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P6 acupressure may relieve nausea and vomiting after gynecological surgery: an effectiveness study in 410 women

[L’acupression en P6 peut soulager les nausées et les vomissements postopératoires gynécologiques : une étude d’efficacité auprès de 410 femmes]

Aidah Alkaissi, RN MSc^*, Karin Evertsson, RN^*, Vivi-Ann Johnsson, RN, Lilli Ofenbartl, RN and Sigga Kalman, MD PhD^*

^* From the Department of Anaesthesiology and Intensive Care, University Hospital in Linköping
the Department of Anaesthesiology and Intensive Care, Västervik Hospital
and the Department of Anaesthesiology and Intensive Care, Eksjö Hospital, Linköping, Sweden.

Address correspondence to: Dr. Sigga Kalman, Department of Anaesthesiology and Intensive Care, University Hospital in Linköping, S-581 85 Linköping, Sweden. Phone: +46 13 22 28 71; Fax: +46 13 22 28 36; E-mail: Sigga.Kalman{at}lio.se

Purpose: To investigate the effect of sensory stimulation of the P6 point on postoperative nausea and vomiting (PONV) after gynecological surgery in the everyday clinical setting (effectiveness study).

Methods: Four hundred and ten women undergoing general anesthesia for elective gynecological surgery were included in a prospective, consecutive, randomized, multicentre, placebo-controlled, double-blind clinical trial with a reference group. One group was given bilateral P6 acupressure (n = 135), a second group similar pressure on bilateral non-acupressure points (n = 139), and a third group (n = 136) served as reference group. Nausea (scale 0–6), vomiting, pain, and satisfaction with the treatment were recorded. Primary outcome was complete response, i.e., no nausea, vomiting or rescue medication for 24 hr. Results were analyzed by applying logistic regression with indicators of treatments, type of operation and risk score for PONV as explanatory variables.

Results: Complete response was more frequent in the P6 acupressure group than in the reference group (P = 0.0194) Conversely, the incidence of PONV was 46% in the reference group, 38% after pressure on a non-acupoint and 33% after P6 acupressure. The decrease from 46% to 33% was statistically significant. When considering vaginal cases separately, the decrease in PONV was from 36% to 20% (P = 0.0168). The corresponding decrease from 59% to 55% in the laparoscopic surgery group was not statistically significant.

Conclusion: P6 acupressure is a non-invasive method that may have a place as prophylactic antiemetic therapy during gynecological surgery.

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