• Philip Niño Tan-Gatue

Pre-Operative Acupuncture to Prevent Opioid-Induced Nausea and Vomiting

I have often mentioned to my medical students that the acupoint PC 6 Neiguan is among the acupuncture points most frequently studied in western medicine.  Here is a newer study from Korea entitled: Electroacupuncture on PC6 prevents opioid-induced nausea and vomiting after laparoscopic surgery. This is from the Chinese Journal of Integrative Medicine.

Methods are as follows:

One hundred and seventy-eight patients, who had received intravenous patient-controlled analgesia (PCA) with Fentanyl, were assigned randomly to three groups using random numbers: a pre-operative EA group (PrEA), a post-operative EA group (PoEA), and a non-acupuncture control group (NC). An anesthetist evaluated the incidence and severity of nausea and vomiting for 48 h after surgery blindly. The main outcomes were severity and freguency of PONV, which were measured with a self-reported questionnaire and a confirmation from the anesthetist. The data were analyzed with ANOVA and Z-test.

What this means is that there are one hundred and seventy-eight (178) patients who had Fentanyl given to them via IV line, but was patient controlled.  This means that the patient can activate the drip when he or she feels the need for it.  For more on patient controlled analgesia, see wikipedia: http://en.wikipedia.org/wiki/Patient-controlled_analgesia

The patients were randomly divided into three groups.  One group received electroacupuncture on PC 6 before the laparoscopy operation, another received electroacupuncture after the procedure, and the last one received none at all.

Two days after the procedure, an anesthesiologist then evaluated the patients without knowing who got what treatment.  Here are the results:

The incidence of nausea and vomiting was significantly lower in the PrEA group than the NC group during 48 h after surgery (P<0.01, P<0.05). The incidence of vomiting was also significantly lower in the PrEA group than the PoEA group (P<0.05). The PoEA subjects evidenced no significant differences compared with the NC subjects in terms of the incidence of nausea and vomiting (P<0.05). The severity of nausea was significantly lower in the PrEA group than in the NC and PoEA groups (P<0.05).

In plain English, it means that yes, acupuncture works.  However, it works much better if given BEFORE the operation than after.

In truth, an ounce of prevention is worth a pound of cure.

Resources:

Lee S, Lee MS, Choi DH, Lee SK.  “Electroacupuncture on PC6 prevents opioid-induced nausea and vomiting after laparoscopic surgery”.  Chin J Integr Med. 2013 Apr;19(4):277-81. doi: 10.1007/s11655-013-1425-7. Epub 2013 Apr 2.

http://en.wikipedia.org/wiki/Patient-controlled_analgesia (accessed 11 April 2013)

#research #neiguan #vomiting #PC6 #acupuncture #nausea #PubMed

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