Alkaissi Aidah, Evertsson Karin, Johnsson Vivi-Ann, Ofenbartl Lilli, Kalman Sigga
Department of Anaesthesiology and Intensive Care, University Hospital in Linköping, Linköping, Sweden.
Can J Anaesth. 2002 Dec;49(10):1034-9. doi: 10.1007/BF03017897.
To investigate the effect of sensory stimulation of the P6 point on postoperative nausea and vomiting (PONV) after gynecological surgery in the everyday clinical setting (effectiveness study).
Four hundred and ten women undergoing general anesthesia for elective gynecological surgery were included in a prospective, consecutive, randomized, multicentre, placebo-controlled, double-blind clinical trial with a reference group. One group was given bilateral P6 acupressure (n = 135), a second group similar pressure on bilateral non-acupressure points (n = 139), and a third group (n = 136) served as reference group. Nausea (scale 0-6), vomiting, pain, and satisfaction with the treatment were recorded. Primary outcome was complete response, i.e., no nausea, vomiting or rescue medication for 24 hr. Results were analyzed by applying logistic regression with indicators of treatments, type of operation and risk score for PONV as explanatory variables.
Complete response was more frequent in the P6 acupressure group than in the reference group (P = 0.0194) Conversely, the incidence of PONV was 46% in the reference group, 38% after pressure on a non-acupoint and 33% after P6 acupressure. The decrease from 46% to 33% was statistically significant. When considering vaginal cases separately, the decrease in PONV was from 36% to 20% (P = 0.0168). The corresponding decrease from 59% to 55% in the laparoscopic surgery group was not statistically significant.
P6 acupressure is a non-invasive method that may have a place as prophylactic antiemetic therapy during gynecological surgery.
在日常临床环境中研究P6穴位感觉刺激对妇科手术后恶心呕吐(PONV)的影响(有效性研究)。
410名接受择期妇科手术全身麻醉的女性纳入一项前瞻性、连续、随机、多中心、安慰剂对照、双盲临床试验,并设一个参照组。一组接受双侧P6穴位按压(n = 135),另一组接受双侧非穴位类似按压(n = 139),第三组(n = 136)作为参照组。记录恶心(0 - 6级)、呕吐、疼痛及对治疗的满意度。主要结局为完全缓解,即24小时内无恶心、呕吐或急救药物使用。采用逻辑回归分析结果,将治疗指标、手术类型及PONV风险评分作为解释变量。
P6穴位按压组的完全缓解率高于参照组(P = 0.0194)。相反,参照组PONV发生率为46%,非穴位按压后为38%,P6穴位按压后为33%。从46%降至33%具有统计学意义。单独考虑阴道手术病例时,PONV从36%降至20%(P = 0.0168)。腹腔镜手术组从59%降至55%无统计学意义。
P6穴位按压是一种非侵入性方法,在妇科手术中可作为预防性止吐治疗手段。