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Seok Y, Suh EE, Yu SY, Park J, Park H, Lee E. Effectiveness of Integrated Education to Reduce Postoperative Nausea, Vomiting, and Dizziness after Abdominal Surgery under General Anesthesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116124. [PMID: 34204087 PMCID: PMC8200998 DOI: 10.3390/ijerph18116124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 11/29/2022]
Abstract
This study presents an anticipatory integrated education program for nausea, vomiting, and dizziness prevention (anti-NVD education program) for patients undergoing abdominal surgery under general anesthesia. The anti-NVD education program for nephrectomy patients consisted of the following: the causes of postoperative nausea, vomiting, and dizziness; effective deep breathing and how to use an inspirometer; postoperative nausea and vomiting; effective methods of patient-controlled analgesia; and the stepwise standing up method to prevent dizziness. A study was conducted among 79 adults (experimental group: n = 40, control group: n = 39). The degree of nausea and dizziness was measured using a numerical rating scale (NRS), and vomiting and the frequency of antiemetic use were measured in terms of the number of patients. The experimental group, which received the anti-NVD education, showed remarkably lower levels of nausea (p = 0.013) and dizziness (p < 0.001) than the control group. The frequency of antiemetic use 48 hours after surgery was significantly lower in the experimental group (p = 0.03). This study proved the efficacy of the anti-NVD education program for reducing postoperative nausea and dizziness. This program can be used as a noninvasive nursing intervention to prevent nausea, vomiting, and dizziness among patients undergoing abdominal surgery.
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Affiliation(s)
- Yoonhee Seok
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul 03080, Korea;
| | - Eunyoung E. Suh
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, Research Institute of Nursing Science, College of Nursing, Seoul National University, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-740-8484
| | - Soo-Young Yu
- Department of Nursing, Chungbuk National University, Cheongju 28644, Korea;
| | - JeongYun Park
- Department of Clinical Nursing, Ulsan University, Seoul 05505, Korea;
| | - Hyunjin Park
- Department of Nursing, Asan Medical Center, Seoul 05505, Korea; (H.P.); (E.L.)
| | - Eunsil Lee
- Department of Nursing, Asan Medical Center, Seoul 05505, Korea; (H.P.); (E.L.)
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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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Matthews C. A review of nausea and vomiting in the anaesthetic and post anaesthetic environment. J Perioper Pract 2017; 27:224-227. [PMID: 29328846 DOI: 10.1177/175045891702701004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 10/25/2016] [Indexed: 06/07/2023]
Abstract
Postoperative nausea and vomiting (PONV) has long been known as a complication of anaesthesia and surgery. This paper focuses on the assessment of the risk factors related to PONV along with the strategies and interventions which can be put in place to manage the condition. The pharmacological and multi-modal treatment methods of managing the risk factors that contribute to PONV are discussed.
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Affiliation(s)
- Claire Matthews
- Placement at East Lancashire Hospitals NHS Trust, Blackburn, UK
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Liu Y, Tang WPY, Gong S, Chan CWH. A Systematic Review and Meta-Analysis of Acupressure for Postoperative Gastrointestinal Symptoms among Abdominal Surgery Patients. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2017; 45:1127-1145. [DOI: 10.1142/s0192415x17500616] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Postoperative ileus is a common and often life-threatening gastrointestinal complication with few management methods available for patients. Integrating acupressure into perioperative care promises to bring benefits into preventing postoperative ileus. This systematic review and meta-analysis aims to evaluate the efficacy of acupressure in identifying the signs and symptoms of postoperative ileus among patients undergoing abdominal surgery. The MEDLINE, EMBASE, Web of Science, CINAHL, China Journal Net and Wanfang databases were searched for high-quality RCTs using keywords such as acupressure, postoperative ileus, abdominal surgery, etc. A total of six studies ([Formula: see text]) were included in this review and meta-analysis. The quality of the literature was found to be uniformly moderate by the Effective Public Health Practice Project (EPHPP) assessment tool. The results of meta-analyses revealed that acupressure could significantly reduce risks for postoperative nausea (OR 0.52, 95% CI 0.39–0.70, [Formula: see text]) and vomiting (OR 0.54, 95% CI 0.39–0.75, [Formula: see text]) compared with the control group, without significant heterogeneity among studies. Meta-analysis of the need for antiemetic drugs suggested that the OR was 0.39 (95% CI 0.20–0.78, [Formula: see text]) with significant heterogeneity among studies. Our results suggested that acupressure might be effective in reducing the incidence of postoperative nausea and vomiting and the need for antiemetic drugs among patients undergoing abdominal surgery. Considering the substantial risk of bias in the articles included, future high-quality RCTs with a rigorous methodology are desirable to provide solid evidence. Furthermore, other signs and symptoms of postoperative ileus should be explored in future.
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Affiliation(s)
- Yunhong Liu
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N. T., Hong Kong SAR
| | - Winnie P. Y. Tang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N. T., Hong Kong SAR
| | - Shengxiang Gong
- Department of Food Science and Technology, School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, P. R. China
| | - Carmen W. H. Chan
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N. T., Hong Kong SAR
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Acupressure in Management of Postoperative Nausea and Vomiting in High-Risk Ambulatory Surgical Patients. J Perianesth Nurs 2016; 32:271-278. [PMID: 28739058 DOI: 10.1016/j.jopan.2015.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 07/25/2015] [Accepted: 09/13/2015] [Indexed: 01/18/2023]
Abstract
PURPOSE The purpose of this randomized blinded placebo-controlled research study was to investigate the effect of acupressure over 24 hours postoperatively for ambulatory surgical patients who are identified as high risk for PONV. DESIGN A randomized blinded placebo-controlled study design was implemented. METHODS Study enrollment criteria included four of five risk factors as defined in 2006 by American Society of PeriAnesthesia Nurses PONV/postdischarge nausea and vomiting guidelines: female, PONV history or motion sickness, nonsmoker, and volatile gas general anesthetic. One hundred ten patients were randomly assigned to an intervention (N = 57) acupressure bead patch or control (N = 53) sham acupressure patch group. Patients rated PONV on scale (0 to 10). FINDINGS Acupressure use at P6 preoperatively was statistically significant in reducing PONV in all three postoperative phases. One hundred ten patients were enrolled; 93 patients finished the study's three phases and nine were admitted postoperatively. CONCLUSIONS Acupressure is an effective minimal risk and low-cost adjunctive therapy for prevention and treatment in ambulatory surgical patients at high risk for PONV. Further studies using other acupressure points should be conducted.
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Hsiung WT, Chang YC, Yeh ML, Chang YH. Acupressure improves the postoperative comfort of gastric cancer patients: A randomised controlled trial. Complement Ther Med 2015; 23:339-46. [PMID: 26051568 DOI: 10.1016/j.ctim.2015.03.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 01/07/2015] [Accepted: 03/29/2015] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE This pilot study evaluated whether acupressure affected the postoperative comfort of gastric cancer patients following a subtotal gastrectomy. METHODS A randomised controlled trial was conducted. Sixty patients were recruited from 141-bed general surgery ward at a 3000-bed medical centre in Northern Taiwan. Participants were randomly assigned to either a control group receiving regular postoperative care or to the experimental group receiving additional acupressure at acupoints of Neiquan (P6) and Zusanli (ST36) for 3 consecutive days. RESULTS The similarities between two groups were in postoperative pain and the onset of postoperative nausea and vomiting (PONV) at the baseline. Following acupressure, significant differences were found in postoperative pain (P=.03) and time of first flatus (P=.04); but not PONV (P=.49), nor the time of first defecation (P=.34). CONCLUSIONS Acupressure is a simple, noninvasive, safe, and economical procedure for improving the comfort of patients who undergo surgery for gastric cancer. Acupressure at the P6 and ST36 acupoints can improve postoperative comfort by alleviating pain and decreasing the time until first flatus. However, additional research is necessary to elucidate how acupressure can improve postoperative outcomes.
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Affiliation(s)
- Wan-Ting Hsiung
- Department of Nursing, Taipei Veterans General Hospital, Taiwan, ROC
| | - Yi-Chuan Chang
- Department of Nursing, Fooyin University, Taiwan, ROC; National Taipei University of Nursing and Health Sciences, Taiwan, ROC
| | - Mei-Ling Yeh
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taiwan, ROC.
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Cooke M, Rapchuk I, Doi SA, Spooner A, Wendt T, Best J, Edwards M, O'Connell L, McCabe D, McDonald J, Fraser J, Rickard C. Wrist acupressure for post-operative nausea and vomiting (WrAP): A pilot study. Complement Ther Med 2015; 23:372-80. [PMID: 26051572 DOI: 10.1016/j.ctim.2015.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 03/16/2015] [Accepted: 03/21/2015] [Indexed: 10/23/2022] Open
Abstract
Post-operative nausea and vomiting are undesirable complications following anaesthesia and surgery. It is thought that acupressure might prevent nausea and vomiting through an alteration in endorphins and serotonin levels. In this two-group, parallel, superiority, randomised control pilot trial we aimed to test pre-defined feasibility outcomes and provide preliminary evidence for the efficacy of PC 6 acupoint stimulation vs. placebo for reducing post-operative nausea and vomiting in cardiac surgery patients. Eighty patients were randomly assigned to either an intervention PC 6 acupoint stimulation via beaded intervention wristbands group (n=38) or placebo sham wristband group (n=42). The main outcome was assessment of pre-defined feasibility criteria with secondary outcomes for nausea, vomiting, rescue anti-emetic therapy, quality of recovery and adverse events. Findings suggest that a large placebo-controlled randomised controlled trial to test the efficacy of PC 6 stimulation on PONV in the post-cardiac surgery population is feasible and justified given the preliminary clinically significant reduction in vomiting in the intervention group in this pilot. The intervention was tolerated well by participants and if wrist acupressure of PC 6 acupoint is proven effective in a large trial it is a simple non-invasive intervention that could easily be incorporated into practice.
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Affiliation(s)
- Marie Cooke
- NHMRC Centre for Research Excellence in Nursing Interventions, Menzies Health Institute Queensland, Centre for Health Practice Innovation, Australia.
| | - Ivan Rapchuk
- Department of Anaesthesia and Perfusion, Critical Care Research Group, The Prince Charles Hospital, Australia
| | - Suhail A Doi
- Research School of Population Health, Australian National University, Australia
| | - Amy Spooner
- Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Australia
| | - Tameka Wendt
- Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Australia
| | - Jessica Best
- Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Australia
| | - Melannie Edwards
- Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Australia
| | - Leanda O'Connell
- Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Australia
| | - Donna McCabe
- Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Australia
| | - John McDonald
- Microbiology and Immunology Research Group, Griffith University, Australia
| | - John Fraser
- Critical Care Research Group, The Prince Charles Hospital and University of Queensland, Australia
| | - Claire Rickard
- NHMRC Centre for Research Excellence in Nursing Interventions, Menzies Health Institute Queensland, Centre for Health Practice Innovation, Australia
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Cooke M, Rickard C, Rapchuk I, Shekar K, Marshall AP, Comans T, Doi S, McDonald J, Spooner A. PC6 acupoint stimulation for the prevention of postcardiac surgery nausea and vomiting: a protocol for a two-group, parallel, superiority randomised clinical trial. BMJ Open 2014; 4:e006179. [PMID: 25394818 PMCID: PMC4244418 DOI: 10.1136/bmjopen-2014-006179] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Postoperative nausea and vomiting (PONV) are frequent but unwanted complications for patients following anaesthesia and cardiac surgery, affecting at least a third of patients, despite pharmacological treatment. The primary aim of the proposed research is to test the efficacy of PC6 acupoint stimulation versus placebo for reducing PONV in cardiac surgery patients. In conjunction with this we aim to develop an understanding of intervention fidelity and factors that support, or impede, the use of PC6 acupoint stimulation, a knowledge translation approach. METHODS AND ANALYSIS 712 postcardiac surgery participants will be recruited to take part in a two-group, parallel, superiority, randomised controlled trial. Participants will be randomised to receive a wrist band on each wrist providing acupressure to PC six using acupoint stimulation or a placebo. Randomisation will be computer generated, use randomly varied block sizes, and be concealed prior to the enrolment of each patient. The wristbands will remain in place for 36 h. PONV will be evaluated by the assessment of both nausea and vomiting, use of rescue antiemetics, quality of recovery and cost. Patient satisfaction with PONV care will be measured and clinical staff interviewed about the clinical use, feasibility, acceptability and challenges of using acupressure wristbands for PONV. ETHICS AND DISSEMINATION Ethics approval will be sought from appropriate Human Research Ethics Committee/s before start of the study. A systematic review of the use of wrist acupressure for PC6 acupoint stimulation reported minor side effects only. Study progress will be reviewed by a Data Safety Monitoring Committee (DSMC) for nausea and vomiting outcomes at n=350. Dissemination of results will include conference presentations at national and international scientific meetings and publications in peer-reviewed journals. Study participants will receive a one-page lay-summary of results. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry--ACTRN12614000589684.
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Affiliation(s)
- Marie Cooke
- NHMRC Centre for Research Excellence in Nursing Interventions, Griffith Health Institute, Centre for Health Practice Innovation, Nathan, Queensland, Australia
| | - Claire Rickard
- NHMRC Centre for Research Excellence in Nursing Interventions, Griffith Health Institute, Centre for Health Practice Innovation, Nathan, Queensland, Australia
| | - Ivan Rapchuk
- Department of Anaesthesia and Perfusion, Critical Care Research Group, The Prince Charles Hospital,Chermside, Queensland, Australia
| | - Kiran Shekar
- Critical Care Research Group, The Prince Charles Hospital and University of Queensland, Chermside, Queensland, Australia
| | - Andrea P Marshall
- Griffith Health Institute, Centre for Health Practice Innovation and Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Tracy Comans
- Griffith Health Institute, Population and Social Health Research Program, Brisbane, Queensland, Australia
| | - Suhail Doi
- Department of Clinical Epidemiology Unit, School of Population Health, University of Queensland, Herston, Queensland, Australia
| | - John McDonald
- Microbiology and Immunology Research Group, Griffith University, Gold Coast, Queensland, Australia
| | - Amy Spooner
- Critical Care Research Group, The Prince Charles Hospital, Chermside, Queensland, Australia
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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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Litscher G, Ofner M, He W, Wang L, Gaischek I. Acupressure at the Meridian Acupoint Xiyangguan (GB33) Influences Near-Infrared Spectroscopic Parameters (Regional Oxygen Saturation) in Deeper Tissue of the Knee in Healthy Volunteers. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:370341. [PMID: 23476689 PMCID: PMC3582098 DOI: 10.1155/2013/370341] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 01/07/2013] [Indexed: 11/25/2022]
Abstract
Up to now, it is still unknown whether microcirculation of deeper peripheral tissue (knee) can be modulated by acupuncture or acupressure on a meridian acupoint. The goal of this pilot study was to investigate possible effects of acupressure at the Xiyangguan acupoint (GB33) on the regional oxygen saturation of the deeper knee tissues by near-infrared spectroscopy (NIRS). Twelve healthy volunteers with a mean age of 23.8 ± 1.6 years were investigated. Acupressure stimulation was performed for 5 minutes at the Xiyangguan acupoint. The results of the controlled study showed a significant increase of the values of regional oxygen saturation on the stimulated side of the knee (P = 0.033), whereas the opposite side on the same knee showed insignificant changes. These results may serve as a valuable basis for monitoring a possible therapeutic effect (e.g., after Khalifa therapy) in patients with knee problems.
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Affiliation(s)
- Gerhard Litscher
- Stronach Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine and TCM Research Center Graz, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria
- Department of Meridians, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Michael Ofner
- Department of Sports Physiology, University of Vienna, 1150 Vienna, Austria
| | - Wei He
- Stronach Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine and TCM Research Center Graz, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria
- Department of Meridians, Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Lu Wang
- Stronach Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine and TCM Research Center Graz, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria
| | - Ingrid Gaischek
- Stronach Research Unit for Complementary and Integrative Laser Medicine, Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine and TCM Research Center Graz, Medical University of Graz, Auenbruggerplatz 29, 8036 Graz, Austria
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Alessandrini M, Napolitano B, Micarelli A, de Padova A, Bruno E. P6 acupressure effectiveness on acute vertiginous patients: a double blind randomized study. J Altern Complement Med 2012; 18:1121-6. [PMID: 22950829 DOI: 10.1089/acm.2011.0384] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES The purpose of this study was to evaluate the effectiveness of P6 acupressure on vertigo and neurovegetative symptoms, its possible interference with vestibular-ocular reflex (VOR), and its clinical usefulness during acute vertigo. MATERIALS AND METHODS Two hundred and four patients, either affected by acute vertigo (n=124) or undergoing labyrinth stimulation (n=80), were randomly divided in two homogeneous groups: an experimental group A and a placebo group B. Each patient rated severity of vertigo and neurovegetative symptoms on a visuo-analogue scale ranging from 0 to 10, before and after bilateral placement of a P6 device. The latter was placed on the P6 acupressure point (appropriate placement) in Group A patients or on the dorsal part of the carpus (inappropriate placement) in the Group B patients. Furthermore, qualitative and quantitative nystagmus parameters were collected via recorded video-oculoscopy and electronystagmography. RESULTS Eighty-five percent of Group A patients reported improvement of symptoms, which was significant for neurovegetative symptoms, but not for vertigo. In contrast, only 11% of the Group B patients reported improvement. VOR analysis did not show any significant variation of qualitative and quantitative nystagmus variables. CONCLUSIONS This study demonstrated that the P6 device is effective in improving neurovegetative symptoms in patients affected by spontaneous and provoked vertigo, without any interference with VOR. Given the low cost and lack of side-effects of the P6 device, its routine application is suggested for acute vertigo and during labyrinth stimulation.
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Doran K, Halm MA. Integrating acupressure to alleviate postoperative nausea and vomiting. Am J Crit Care 2010; 19:553-6. [PMID: 21041197 DOI: 10.4037/ajcc2010900] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Rüsch D, Eberhart LHJ, Wallenborn J, Kranke P. Nausea and vomiting after surgery under general anesthesia: an evidence-based review concerning risk assessment, prevention, and treatment. DEUTSCHES ARZTEBLATT INTERNATIONAL 2010; 107:733-41. [PMID: 21079721 DOI: 10.3238/arztebl.2010.0733] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Accepted: 04/13/2010] [Indexed: 02/07/2023]
Abstract
BACKGROUND The German-language recommendations for the management of postoperative nausea and vomiting (PONV) have been revised by an expert committee. Major aspects of this revision are presented here in the form of an evidence-based review article. METHODS The literature was systematically reviewed with the goal of revising the existing recommendations. New evidence-based recommendations for the management of PONV were developed, approved by consensus, and graded according to the scheme of the Scottish Intercollegiate Guidelines Network (SIGN). RESULTS The relevant risk factors for PONV include female sex, nonsmoker status, prior history of PONV, motion sickness, use of opioids during and after surgery, use of inhalational anesthetics and nitrous oxide, and the duration of anesthesia. PONV scoring systems provide a rough assessment of risk that can serve as the basis for a risk-adapted approach. Risk-adapted prophylaxis, however, has not been shown to provide any greater benefit than fixed (combination) prophylaxis, and PONV risk scores have inherent limitations; thus, fixed prophylaxis may be advantageous. Whichever of these two approaches to manage PONV is chosen, high-risk patients must be given multimodal prophylaxis, involving both the avoidance of known risk factors and the application of multiple validated and effective antiemetic interventions. PONV should be treated as soon as it arises, to minimize patient discomfort, the risk of medical complications, and the costs involved. CONCLUSION PONV lowers patient satisfaction but is treatable. The effective, evidence-based measures of preventing and treating it should be implemented in routine practice.
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Affiliation(s)
- Dirk Rüsch
- Klinik für Anästhesie und Intensivtherapie, Universitätsklinikum Gießen und Marburg GmbH
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