Department of Anesthesiology, Geriatric Diseases Institute of Chengdu/Cancer Prevention and Treatment Institute of Chengdu, Chengdu Fifth People's Hospital (The Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine), Chengdu, 611137, China.
Department of Anesthesiology, Pidu District People's Hospital, Chengdu & The Third Affiliated Hospital of Chengdu Medical College, Chengdu, 611730, China.
Obes Surg. 2023 Sep;33(9):2831-2840. doi: 10.1007/s11695-023-06752-7. Epub 2023 Jul 28.
Being overweight or obese is becoming increasingly prevalent worldwide and seriously endangers human health. Laparoscopic sleeve gastrectomy (LSG) has been successfully used for the treatment of severe obesity, but the incidence of postoperative nausea and vomiting (PONV) is high. However, traditional antiemetics have limited effects on PONV. Electropress needle therapy, which can be enhanced with electrical stimulation, is a promising therapy for the prevention and treatment of PONV. However, whether the electropress needle is effective for PONV in patients with LSG remains uncertain.
This was a prospective, randomized controlled trial. A total of 106 patients who planned to undergo elective LSG between October 2021 and July 2022 were randomly allocated to receive electropress needle stimulation combined with dexamethasone and granisetron (group A) or dexamethasone plus granisetron (group B). The primary outcome was the incidence of PONV 48 h after surgery. The secondary outcomes were PONV severity score, time to first flatus, length of hospital stay, visual analogue scale (VAS) score, and postoperative remedial medication use.
Compared with dexamethasone plus granisetron, electropress needle stimulation combined with dexamethasone and granisetron significantly decreased the incidence and severity of PONV (P<0.001). Patients in Group A consumed less antiemetics postoperatively (P<0.05) and had a much shorter length of postoperative hospital stay (P<0.05). There was no difference in the time to first flatus between the two groups (P > 0.05).
Electropress needle acupoint stimulation can reduce the incidence and severity of PONV in patients undergoing LSG.
超重或肥胖在全球范围内日益普遍，严重威胁人类健康。腹腔镜袖状胃切除术（LSG）已成功用于治疗严重肥胖，但术后恶心和呕吐（PONV）的发生率较高。然而，传统的止吐药对 PONV 的效果有限。电针刺激疗法可以增强疗效，是预防和治疗 PONV 的有前途的疗法。然而，电针在 LSG 患者中的 PONV 预防效果尚不确定。
这是一项前瞻性、随机对照试验。共有 106 名计划在 2021 年 10 月至 2022 年 7 月间接受择期 LSG 的患者被随机分配接受电针刺激联合地塞米松和格拉司琼（A 组）或地塞米松加格拉司琼（B 组）治疗。主要结局是术后 48 小时 PONV 的发生率。次要结局是 PONV 严重程度评分、首次排气时间、住院时间、视觉模拟评分（VAS）和术后补救用药。
与地塞米松加格拉司琼相比，电针刺激联合地塞米松和格拉司琼可显著降低 PONV 的发生率和严重程度（P<0.001）。A 组患者术后使用止吐药较少（P<0.05），术后住院时间较短（P<0.05）。两组首次排气时间无差异（P > 0.05）。
电针穴位刺激可降低 LSG 患者 PONV 的发生率和严重程度。
