Abstract
Purpose
In a previous study we noticed that P6 acupressure ecreased postoperative nausea and vomiting (PONV) more markedly after discharge. As motion sickness susceptibility is increased by, for example, opioids we hypothesized that P6 acupressure decreased PONV by decreasing motion sickness susceptibility. We studied time to nausea by a laboratory motion challenge in a group of volunteers, during P6 and placebo acupressure.
Methods
60 women with high and low susceptibilities for motion sickness participated in a randomized and double-blind study with an active P6 acupressure, placebo acupressure, and a control group (n = 20 in each group). The risk score for PONV was over 50%. The motion challenge was by eccentric rotation in a chair, blindfolded and with chin to chest movements of the head. The challenge was stopped when women reported moderate nausea. Symptoms were recorded.
Results
Mean time to moderate nausea was longer in the P6 acupressure group compared to the control group. P6 acupressure = 352 (259-445), mean (95% confidence interval) in seconds, control = 151 (121-181) and placebo acupressure = 280 (161-340); (P = 0.006). No difference was found between P6 and placebo acupressure or placebo acupressure and control groups. Previous severity of motion sickness did not influence time to nausea (P = 0.107). The cumulative number of symptoms differed between the three groups (P < 0.05). Fewer symptoms were reported in the P6 acupressure compared to the control group P < 0.009. Overall, P6 acupressure was only marginally more effective than placebo acupressure on the forearms.
Conclusion
In females with a history of motion sickness P6 acupressure increased tolerance to experimental nauseogenic stimuli, and reduced the total number of symptoms reported.
Résumé
Objectif
Nous avions expérimenté déjà que ľacupression en P6 diminuait davantage les nausées et les vomissements postopératoires (NVPO) après ľhospitalisation. Comme la susceptibilité au mal des transports est augmentée par les opioides, entre autres, nous avons pensé que ľacupression en P6 diminuerait les NVPO en réduisant la susceptibilité au mal des transports. Nous avons mesuré le temps écoulé avant les premières nausées lors de ďune épreuve de mouvement chez des volontaires pendant ľapplication ďacupression en P6 ou ďun placebo.
Méthode
Notre essai randomisé et à double insu a réuni 60 femmes, peu ou très sujettes au mal des transports, réparties en trois groupes: avec acupression active en P6, acupression placebo, ou groupe témoin (n = 20 dans chaque groupe). Ľévaluation des risques de NVPO était de plus de 50 %. Ľépreuve de mouvement consistait en une rotation excentrique dans une chaise, les yeux bandés, et en des mouvements de la tête vers la poitrine. Ľépreuve était arrêtée quand les femmes avaient des nausées modérées. Les symptômes étaient notés.
Résultats
Le temps moyen écoulé avant ľapparition de nausées modérées a été plus long dans le groupe avec acupression en P6 comparé au groupe témoin. Acupression en P6 = 352 (259-445), moyenne (intervalle de confiance de 95 %) en secondes, groupe témoin = 151 (121-181) et acupression placebo = 280 (161-340) ; (P = 0,006). Aucune différence n’a été trouvée entre les groupes ďacupression en P6 et placebo ou entre les groupes placebo et témoin. La sévérité du mal des transports préalable n’a pas eu ďinfluence sur le temps écoulé avant les nausées (P = 0,107). Ľensemble des symptômes diffère entre les trois groupes (P < 0,05). Moins de symptômes ont été rapportés chez les patientes soumises à ľacupression en P6 comparées aux témoins P < 0,009. Sur ľensemble, ľacupression en P6 n’a été que marginalement plus efficace que le placebo appliqué sur les avant-bras.
Conclusion
Chez des femmes qui présentent des antécédents de mal des transports, ľacupression en P6 augmente la tolérance aux stimuli nauséogènes expérimentaux et réduit en nombre la fréquence des symptômes.
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Alkaissi, A., Ledin, T., Odkvist, L.M. et al. P6 acupressure increases tolerance to nauseogenic motion stimulation in women at high risk for PONV. Can J Anesth 52, 703–709 (2005). https://doi.org/10.1007/BF03016557
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DOI: https://doi.org/10.1007/BF03016557