Acupuncture for postoperative nausea and vomiting
Sübutlu məlumatların xülasələri
13.07.2017 • Sonuncu dəyişiklik 13.07.2017
Editors
Acupuncture appears to be effective for postoperative and chemotherapy-related nausea and vomiting.
A Cochrane review included 59 studies with a total of 7667 subjects. Compared with sham treatment, PC6 acupoint stimulation significantly reduced the incidence of nausea (RR 0.68, 95% CI 0.60 to 0.77; 40 trials, 4742 participants), vomiting (RR 0.60, 95% CI 0.51 to 0.71; 45 trials, 5147 participants) and the need for rescue antiemetics (RR 0.64, 95% CI 0.55 to 0.73; 39 trials, 4622 participants).
PC6 acupoint stimulation was compared with six different types of antiemetic drugs (metoclopramide, cyclizine, prochlorperazine, droperidol. ondansetron and dexamethasone). There was no difference between PC6 acupoint stimulation and antiemetic drugs in the incidence of nausea (RR 0.91, 95% CI 0.75 to 1.10; 14 trials, 1332 participants), vomiting (RR 0.93, 95% CI 0.74 to 1.17; 19 trials, 1708 participants), or the need for rescue antiemetics (RR 0.87, 95% CI 0.65 to 1.16; 9 trials, 895 participants). Compared to antiemetic drugs, the combination of PC6 acupoint stimulation and antiemetic therapy reduced the incidence of vomiting (RR 0.56, 95% CI 0.35 to 0.91; 9 trials, 687 participants) but not nausea (RR 0.79, 95% CI 0.55 to 1.13; 8 trials, 642 participants). The need for rescue antiemetic was lower in the combination PC6 acupoint stimulation and antiemetic group than the antiemetic group (RR 0.61, 95% CI 0.44 to 0.86; 5 trials, 419 participants).
The side effects associated with PC6 acupoint stimulation were minor, transient and self-limiting (e.g. skin irritation, blistering, redness and pain) in 14 trials.
There were significant reductions in the risks of nausea (RR 0.71, 95% CI 0.61 to 0.83), vomiting (RR 0.70, 95% CI 0.59 to 0.83) and the need for rescue antiemetics (RR 0.69, 95% CI 0.57 to 0.83) in the P6 acupoint stimulation group compared with the sham treatment, although heterogeneity among trials was moderate. There was no clear difference in the effectiveness of P6 acupoint stimulation for adults and children; or for invasive and noninvasive acupoint stimulation. There was no evidence of difference between P6 acupoint stimulation and antiemetic drugs in the risk of nausea (RR 0.82, 95% CI 0.60 to 1.13), vomiting (RR 1.01, 95% CI 0.77 to 1.31), or the need for rescue antiemetics (RR 0.82, 95% CI 0.59 to 1.13). The side effects associated with P6 acupoint stimulation were minor.
A systematic review
was abstracted in DARE. Acupuncture appears to be effective for postoperative nausea and vomiting in adults, chemotherapy-related nausea and vomiting and for postoperative dental pain. Current evidence suggests that acupuncture is unlikely to be of benefit for obesity, smoking cessation and tinnitus. For most other conditions, the available evidence is insufficient to guide clinical decisions. Acupuncture appears a relatively safe treatment in the hands of suitably qualified practitioners, with serious adverse
events being extremely rare.
Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes).
Ədəbiyyat
- Lee A, Chan SK, Fan LT. Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev 2015;(11):CD003281. . .
University of York. NHS Centre for Reviews and Dissemination. Acupuncture. Effective Health Care, 2001;7(2):1-12.