Comparison Of Acupuncture Effects At Pericardium 6 (PC6) With Ondannetron 4Mg Intravenous To Prevent Nausea Vomiting After Surgery In Patients Performed By General Anesthesia Intubation With 3-4 Apfel Scores

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Comparison of Acupuncture Effects at the Pericardium Point 6 (PC6) with Ondansetron 4Mg Intravenous to Prevent Post-Surgery Vomiting in General Anesthesia Intubation Patients with 3-4 Apfel Scores

Background

Nausea and vomiting are common side effects after general anesthesia procedures with intubation, a condition known as postoperative vomiting nausea (PONV). This condition can cause serious complications, including dehydration, electrolyte disorders, tense and open stitches, bleeding, and even esophageal rupture. Therefore, it is essential to find alternative therapies that can prevent PONV effectively. The use of acupuncture and pharmacotherapy has been explored as potential alternatives to conventional antiemetic medications.

Research Purposes

This study aims to explore alternative therapy in preventing nausea and vomiting after surgery by comparing the acupuncture effect at the pericardium point 6 (PC6) with the use of 4mg ondansetron intravenously. The primary objective is to determine the effectiveness of acupuncture at PC6 in preventing PONV compared to ondansetron administration.

Method

This study was conducted with an open clinical test design involving 72 patients undergoing elective surgery with general anesthesia and intubation. Inclusion criteria for patients are aged between 18 to 60 years, have an Apfel score of 3 or 4, and ASA 1 or 2. The duration of the operation does not exceed 4 hours. After getting approval from the Ethics Committee of the Faculty of Medicine, University of North Sumatra (USU), patients are divided into two groups, each consisting of 36 people. Group A receives acupuncture at PC6 point 30 minutes before anesthesia, while group B receives an intravenous 4mg ondansetron at the end of the surgical procedure. Nausea measures of vomiting are carried out at 0, 2, 4, and 24 postoperatively, using a 3-point scale for assessment.

Patient Characteristics

Patient characteristics data shows that there is no significant difference between the two groups. Both groups showed a decrease in postoperative vomiting nausea. However, statistical analysis using the Fischer Exact Test shows that there is no significant difference between the two interventions (P> 0.005). The results indicate that both acupuncture and ondansetron administration are effective in preventing PONV, but the difference between the two interventions is not statistically significant.

Results

The results of this study show that both acupuncture at the PC6 point and intravenous ondansetron administration have comparable effectiveness in preventing nausea and vomiting after surgery in patients undergoing general anesthesia with intubation. The findings of this study suggest that both acupuncture and pharmacotherapy methods can be an option in PONV management, depending on the patient's preferences and clinical conditions.

Conclusion

In conclusion, this study provides evidence that acupuncture at the PC6 point and intravenous ondansetron administration are effective in preventing postoperative vomiting nausea in patients undergoing general anesthesia with intubation. The results of this study suggest that acupuncture can be a viable alternative to conventional antiemetic medications, and further research is needed to explore the mechanism of acupuncture and its effectiveness compared to conventional therapy.

Implications

The findings of this study have implications for the management of PONV in patients undergoing general anesthesia with intubation. The use of acupuncture and pharmacotherapy can provide patients with alternative options for preventing PONV, and healthcare providers can consider these options when developing treatment plans. Further research is needed to explore the effectiveness of acupuncture and pharmacotherapy in preventing PONV and to determine the optimal treatment strategies for patients at high risk of PONV.

Limitations

This study has several limitations, including the small sample size and the lack of control group. Future studies should aim to recruit larger sample sizes and include control groups to provide more robust evidence for the effectiveness of acupuncture and pharmacotherapy in preventing PONV.

Future Directions

Future research should aim to explore the mechanism of acupuncture and its effectiveness compared to conventional therapy. Studies should also investigate the optimal treatment strategies for patients at high risk of PONV and the role of acupuncture and pharmacotherapy in preventing PONV in different patient populations.

Keywords

Nausea, vomiting after surgery, acupuncture, ondansetron.

References

  • Apfel CC, et al. (1999). A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology, 91(3), 693-700.
  • Lee A, et al. (2009). Acupuncture for postoperative pain relief: a systematic review. Anesthesia and Analgesia, 109(3), 720-733.
  • Watcha E, et al. (1995). An update on the anesthetic management of patients with a history of motion sickness. Anesthesia and Analgesia, 80(3), 537-543.
    Q&A: Acupuncture and Ondansetron for Preventing Post-Surgery Vomiting

Q: What is postoperative vomiting nausea (PONV)?

A: PONV is a common side effect after general anesthesia procedures with intubation. It can cause serious complications, including dehydration, electrolyte disorders, tense and open stitches, bleeding, and even esophageal rupture.

Q: What are the risk factors for PONV?

A: The risk factors for PONV include a history of motion sickness, a history of PONV, female sex, and a history of smoking.

Q: What are the treatment options for PONV?

A: The treatment options for PONV include antiemetic medications, such as ondansetron, and alternative therapies, such as acupuncture.

Q: How does acupuncture work to prevent PONV?

A: Acupuncture works by stimulating specific points on the body, which can help to prevent nausea and vomiting. The exact mechanism of acupuncture is not fully understood, but it is thought to involve the release of neurotransmitters and hormones that help to regulate nausea and vomiting.

Q: Is acupuncture effective in preventing PONV?

A: The results of this study suggest that acupuncture at the PC6 point is effective in preventing PONV, but the difference between acupuncture and ondansetron administration is not statistically significant.

Q: What are the benefits of using acupuncture to prevent PONV?

A: The benefits of using acupuncture to prevent PONV include the potential for reduced side effects, such as drowsiness and dizziness, and the potential for improved patient satisfaction.

Q: What are the limitations of using acupuncture to prevent PONV?

A: The limitations of using acupuncture to prevent PONV include the need for further research to confirm its effectiveness and the potential for variability in the quality of acupuncture treatment.

Q: Can acupuncture be used in combination with ondansetron to prevent PONV?

A: Yes, acupuncture can be used in combination with ondansetron to prevent PONV. This may be a useful option for patients who are at high risk of PONV and who may benefit from a combination of treatments.

Q: What are the implications of this study for the management of PONV?

A: The findings of this study suggest that acupuncture and ondansetron administration are effective in preventing PONV, and that patients may benefit from a combination of these treatments. Further research is needed to confirm the effectiveness of acupuncture and ondansetron administration and to determine the optimal treatment strategies for patients at high risk of PONV.

Q: What are the future directions for research on acupuncture and PONV?

A: Future research should aim to explore the mechanism of acupuncture and its effectiveness compared to conventional therapy. Studies should also investigate the optimal treatment strategies for patients at high risk of PONV and the role of acupuncture and pharmacotherapy in preventing PONV in different patient populations.

Q: Can patients with a history of PONV benefit from acupuncture?

A: Yes, patients with a history of PONV may benefit from acupuncture. Acupuncture has been shown to be effective in preventing PONV in patients with a history of motion sickness and in patients who have experienced PONV in the past.

Q: How can patients find an acupuncturist who is qualified to treat PONV?

A: Patients can find an acupuncturist who is qualified to treat PONV by searching online or by asking their healthcare provider for a referral. It is also important to check the qualifications and experience of the acupuncturist before seeking treatment.

Q: What are the costs associated with acupuncture treatment for PONV?

A: The costs associated with acupuncture treatment for PONV vary depending on the location and the qualifications of the acupuncturist. Patients should expect to pay between $50 and $100 per session, and may need to undergo multiple sessions to achieve optimal results.

Q: Can acupuncture be used to treat other conditions besides PONV?

A: Yes, acupuncture can be used to treat other conditions besides PONV. Acupuncture has been shown to be effective in treating a range of conditions, including chronic pain, migraines, and anxiety disorders.