
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Oh H, Kim BH. Comparing Effects of Two Different Types of Nei-Guan Acupuncture Stimulation Devices in Reducing Postoperative Nausea and Vomiting. J Perianesth Nurs 2016; 32:177-187. [PMID: 28527545 DOI: 10.1016/j.jopan.2015.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 11/22/2015] [Accepted: 12/05/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare the effects of a relief band using transcutaneous electrical nerve stimulation with a wrist band using acupressure on the Nei-Guan acupuncture point to relieve postoperative nausea and vomiting (PONV) in patients who had undergone gynecologic surgery. DESIGN A double-blinded randomized controlled trial. METHODS In total, 54 patients scheduled for gynecologic surgery under general anesthesia were included in this study. Assessments of PONV were performed 0, 2, 6, and 24 hours after discharge from the postanesthesia care unit. The severity of PONV was measured using the Rhodes' Index of Nausea, Vomiting and Retching and by recording the frequency of patient-requested antiemetic administration that is used to treat severe cases of PONV. FINDINGS The relief band reduced the severity of PONV and the need for antiemetic administration within the first 24 hours postsurgery. CONCLUSIONS The results of this study support the use of a relief band when compared with a wrist band and with a control group to reduce PONV in women after gynecologic surgery.
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Stoicea N, Gan TJ, Joseph N, Uribe A, Pandya J, Dalal R, Bergese SD. Alternative Therapies for the Prevention of Postoperative Nausea and Vomiting. Front Med (Lausanne) 2015; 2:87. [PMID: 26734609 PMCID: PMC4679858 DOI: 10.3389/fmed.2015.00087] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 11/24/2015] [Indexed: 11/13/2022] Open
Abstract
Postoperative nausea and vomiting (PONV) is a complication affecting between 20 and 40% of all surgery patients, with high-risk patients experiencing rates of up to 80%. Recent studies and publications have shed light on the uses of alternative treatment for PONV through their modulation of endogenous opioid neuropeptides and neurokinin ligands. In addition to reducing PONV, hypnosis was reported to be useful in attenuating postoperative pain and anxiety, and contributing to hemodynamic stability. Music therapy has been utilized to deepen the sedation level and decrease patient anxiety, antiemetic and analgesic requirements, hospital length of stay, and fatigue. Isopropyl alcohol and peppermint oil aromatherapy have both been used to reduce postoperative nausea. With correct training in traditional Chinese healing techniques, acupuncture (APu) at the P6 acupoint has also been shown to be useful in preventing early PONV, postdischarge nausea and vomiting, and alleviating of pain. Electro-acupuncture (EAPu), as with APu, provided analgesic and antiemetic effects through release and modulation of opioid neuropeptides. These non-pharmacological modalities of treatment contribute to an overall patient wellbeing, assisting in physical and emotional healing.
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Affiliation(s)
- Nicoleta Stoicea
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Tong J. Gan
- Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY, USA
| | - Nicholas Joseph
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Department of Neuroscience, The Ohio State University, Columbus, OH, USA
| | - Alberto Uribe
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Jyoti Pandya
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Rohan Dalal
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Sergio D. Bergese
- Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA
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Yoo JE, Oh DS. Potential benefits of acupuncture for enhanced recovery in gynaecological surgery. Complement Med Res 2015; 22:111-6. [PMID: 26021961 DOI: 10.1159/000381360] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We aimed to evaluate if acupuncture can improve clinical benefits and patient satisfaction after gynaecological surgery supported by enhanced recovery after surgery (ERAS) programmes. Therefore, we evaluated patient as well as clinical outcome in patient recovery after surgery. We searched MEDLINE, PubMed and EMBASE for articles dealing with post-operative acupuncture and extracted 9 suitable studies. We expected acupuncture to alleviate surgical stress, reduce emetic symptom and accelerate recovery from complications in pre-, intra-, and post-operative phases. Gastrointestinal motility and coldness achieved the full improvement rate of 50%. With regard to post-operative nausea and vomiting, 3 studies showed more than 30% and 1 showed 16% improvement. Sore throat and urinary retention achieved a mild improvement rate of 16% and 12%, respectively. In this study, we demonstrated that acupuncture can enhance recovery in gynaecological surgery without adverse effects and thus should be considered in ERAS.
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Affiliation(s)
- Jeong-Eun Yoo
- National Clinical Research Centre for Korean Medicine (NCRC), Pusan National University Korean Medicine Hospital (PNUKH), Yangsan, South Korea
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McCrae N, Blackstock M, Purssell E. Eligibility criteria in systematic reviews: A methodological review. Int J Nurs Stud 2015; 52:1269-76. [PMID: 25726430 DOI: 10.1016/j.ijnurstu.2015.02.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 12/10/2014] [Accepted: 02/05/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND Systematic reviews of literature are increasingly important in healthcare. While reviewers are expected to follow reporting guidelines, inconsistencies may be observed in presentation of reviews, potentially detracting from the credibility of findings. Predetermined eligibility criteria are fundamental to the systematic process of reviewing, and should be given primacy in authors' reports. METHOD This methodological review assessed the specification and application of eligibility criteria in systematic reviews in three leading generic nursing journals. RESULTS While reporting guidelines were generally followed, major anomalies were revealed by this review. Over three-quarters of review papers placed eligibility criteria after description of the search strategy. Unjustified time restrictions were common, and many flowcharts omitted vital information. CONCLUSION Greater scrutiny of systematic reviews submitted to nursing journals would enhance the quality of reports and contribute to more robust evidence-based practice.
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Affiliation(s)
- Niall McCrae
- Florence Nightingale Faculty of Nursing & Midwifery, King's College London, United Kingdom.
| | - Marlene Blackstock
- Florence Nightingale Faculty of Nursing & Midwifery, King's College London, United Kingdom
| | - Edward Purssell
- Florence Nightingale Faculty of Nursing & Midwifery, King's College London, United Kingdom
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Narrative Review of Perioperative Acupuncture for Clinicians. J Acupunct Meridian Stud 2015; 8:264-9. [PMID: 26433805 DOI: 10.1016/j.jams.2014.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 12/16/2014] [Accepted: 12/30/2014] [Indexed: 11/20/2022] Open
Abstract
Acupuncture is one of the oldest forms of the natural healing arts. The exact mechanisms of action are unknown at this time; however, current theories to explain the benefits experienced after acupuncture include Traditional Chinese Medicine and Western medicine concepts. Acupuncture may improve the quality of perioperative care and reduce associated complications. Perioperative acupuncture is apparently effective in reducing preoperative anxiety, postoperative nausea and vomiting, and postoperative pain. The Pericardium-6 (P-6; Nei Guan), Yintang (Extra 1), and Shenmen acupuncture points are the most studied and effective acupuncture points in reducing preoperative anxiety, postoperative nausea and vomiting, and postoperative pain experiences. Intraoperatively administered acupuncture may reduce immunosuppression in patients and lessen intraoperative anesthetic requirements, although the clinical usefulness of acupuncture in the intraoperative period remains inconclusive. Perioperative acupuncture is a promising intervention, but additional studies are needed to further understand and define acupuncture's role throughout the perioperative period and determine its clinical usefulness. The purpose of this article is to provide a brief clinical review concerning acupuncture and its application for common issues that occur in the perioperative period.
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Glickman-Simon R, Tessier J. Guided imagery for postoperative pain, energy healing for quality of life, probiotics for acute diarrhea in children, acupuncture for postoperative nausea and vomiting, and animal-assisted therapy for mental disorders. Explore (NY) 2014; 10:326-9. [PMID: 25112585 DOI: 10.1016/j.explore.2014.06.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Abstract
AIM Several systematic reviews (SRs) of acupuncture for surgical conditions have recently been published with sometimes contradicting results. The aim of this overview was to summarise recent SRs of acupuncture for surgical conditions. METHOD Thirteen electronic databases were searched for relevant reviews published since 2000. Data were extracted by two independent reviewers according to predefined criteria. RESULTS Twelve SRs met our inclusion criteria. They related to the prevention or treatment of postoperative nausea and vomiting as well as to surgical or postoperative pain. Their results were far from uniform, and several caveats need to be considered. CONCLUSION The evidence is insufficient to suggest that acupuncture is an effective intervention in surgical settings. More rigorous research seems warranted. This protocol was registered with PROSPERO database (registration number: CRD42013004817).
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Affiliation(s)
- M S Lee
- Medical Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
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Cheong KB, Zhang JP, Huang Y, Zhang ZJ. The effectiveness of acupuncture in prevention and treatment of postoperative nausea and vomiting--a systematic review and meta-analysis. PLoS One 2013; 8:e82474. [PMID: 24349293 PMCID: PMC3862842 DOI: 10.1371/journal.pone.0082474] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Accepted: 10/23/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Acupuncture therapy for preventive and treatment of postoperative nausea and vomiting(PONV), a condition which commonly present after anaesthesia and surgery is a subject of growing interest. OBJECTIVE This paper included a systematic review and meta-analysis on the effect of different type of acupuncture and acupoint selection in PONV prevention and treatment. METHODS Randomised controlled trials(RCTs) comparing acupuncture with non-acupuncture treatment were identified from databases PubMed, Cochrane, EBSCO, Ovid, CNKI and Wanfangdata. Meta-analysis on eligible studies was performed using fixed-effects model with RevMan 5.2. Results were expressed as RR for dichotomous data, with 95%CI. RESULTS Thirty RCTs, 1276 patients (intervention) and 1258 patients (control) were identified. Meta-analysis showed that PC6 acupuncture significantly reduced the number of cases of early vomiting (postoperative 0-6h) (RR=0.36, 95%CI 0.19,0.71; P=0.003) and nausea (postoperative 0-24h) (RR=0.25, 95%CI 0.10,0.61; P=0.002), but not early nausea (postoperative 0-6h) (RR=0.64, 95%CI 0.34,1.19; P=0.150) and vomiting (postoperative 0-24h) (RR=0.82, 95%CI 0.48,1.38; P=0.450). PC6 acupressure significantly reduced the number of cases of nausea (RR=0.71, 95%CI 0.57,0.87; P=0.001) and vomiting (RR=0.62, 95%CI 0.49,0.80; P=0.000) at postoperative 0-24h. PC6 electro-acupoint stimulation significantly reduced the number of cases of nausea (RR=0.49, 95%CI 0.38,0.63; P<0.000) and vomiting (RR=0.50, 95%CI 0.36,0.70; P<0.000) at postoperative 0-24h. Stimulation of PC6 with other acupoint(s) significantly reduced the number of cases of nausea and vomiting (RR=0.29, 95%CI 0.17,0.49; P<0.000) at postoperative 0-24h. Stimulation of other acupoint(s)(non PC6) also significantly reduced the number of cases of nausea and vomiting (RR=0.63, 95%CI 0.49,0.81; P=0.000) at postoperative 0-24h. However, the quality of study was generally low in studies of PC6 combined with other acupoint(s) and other acupoint(s). Details of blinding were not reported in most reports. CONCLUSIONS Besides PC6, PC6 combined with other acupoint(s) and other alternative acupoint(s) might be beneficial in prevention and treatment of PONV, the evidence justifies future high-quality studies.
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Affiliation(s)
- Kah Bik Cheong
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Ji-ping Zhang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Yong Huang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhang-jin Zhang
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
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Abstract
BACKGROUND Acupuncture is commonly undertaken during an assisted reproductive technology (ART) cycle although its role in improving live birth and pregnancy rates is unclear. OBJECTIVES To determine the effectiveness and safety of acupuncture as an adjunct to ART cycles for male and female subfertility. SEARCH METHODS All reports which described randomised controlled trials of acupuncture in assisted conception were obtained through searches of the Menstrual Disorders and Subfertility Group Specialised Register, CENTRAL, Ovid MEDLINE, EMBASE, CINAHL (Cumulative Index to Nursing & Allied Health Literature), AMED , www.clinicaltrials.gov (all from inception to July 2013), National Research Register, and the Chinese clinical trial database (all to November 2012). SELECTION CRITERIA Randomised controlled trials of acupuncture for couples who were undergoing ART, comparing acupuncture treatment alone or acupuncture with concurrent ART versus no treatment, placebo or sham acupuncture plus ART for the treatment of primary and secondary infertility. Women with medical illness that was deemed to contraindicate ART or acupuncture were excluded. DATA COLLECTION AND ANALYSIS Twenty randomised controlled trials were included in the review and nine were excluded. Study selection, quality assessment and data extraction were performed independently by two review authors. Meta-analysis was performed using odds ratio (OR) and 95% confidence intervals (CI). The outcome measures were live birth rate, clinical ongoing pregnancy rate, miscarriage rate, and any reported side effects of treatment. The quality of the evidence for the primary outcome (live birth) was rated using GRADE methods. MAIN RESULTS This updated meta-analysis showed no evidence of overall benefit of acupuncture for improving live birth rate (LBR) regardless of whether acupuncture was performed around the time of oocyte retrieval (OR 0.87, 95% CI 0.59 to 1.29, 2 studies, n = 464, I(2) = 0%, low quality evidence) or around the day of embryo transfer (ET) (OR 1.22, 95% CI 0.87 to 1.70, 8 studies, n = 2505, I(2) = 69%, low quality evidence). There was no evidence that acupuncture had any effect on pregnancy or miscarriage rates, or had significant side effects. AUTHORS' CONCLUSIONS There is no evidence that acupuncture improves live birth or pregnancy rates in assisted conception.
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Affiliation(s)
- Ying C Cheong
- Obstetrics and Gynaecology, University of Southampton, Southampton, UK.
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Abstract
Cancer pain is one of most prevalent symptoms in patients with cancer. Acupuncture and related techniques have been suggested for the management of cancer pain. The National Comprehensive Cancer Network guidelines for adult cancer pain recommends acupuncture, as one of several integrative interventions, in conjunction with pharmacologic intervention as needed. This review presents the latest available evidence regarding the use of acupuncture for cancer pain. It also provides "actionable" acupuncture protocols for specific cancer pain conditions and related symptoms in order to provide more clinically relevant solutions for clinicians and cancer patients with pain. These conditions include postoperative cancer pain, postoperative nausea and vomiting, postsurgical gastroparesis syndrome, opioid-induced constipation, opioid-induced pruritus, chemotherapy-induced neuropathy, aromatase inhibitor-associated joint pain, and neck dissection-related pain and dysfunction.
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Affiliation(s)
- Weidong Lu
- Leonard P. Zakim Center for Integrative Therapies, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
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