Gieron C, Wieland B, von der Laage D, Tolksdorf W
Klinik für Anästhesiologie, Medizinische Fakultät, RWTH Aachen.
Anaesthesist. 1993 Apr;42(4):221-6.
Despite modern anaesthetic procedures, postoperative nausea and vomiting are still the side-effects most often mentioned: acupressure is reported to be an additional method of preventing these effects in minor gynaecological surgery. We investigated the effectiveness of acupressure in patients undergoing gynaecological operations of longer duration (6-8 h) in a verum acupressure group compared to a placebo group. Before beginning the study we investigated a control group to find out the frequency of emesis. In the worst case of nausea that we encountered, 80% in the 0-6 h postoperative period, the number of random samples for the acupressure and placebo groups was calculated (30 patients in each group). The error for alpha was established at 5% and the reduction of nausea was 50%. METHODS. The female patients were 18 to 65 years old (ASA group I and II). Acupressure was carried out by fastening small metal bullets at the point P 6 to each forearm by means of an elastic bandage. The bullets were left there for 24 h. The premedication anaesthesia, postoperative analgesia, and antiemetic treatment were standardized. During a 24-h period we investigated the incidence of nausea and vomiting. RESULTS. The anthropometric data, the duration of surgery and the amount of postoperative analgesia were comparable between the three groups. Verum acupressure obtained a statistically significant and relevant reduction in nausea up to the 6th postoperative hour in comparison with the placebo group (P = 0.03). Nausea was reduced from 53% in the placebo group to 23% in the acupressure group. CONCLUSION. As demonstrated in this group of longer gynaecological surgery patients as well as in chemotherapy-induced nausea and vomiting, we were able to demonstrate that acupressure is an effective method of preventing nausea and vomiting without any side-effects. It is a valuable addition to the prevention of postoperative nausea and vomiting. Further studies should be conducted to investigate this possibility further.
尽管有现代麻醉程序,但术后恶心和呕吐仍是最常被提及的副作用:据报道,穴位按压是预防小妇科手术中这些副作用的一种额外方法。我们调查了穴位按压对接受较长时间(6 - 8小时)妇科手术患者的有效性,将真穴穴位按压组与安慰剂组进行比较。在开始研究之前,我们调查了一个对照组以了解呕吐频率。在我们遇到的最严重恶心情况中,术后0 - 6小时内发生率为80%,据此计算了穴位按压组和安慰剂组的随机样本数量(每组30例患者)。α错误设定为5%,恶心减轻率设定为50%。方法:女性患者年龄在18至65岁之间(ASA分级I级和II级)。通过弹性绷带将小金属珠固定在前臂的内关穴(P 6)处进行穴位按压。金属珠留置24小时。术前用药、麻醉、术后镇痛和止吐治疗均标准化。在24小时内,我们调查了恶心和呕吐的发生率。结果:三组患者的人体测量数据、手术时间和术后镇痛量具有可比性。与安慰剂组相比,真穴穴位按压在术后第6小时前能使恶心有统计学意义且显著减轻(P = 0.03)。恶心发生率从安慰剂组的53%降至穴位按压组的23%。结论:正如在这组较长时间妇科手术患者以及化疗引起的恶心和呕吐中所证明的那样,我们能够证明穴位按压是预防恶心和呕吐的有效方法且无任何副作用。它是预防术后恶心和呕吐的一项有价值的补充措施。应进一步开展研究以深入调查这种可能性。