Cargando…
Transcutaneous Electrical Acupoint Stimulation Decreases the Incidence of Postoperative Nausea and Vomiting After Laparoscopic Non-gastrointestinal Surgery: A Multi-Center Randomized Controlled Trial
IMPORTANCE: Postoperative nausea and vomiting (PONV) gives patients a bad experience and negates their good recovery from surgery. OBJECTIVE: This trial aims to assess the preventive effectiveness of transcutaneous electrical acupoint stimulation (TEAS) on the incidence of PONV in high-risk surgical...
Autores principales: | , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8964119/ https://www.ncbi.nlm.nih.gov/pubmed/35360742 http://dx.doi.org/10.3389/fmed.2022.766244 |
_version_ | 1784678140287647744 |
---|---|
author | Gao, Wei Zhang, Linzhong Han, Xuechang Wei, Lai Fang, Jie Zhang, Xiaqing Zhang, Jiaqiang Wang, Haiyun Zhou, Qi Wang, Chenggang Chen, Wenting Ni, Xinli Yang, Lan Du, Ruini Wang, Ge Liu, Bingyu Li, Yajuan Zhang, Shanshan Wang, Qiang |
author_facet | Gao, Wei Zhang, Linzhong Han, Xuechang Wei, Lai Fang, Jie Zhang, Xiaqing Zhang, Jiaqiang Wang, Haiyun Zhou, Qi Wang, Chenggang Chen, Wenting Ni, Xinli Yang, Lan Du, Ruini Wang, Ge Liu, Bingyu Li, Yajuan Zhang, Shanshan Wang, Qiang |
author_sort | Gao, Wei |
collection | PubMed |
description | IMPORTANCE: Postoperative nausea and vomiting (PONV) gives patients a bad experience and negates their good recovery from surgery. OBJECTIVE: This trial aims to assess the preventive effectiveness of transcutaneous electrical acupoint stimulation (TEAS) on the incidence of PONV in high-risk surgical patients. DESIGN: The large sample size, multicenter, evaluator-blinded, and randomized controlled study was conducted between September 3, 2019 to February 6, 2021. SETTING: The 12 hospitals were from different Chinese provinces. PARTICIPANTS: After obtaining ethics approval and written informed consent, 1,655 patients with Apfel score ≥ 3 points were enrolled for selective laparoscopic non-gastrointestinal surgery under general anesthesia. INTERVENTIONS: Patients were randomly allocated into the TEAS and Sham group with a 1:1 ratio. The TEAS group was stimulated on bilateral Neiguan and Zusanli acupoints after recovery from anesthesia on the surgical day and the next morning for 30 min, while the Sham group received an identical setting as TEAS but without currents delivered. Electronic patient self-reported scale was used to evaluate and record the occurrence of PONV. MAIN OUTCOMES AND MEASURES: Primary clinical end point is the incidence of PONV which was defined as at least one incidence of nausea, retching, or vomiting after operation within postoperative 24 h. RESULTS: Compared with the Sham treatment, the TEAS lowered the PONV incidence by 4.8% (29.4 vs. 34.2%, P = 0.036) and vomiting incidence by 7.4% (10.4 vs. 17.8%, P < 0.001). TEAS also lowered persistent nausea incidence and PONV scores and decreased PONV related complications and Quality of Recovery−40 scores (P < 0.05). TEAS lowered the 24 h PONV risk by 20% (OR, 0.80, 95% CI, 0.65 −0.98; P = 0.032), and lowered hazard ratio by 17% (HR, 0.83, 95% CI, 0.70–0.99; P = 0.035). Both TEAS and palonosetron were the independent PONV risk protective factors for 24 h PONV incidence and cumulative PONV incidence. The combination of TEAS and palonosetron was the most effective strategy to reduce the PONV incidence (P < 0.001). CONCLUSIONS AND RELEVANCE: TEAS attenuated the PONV incidence and severity in high-risk surgical patients and may be applied clinically as a complement therapy to prevent PONV. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT04043247, identifier: NCT04043247. |
format | Online Article Text |
id | pubmed-8964119 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-89641192022-03-30 Transcutaneous Electrical Acupoint Stimulation Decreases the Incidence of Postoperative Nausea and Vomiting After Laparoscopic Non-gastrointestinal Surgery: A Multi-Center Randomized Controlled Trial Gao, Wei Zhang, Linzhong Han, Xuechang Wei, Lai Fang, Jie Zhang, Xiaqing Zhang, Jiaqiang Wang, Haiyun Zhou, Qi Wang, Chenggang Chen, Wenting Ni, Xinli Yang, Lan Du, Ruini Wang, Ge Liu, Bingyu Li, Yajuan Zhang, Shanshan Wang, Qiang Front Med (Lausanne) Medicine IMPORTANCE: Postoperative nausea and vomiting (PONV) gives patients a bad experience and negates their good recovery from surgery. OBJECTIVE: This trial aims to assess the preventive effectiveness of transcutaneous electrical acupoint stimulation (TEAS) on the incidence of PONV in high-risk surgical patients. DESIGN: The large sample size, multicenter, evaluator-blinded, and randomized controlled study was conducted between September 3, 2019 to February 6, 2021. SETTING: The 12 hospitals were from different Chinese provinces. PARTICIPANTS: After obtaining ethics approval and written informed consent, 1,655 patients with Apfel score ≥ 3 points were enrolled for selective laparoscopic non-gastrointestinal surgery under general anesthesia. INTERVENTIONS: Patients were randomly allocated into the TEAS and Sham group with a 1:1 ratio. The TEAS group was stimulated on bilateral Neiguan and Zusanli acupoints after recovery from anesthesia on the surgical day and the next morning for 30 min, while the Sham group received an identical setting as TEAS but without currents delivered. Electronic patient self-reported scale was used to evaluate and record the occurrence of PONV. MAIN OUTCOMES AND MEASURES: Primary clinical end point is the incidence of PONV which was defined as at least one incidence of nausea, retching, or vomiting after operation within postoperative 24 h. RESULTS: Compared with the Sham treatment, the TEAS lowered the PONV incidence by 4.8% (29.4 vs. 34.2%, P = 0.036) and vomiting incidence by 7.4% (10.4 vs. 17.8%, P < 0.001). TEAS also lowered persistent nausea incidence and PONV scores and decreased PONV related complications and Quality of Recovery−40 scores (P < 0.05). TEAS lowered the 24 h PONV risk by 20% (OR, 0.80, 95% CI, 0.65 −0.98; P = 0.032), and lowered hazard ratio by 17% (HR, 0.83, 95% CI, 0.70–0.99; P = 0.035). Both TEAS and palonosetron were the independent PONV risk protective factors for 24 h PONV incidence and cumulative PONV incidence. The combination of TEAS and palonosetron was the most effective strategy to reduce the PONV incidence (P < 0.001). CONCLUSIONS AND RELEVANCE: TEAS attenuated the PONV incidence and severity in high-risk surgical patients and may be applied clinically as a complement therapy to prevent PONV. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT04043247, identifier: NCT04043247. Frontiers Media S.A. 2022-03-14 /pmc/articles/PMC8964119/ /pubmed/35360742 http://dx.doi.org/10.3389/fmed.2022.766244 Text en Copyright © 2022 Gao, Zhang, Han, Wei, Fang, Zhang, Zhang, Wang, Zhou, Wang, Chen, Ni, Yang, Du, Wang, Liu, Li, Zhang and Wang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Medicine Gao, Wei Zhang, Linzhong Han, Xuechang Wei, Lai Fang, Jie Zhang, Xiaqing Zhang, Jiaqiang Wang, Haiyun Zhou, Qi Wang, Chenggang Chen, Wenting Ni, Xinli Yang, Lan Du, Ruini Wang, Ge Liu, Bingyu Li, Yajuan Zhang, Shanshan Wang, Qiang Transcutaneous Electrical Acupoint Stimulation Decreases the Incidence of Postoperative Nausea and Vomiting After Laparoscopic Non-gastrointestinal Surgery: A Multi-Center Randomized Controlled Trial |
title | Transcutaneous Electrical Acupoint Stimulation Decreases the Incidence of Postoperative Nausea and Vomiting After Laparoscopic Non-gastrointestinal Surgery: A Multi-Center Randomized Controlled Trial |
title_full | Transcutaneous Electrical Acupoint Stimulation Decreases the Incidence of Postoperative Nausea and Vomiting After Laparoscopic Non-gastrointestinal Surgery: A Multi-Center Randomized Controlled Trial |
title_fullStr | Transcutaneous Electrical Acupoint Stimulation Decreases the Incidence of Postoperative Nausea and Vomiting After Laparoscopic Non-gastrointestinal Surgery: A Multi-Center Randomized Controlled Trial |
title_full_unstemmed | Transcutaneous Electrical Acupoint Stimulation Decreases the Incidence of Postoperative Nausea and Vomiting After Laparoscopic Non-gastrointestinal Surgery: A Multi-Center Randomized Controlled Trial |
title_short | Transcutaneous Electrical Acupoint Stimulation Decreases the Incidence of Postoperative Nausea and Vomiting After Laparoscopic Non-gastrointestinal Surgery: A Multi-Center Randomized Controlled Trial |
title_sort | transcutaneous electrical acupoint stimulation decreases the incidence of postoperative nausea and vomiting after laparoscopic non-gastrointestinal surgery: a multi-center randomized controlled trial |
topic | Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8964119/ https://www.ncbi.nlm.nih.gov/pubmed/35360742 http://dx.doi.org/10.3389/fmed.2022.766244 |
work_keys_str_mv | AT gaowei transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT zhanglinzhong transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT hanxuechang transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT weilai transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT fangjie transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT zhangxiaqing transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT zhangjiaqiang transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT wanghaiyun transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT zhouqi transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT wangchenggang transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT chenwenting transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT nixinli transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT yanglan transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT duruini transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT wangge transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT liubingyu transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT liyajuan transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT zhangshanshan transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial AT wangqiang transcutaneouselectricalacupointstimulationdecreasestheincidenceofpostoperativenauseaandvomitingafterlaparoscopicnongastrointestinalsurgeryamulticenterrandomizedcontrolledtrial |