The Effects of P6 Electrical Acustimulation on Postoperative Nausea and Vomiting in Patients After Infratentorial Craniotomy
The Effects of P6 Electrical Acustimulation on Postoperative Nausea and Vomiting in Patients After Infratentorial Craniotomy
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DOI：
10.1097/ana.0b013e31825eb5ef
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发表时间：
2012-10
影响因子：
3.7
通讯作者：
Ming Xu;Shou-jing Zhou;Cheng-chuan Jiang;Yi Wu;Weining Shi;Huahua Gu;Hua-Di Cai;Xiao-Qiang Wang
中科院分区：
文献类型：
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作者：
Ming Xu;Shou-jing Zhou;Cheng-chuan Jiang;Yi Wu;Weining Shi;Huahua Gu;Hua-Di Cai;Xiao-Qiang Wang
背景：术后恶心和呕吐（PONV）是神经外科手术后常见且有害的并发症。目前的标准治疗是基于药物的治疗；然而，它缺乏效率。有创和无创针刺 P6 经络穴位已被证明可有效预防 PONV。我们评估了 P6 时经皮穴位电刺激 (TEAS) 对幕下开颅手术患者预防 PONV 的有效性。方法：在这项前瞻性、盲法、随机研究中，患者在麻醉诱导前 30 分钟开始，一直到术后或 P6 假针刺后 24 小时内，在 P6 时在优势侧接受 TEAS。用七氟醚/瑞芬太尼和间歇性芬太尼/顺阿曲库铵维持麻醉。术中给予 4 mg 昂丹司琼和 10 mg 地塞米松止吐药。收集记录术后恶心和呕吐发作以及需要止吐救援（肌注 10 毫克甲氧氯普胺）的数据。使用2检验进行统计分析。 P<0.05被认为是显着的。结果：在 130 名入组患者中，119 名患者完成了研究。 TEAS组24小时累计呕吐发生率显着低于对照组（22% vs. 41%，P=0.025）。与对照组相比，TEAS组术后6小时（27% vs. 47%，P=0.019）和24小时（33% vs. 58%，P=0.008）的累积恶心发生率也显着降低。各组之间救援止吐药的总体要求相似。结论：P6 围手术期 TEAS 可能是标准止吐药物治疗的有效辅助疗法，用于预防幕下开颅术后 PONV。
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 2 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.