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Randomized Controlled Trial
. 2013 May 28:14:153.
doi: 10.1186/1745-6215-14-153.

P6 acupoint stimulation for prevention of postoperative nausea and vomiting in patients undergoing craniotomy: study protocol for a randomized controlled trial

Jian-qin Lv  1 , Rui-zhi Feng, Ning Li
Affiliations
Randomized Controlled Trial

P6 acupoint stimulation for prevention of postoperative nausea and vomiting in patients undergoing craniotomy: study protocol for a randomized controlled trial

Jian-qin Lv et al. Trials. .

Abstract

Background: The incidence of postoperative nausea and vomiting (PONV) is 50 to 79% after neurosurgery. Our study is designed to evaluate the efficacy of pericardium 6 (P6; also known as Neiguan) acupoint stimulation versus placebo, and versus routine antiemetic for the prevention of PONV after craniotomy, as well as to compare the efficacy of invasive acupuncture with non-invasive transcutaneous electrical nerve stimulation (TENS) on P6.

Methods/design: This is a single-center, prospective, double-blind, five-arm, parallel-group, randomized controlled trial (RCT). All groups will be given routine intravenous ondansetron 8 mg administered before skin closure. Upon regaining consciousness from general anaesthesia, patients will receive one of five interventions: 1) P6 acupuncture bilaterally for 30 minutes, stimulated every 10 minutes to keep de qi sensation; 2) sham acupuncture bilaterally for 30 minutes with no stimulation; 3) P6 stimulation via active TENS electrodes bilaterally for 30 minutes, with stimulation frequency and intensity set to when de qi sensation is felt; 4) sham P6 stimulation via inactive TENS electrode bilaterally for 30 minutes; and 5) usual practice of pharmacological emesis prevention. The incidence of postoperative vomiting during the first 24 hours is the main outcome. Secondary outcomes include: complete response rate, severity of nausea, total rescue metoclopramide dose used and patient satisfaction with PONV management.

Discussion: The results from this study could potentially confirm that P6 acupoint stimulation is an effective adjunct to standard antiemetic drug therapy for the prevention of PONV in patients undergoing craniotomy. Our study may also confirm that conventional acupuncture is more effective than TENS.

Trial registration: This study is registered with the Chinese Clinical Trial Registry: ChiCTR-TRC-13003026.

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Figures

Figure 1
Figure 1
Trial flow chart. If a patient can not complete the study due to death, re-operation, unconsciousness or cognitive impairment, the patient will be considered a lost case and recorded as an occurrence of PONV. PONV, postoperative nausea and vomiting; TENS, transcutaneous electrical nerve stimulation.
Figure 2
Figure 2
Location of P6 acupoint and sham acupoint.
Figure 3
Figure 3
The SDZ-V nerve and muscle stimulator (Hwato, Jiangsu, China) and self-adhesive electrodes.
See this image and copyright information in PMC

References

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