术前针刺对预防子宫切除术后恶心呕吐和血浆 5-羟色胺值的影响：一项随机临床试验。

Effects of Preoperative Acupuncture on Prevention of Nausea and Vomiting and Plasma Serotonin Values in the Hysterectomy Postoperative Period: a Randomized Clinical Trial.

机构信息

Department of Surgical Specialties and Anaesthesiology, Botucatu Medical School, São Paulo State University, UNESP, Botucatu, São Paulo, Brazil.

出版信息

J Acupunct Meridian Stud. 2022 Oct 31;15(5):300-306. doi: 10.51507/j.jams.2022.15.5.300.

DOI:10.51507/j.jams.2022.15.5.300

PMID:36521827

Abstract

BACKGROUND

Nausea and vomiting are frequent complications of anesthesia in the postoperative period. Acupuncture at the pericardium point 6 (PC6) is known to be effective in preventing postoperative nausea and vomiting (PONV).

OBJECTIVES

The objective of the present study is to investigate the effects of acupuncture performed at the PC6 point in the prevention of PONV in women undergoing elective open hysterectomy under general inhalational anesthesia and to assess its association with plasma serotonin levels.

METHODS

97 patients undergoing elective open hysterectomy were randomly divided into two groups: acupuncture group (bilateral acupuncture at PC6, n = 49), and a control group (no acupuncture, n = 48). All patients prophylactically received ondansetron and dexamethasone and, as rescue medication, metoclopramide in case of occurrence of PONV. The primary outcome evaluated was occurrence of nausea and vomiting within 24 hours after surgery. Serotonin plasma levels were measured before and after acupuncture prior to anesthesia induction. For the control group, the repeat measurement was performed 30 minutes after admission to the preoperative unit.

RESULTS

Acupuncture at PC6 significantly reduced the incidence of nausea (29.2% vs. 6.1%; > 0.003), and the need of rescue medication (metoclopramide) (33.3% vs. 10.2%; > 0.006), but not vomiting (4.2 vs. 4.1; > 0.98). The plasma serotonin levels between control and acupuncture groups did not differ.

CONCLUSION

This study shows that acupuncture at PC6 resulted in a lower incidence of postoperative nausea in patients undergoing hysterectomy.

摘要

背景

恶心和呕吐是术后麻醉期间常见的并发症。针刺心包经 6 穴（PC6）已被证实可有效预防术后恶心和呕吐（PONV）。

目的

本研究旨在探讨针刺 PC6 穴对预防全身吸入麻醉下择期开腹子宫切除术患者 PONV 的效果，并评估其与血浆 5-羟色胺水平的关系。

方法

97 例行择期开腹子宫切除术的患者随机分为两组：针刺组（双侧 PC6 针刺，n = 49）和对照组（不针刺，n = 48）。所有患者均预防性给予昂丹司琼和地塞米松，如果发生 PONV，则给予甲氧氯普胺作为解救药物。主要观察指标为术后 24 小时内恶心和呕吐的发生情况。在麻醉诱导前测量针刺前后的血浆 5-羟色胺水平。对于对照组，在进入术前病房 30 分钟后进行重复测量。