Antiemetic efficacy of capsicum plaster on acupuncture points in patients undergoing thyroid operation

Abstract

Background: Postoperative nausea and vomiting (PONV) occurs in up to 63-84% of patients after thyroid surgery. This study aims to assess the effects of using a capsicum plaster to reduce PONV after thyroid surgery at either the Chinese acupuncture point (acupoint) Pericardium 6 (P6) or Korean hand acupuncture point K-D2.

Methods: One-hundred eighty-four patients who underwent thyroid surgery were randomized in four groups (n = 46 each): control group = inactive tape at P6 acupoints and on both shoulders as a nonacupoint; P6 group = capsicum plaster at P6 points and inactive tape on both shoulders; K-D2 group = capsicum plaster at K-D2 acupoints and inactive tape on both shoulders; Sham group = capsicum plaster on both shoulders and inactive tape at P6 acupoints. The capsicum plaster was applied before the induction of anesthesia and removed at 8 hr after surgery.

Results: The incidence and severity of nausea and vomiting and the need for rescue antiemetics were decreased in the patients in the P6 and K-D2 groups compared to the patients in the control and sham groups (P < 0.001). The patients in the P6 and K-D2 groups also reported that they were more satisfied (P < 0.05).

Conclusions: We conclude that the capsicum plaster at the P6 and K-D2 acupoint was a promising antiemetic method for the patients undergoing thyroid surgery.

Keywords: Acupuncture; Capsaicin; Nausea and vomiting; Thyroid surgery.

Fig. 1

Flow diagram of study participants. P6 group: capsicum plaster at the P6 and an inactive tape at the deltoid region of both shoulders, K-D2 group: capsicum plaster at the K-D2 acupoint and an inactive tape at both deltoid regions, Control group: an inactive tape at the P6 acupoint and at both deltoid regions, Sham group: capsicum plaster on both shoulders and an inactive tape at both P6 points.

Fig. 2

Incidence of (A) nausea and (B) vomiting, and (C) the use of antiemetics in each study group during the 24 hr postoperative period. P6 group: capsicum plaster at the P6 and an inactive tape at the deltoid region of both shoulders, K-D2 group: capsicum plaster at the K-D2 acupoint and an inactive tape at both deltoid regions, Control group: an inactive tape at the P6 acupoint and at both deltoid regions, Sham group: capsicum plaster on both shoulders and an inactive tape at both P6 points. For each group, the error bar indicates the value of the upper limit of the 95% confidence interval for the percentage of patients achieving the endpoint. ^*P < 0.001 compared with the control and sham groups.

Fig. 3

Severity of nausea during the 24 hr postoperative period. ^*P < 0.001 compared with the control and sham groups. P6 group: capsicum plaster at the P6 and an inactive tape at the deltoid region of both shoulders, K-D2 group: capsicum plaster at the K-D2 acupoint and an inactive tape at both deltoid regions, Control group: an inactive tape at the P6 acupoint and at both deltoid regions, Sham group: capsicum plaster on both shoulders and an inactive tape at both P6 points.

Fig. 4

Satisfaction scores (mean ± SD) at the 24 hr postoperative period. VAS: visual analog scale. ^*P < 0.05 compared with the control and sham groups. P6 group: capsicum plaster at the P6 and an inactive tape at the deltoid region of both shoulders, K-D2 group: capsicum plaster at the K-D2 acupoint and an inactive tape at both deltoid regions, Control group: an inactive tape at the P6 acupoint and at both deltoid regions, Sham group: capsicum plaster on both shoulders and an inactive tape at both P6 points.