Wang Shu-Ming, Kain Zeev N
Department of Anesthesiology, Pediatrics, and Child and Adolescent Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06520-8051, USA.
Anesthesiology. 2002 Aug;97(2):359-66. doi: 10.1097/00000542-200208000-00012.
P6 acupuncture in adults is reported to be an effective preventive treatment for postoperative nausea and vomiting (PONV). It is not clear, however, whether this technique is effective as a preventive treatment for PONV in children.
Children undergoing anesthesia and surgery were randomized to four groups: (a) intravenous saline + bilateral P6 acupoint injections (n = 50); (b) intravenous droperidol + bilateral P6 sham acupuncture (n = 49); (c) intravenous saline + bilateral sham point injections (n = 43); (d) intravenous saline +bilateral P6 sham acupuncture (n = 45). The perioperative anesthetic technique was standardized in all subjects. The incidence of postoperative nausea and vomiting (PONV) was evaluated in postanesthesia care unit (PACU) and 24 h after surgery.
Incidence of nausea in the PACU was significantly lower in the acupoint group as compared with the sham point group (32% vs. 56%, P = 0.029) and P6 sham group (32% vs. 64%, P = 0.002) but not as compared with the droperidol group (32% vs. 46%, P = ns). Similarly, subjects in the acupoint group had a significantly lower incidence of vomiting in the PACU as compared with the sham point group (12% vs. 33%, P = 0.026) and P6 sham group (12% vs. 31%, P = 0.029) but not as compared with the droperidol group (12% vs. 18%, P = ns). The combined incidence of early PONV was also lower in the acupoint group as compared with the sham point group (P = 0.045) and P6 sham group (P = 0.004) but not as compared with the droperidol group (42% vs. 51%, P = ns). Finally, significantly fewer subjects in the acupoint group required intravenous ondansetron as an initial rescue therapy (P = 0.024). At 24 h after surgery, however, the incidence of late PONV was similar among the four study groups (P = ns).
In children, P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting.
据报道,成人P6穴位针刺是预防术后恶心呕吐(PONV)的有效治疗方法。然而,尚不清楚该技术对儿童PONV的预防治疗是否有效。
接受麻醉和手术的儿童被随机分为四组:(a)静脉注射生理盐水+双侧P6穴位注射(n = 50);(b)静脉注射氟哌利多+双侧P6假针刺(n = 49);(c)静脉注射生理盐水+双侧假穴位注射(n = 43);(d)静脉注射生理盐水+双侧P6假针刺(n = 45)。所有受试者的围手术期麻醉技术均标准化。在麻醉后护理单元(PACU)和术后24小时评估术后恶心呕吐(PONV)的发生率。
与假穴位组(32%对56%,P = 0.029)和P6假针刺组(32%对64%,P = 0.002)相比,穴位组在PACU中的恶心发生率显著较低,但与氟哌利多组(32%对46%,P = 无统计学意义)相比无差异。同样,与假穴位组(12%对33%,P = 0.026)和P6假针刺组(12%对31%,P = 0.029)相比,穴位组在PACU中的呕吐发生率显著较低,但与氟哌利多组(12%对18%,P = 无统计学意义)相比无差异。穴位组早期PONV的合并发生率也低于假穴位组(P = 0.045)和P6假针刺组(P = 0.004),但与氟哌利多组(42%对51%,P = 无统计学意义)相比无差异。最后,穴位组中需要静脉注射昂丹司琼作为作为作为初始抢救治疗的受试者明显较少(P = 0.024)。然而,在术后24小时,四个研究组之间的晚期PONV发生率相似(P = 无统计学意义)。
在儿童中,P6穴位注射在控制术后早期恶心呕吐方面与氟哌利多同样有效。