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针刺预防心脏手术患者术后恶心的疗效

Efficacy of acupuncture in prevention of postoperative nausea in cardiac surgery patients.

作者信息

Korinenko Yuliya, Vincent Ann, Cutshall Susanne M, Li Zhuo, Sundt Thoralf M

机构信息

Mayo Medical School, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.

出版信息

Ann Thorac Surg. 2009 Aug;88(2):537-42. doi: 10.1016/j.athoracsur.2009.04.106.

Abstract

BACKGROUND

Coronary artery bypass graft and cardiac valve surgeries are frequently performed in medical facilities in the United States, and postoperative nausea (PON) is a prevalent problem in this patient population. The purpose of this study was to evaluate the efficacy of a single preoperative acupuncture treatment in the prevention of PON in patients undergoing coronary artery bypass graft or cardiac valve surgery, or both.

METHODS

Ninety participants presenting for coronary artery bypass graft or cardiac valve surgery, or both, were recruited for this study. Patients were randomly assigned to receive either one preoperative acupuncture and standard postoperative care (acupuncture group) or solely standard postoperative care (control group). Acupuncture was performed 0.5 to 3 hours before surgery. The PON incidence and severity on postoperative day (POD) 2 and POD 3 were measured with validated nausea tools.

RESULTS

The acupuncture group had a significantly lower incidence of nausea compared with the control group (POD 2, odds ratio [OR], 0.38; p = 0.05; and POD 3, OR, 0.26; p = 0.01). The acupuncture group also had a significantly lower score of nausea severity than the control group (POD 2, OR, 0.29; p = 0.01; and POD 3, OR, 0.25; p = 0.01). No adverse effects due to acupuncture treatment were reported. Antiemetics, pain medications, and anesthetics administered intraoperatively did not differ between the two groups and did not influence study results.

CONCLUSIONS

A single preoperative acupuncture treatment decreased incidence and severity of PON in patients undergoing coronary artery bypass graft or cardiac valve surgery, or both, and caused no adverse effects.

摘要

背景

冠状动脉旁路移植术和心脏瓣膜手术在美国的医疗机构中经常进行,术后恶心(PON)是该患者群体中普遍存在的问题。本研究的目的是评估术前单次针灸治疗对接受冠状动脉旁路移植术或心脏瓣膜手术或两者兼有的患者预防PON的疗效。

方法

本研究招募了90名接受冠状动脉旁路移植术或心脏瓣膜手术或两者兼有的参与者。患者被随机分配接受术前单次针灸和标准术后护理(针灸组)或仅接受标准术后护理(对照组)。针灸在手术前0.5至3小时进行。使用经过验证的恶心工具测量术后第2天(POD 2)和第3天(POD 3)的PON发生率和严重程度。

结果

与对照组相比,针灸组的恶心发生率显著降低(POD 2,优势比[OR],0.38;p = 0.05;POD 3,OR,0.26;p = 0.01)。针灸组的恶心严重程度评分也显著低于对照组(POD 2,OR,0.29;p = 0.01;POD 3,OR,0.25;p = 0.01)。未报告因针灸治疗引起的不良反应。两组术中使用的止吐药、止痛药和麻醉药没有差异,也不影响研究结果。

结论

术前单次针灸治疗可降低接受冠状动脉旁路移植术或心脏瓣膜手术或两者兼有的患者PON的发生率和严重程度,且未引起不良反应。

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