Description patients received TEAS at P6 on the dominant side
Experimental Description
Using a computer-generated random number table and allocation concealment of sequentially numbered, opaque, sealed envelopes, eligible patients were randomized into groups in consecutive order: the TEAS group (n=65) in which patients received transcutaneous electrical acustimulation and the control group (n=65) in which patients received a sham treatment.
Sample Count
130
Control
Sham
Sham group(n=65)
Experiment
TEAS group (n=65)
Indicator
Postoperative Nausea and Vomiting(PONV)The need for antiemetic rescue
Auxiliary Medication
The anesthetic technique was standardized as follows: patients were premedicated with midazolam intravenously (IV) (up to 2 mg), and anesthesia was induced with propofol (1 to 2 mg/kg), fentanyl (3 to 5 mg/kg), and a muscle relaxant of choice (cisatracurium, rocuronium, vecuronium). Anesthesia was maintained using sevoflurane (1.8% to 2.5%), remifentanil (0.05 to 0.2mg/kg/ min), and intermittent fentanyl (4mg/kg). All patients received dexamethasone IV (10mg) after induction and ondansetron IV (4 mg) before skin closure.
Stimulation Method
TEAS
Induction Method
Electroacupuncture Instrument Model
Manufacturer
Frequency
Waveform
Strength
Induction Time
HANS
Beijing Huawei Co, Ltd., Beijing, China
2/100 Hz
alternating wave
2 mA
30 minutes before the induction of anesthesia and lasted up to 24 hours postoperatively
Acupuncture_Needle
Needle_Manufacturer
Needle_Depth
-
-
-
Description Acustimulation was provided by an electrical stimulation unit (HANS dual-channel unit; Huawei Limited) that was connected to both electrodes with electrical wires and set at a strength of 2 mA with an alternating waveform of 2 to 100 Hz. All of the patients were told that a tingling or numbing sensation might or might not be felt, regardless of the group assignment. In the TEAS group, the unit was activated 30 minutes before the induction of anesthesia and lasted up to 24 hours postoperatively.
Anesthesia Method
AAA
Clinical Trial Type
random
Adverse Effects
No side effects (eg, cutaneous irritation, bleeding, nerve injury) associated with acustimulation were recorded.
Contraindications
Cardiac pacemaker, cardioverter, or defibrillator
Effector
Of the 130 patients enrolled, 119 patients completed the study. The 24-hour cumulative incidence of vomiting was significantly lower in the TEAS group than in the control group (22% vs. 41%, P=0.025). The cumulative incidences of nausea at 6 hours (27% vs. 47%, P=0.019) and 24 hours (33% vs. 58%, P=0.008) after surgery were also significantly lower in the TEAS group compared with the control group. The overall requirements of rescue antiemetics were similar between the groups.Perioperative TEAS at P6 may be an effective adjunct to the standard antiemetic drug therapy for the prevention of PONV after infratentorial craniotomy.
The effects of P6 electrical acustimulation on postoperative nausea and vomiting in patients after infratentorial craniotomy.
Abstract
BACKGROUND: Postoperative nausea and vomiting (PONV) are frequent and harmful complications after neurosurgery. Current pharmacy-based treatment is the standard of care; it, however, lacks efficiency. Invasive and noninvasive acupuncture at the P6 meridian point has been shown to be effective in the prevention of PONV. We evaluated the effectiveness of transcutaneous electrical acupoint stimulation (TEAS) at P6 for the prophylaxis of PONV in patients undergoing infratentorial craniotomy. METHODS: In this prospective, blind, and randomized study, patients received TEAS at P6 on the dominant side starting 30 minutes before the induction of anesthesia and up to 24 hours after surgery or sham acustimulation at P6. The anesthesia was maintained with sevoflurane/remifentanil and intermittent fentanyl/cisatracurium. Antiemetics with 4 mg ondansetron and 10 mg dexamethasone were administered intraoperatively. Data documenting postoperative episodes of nausea and vomiting and the need for antiemetic rescue (10 mg metoclopramide intramuscularly) were collected. Statistical analysis was performed using the chi test. P<0.05 was considered to be significant. RESULTS: Of the 130 patients enrolled, 119 patients completed the study. The 24-hour cumulative incidence of vomiting was significantly lower in the TEAS group than in the control group (22% vs. 41%, P=0.025). The cumulative incidences of nausea at 6 hours (27% vs. 47%, P=0.019) and 24 hours (33% vs. 58%, P=0.008) after surgery were also significantly lower in the TEAS group compared with the control group. The overall requirements of rescue antiemetics were similar between the groups. CONCLUSION: Perioperative TEAS at P6 may be an effective adjunct to the standard antiemetic drug therapy for the prevention of PONV after infratentorial craniotomy."
