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[针刺对预防腹腔镜胆囊切除术后恶心呕吐的作用:一项随机临床试验]

[Effect of acupuncture on the prevention of nausea and vomiting after laparoscopic cholecystectomy: a randomized clinical trial].

作者信息

Miranda Luiz Eduardo, Filho Luiz de França Maia E Silva, Siqueira Ana Carolina Brainer de, Miranda Ana Clara, Rocha Bianca Rodrigues Castelo Branco, Lima Ian Victor Paiva de, Silva Victor Soares Gomes da, Lima Diego Laurentino de, Naspollini Holmes

机构信息

Universidade de Pernambuco (UPE), Hospital Universitário Oswaldo Cruz, Divisão de Cirurgia Geral e Transplante de Fígado, Recife, PE, Brasil.

Universidade de Pernambuco (UPE), Faculdade de Ciências Médicas, Recife, PE, Brasil.

出版信息

Braz J Anesthesiol. 2020 Sep-Oct;70(5):520-526. doi: 10.1016/j.bjan.2019.08.001. Epub 2020 Jul 30.

Abstract

BACKGROUND AND OBJECTIVES

Postoperative nausea and vomiting (PONV) is a common and undesirable complication observed after laparoscopic cholecystectomy (LC). We investigated the effects of auriculoacupuncture (AA) on the prevention of postoperative nausea and vomiting in the immediate postoperative period of uncomplicated laparoscopic cholecystectomy.

METHODS

Sixty-eight patients were randomly divided into two groups, auriculoacupuncture (n = 35) and control (n = 33), and then they were evaluated prospectively. The needle was placed before anaesthesia induction and remained for 20 minutes. Nausea intensity was evaluated using an analogic visual scale and PONV events were registered immediately after anaesthesia care unit admission and in the second, fourth and sixth hours after the surgery.

RESULTS

The auriculoacupuncture group had a significantly smaller incidence of nausea and vomiting than the control group throughout the whole postoperative period (16/35 vs. 27/33,  = 0.03 and 4/35 vs. 15/33,  = 0.005, respectively); the AA group had fewer nausea events 2 h ( = 0.03) and 6 h ( = 0.001) after surgery and fewer vomiting events 2 h ( = 0.01) and 6 h ( = 0.02) after surgery.

CONCLUSIONS

Auriculoacupuncture can partially prevent postoperative nausea and vomiting when compared to metoclopramide alone after uncomplicated laparoscopic cholecystectomy. Auriculoacupuncture can be recommended as an adjuvant therapy for postoperative nausea and vomiting prevention in selected patients.

摘要

背景与目的

术后恶心呕吐(PONV)是腹腔镜胆囊切除术(LC)后常见且不良的并发症。我们研究了耳针疗法(AA)对单纯性腹腔镜胆囊切除术后即刻预防术后恶心呕吐的效果。

方法

68例患者随机分为两组,耳针组(n = 35)和对照组(n = 33),然后进行前瞻性评估。在麻醉诱导前放置耳针并保留20分钟。使用视觉模拟量表评估恶心强度,并在进入麻醉恢复室后以及术后第2、4和6小时记录PONV事件。

结果

在整个术后期间,耳针组的恶心呕吐发生率明显低于对照组(分别为16/35对27/33,P = 0.03;4/35对15/33,P = 0.005);耳针组术后2小时(P = 0.03)和6小时(P = 0.001)恶心事件较少,术后2小时(P = 0.01)和6小时(P = 0.02)呕吐事件较少。

结论

与单纯使用胃复安相比,耳针疗法在单纯性腹腔镜胆囊切除术后可部分预防术后恶心呕吐。耳针疗法可推荐作为特定患者预防术后恶心呕吐的辅助治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7945/9373667/5b8ea46b4218/gr1.jpg

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