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      Acupressure the PC6 point for alleviating postoperative nausea and vomiting : A systematic review protocol

      review-article
      Author(s): , PhD, , MD, , PhD, , PhD, , PhD, , PhD ∗ , , Prof ∗
      Publication date (Electronic):
      Journal: Medicine
      Publisher: Wolters Kluwer Health
      Keywords: acupressure, PC6 point, PONV, protocol, systematic review

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          Abstract

          Background:

          Postoperative nausea and vomiting (PONV) are common complications following surgery and anesthesia, conventional drugs can carry some side effect in treating PONV. Acupressure PC6 point has been widely used in clinical, but there still exist controversy towards its effectiveness and safety. We, therefore, design this study to systematically assess the effectiveness and safety of acupressure PC6 point for treating PONV.

          Methods and analysis:

          Nine online databases will be searched from their inception to May 2019. We will include randomized controlled trials (RCTs) involving patients with PONV and receiving acupressure PC6 point treatment. Two independent reviewers will be responsible for the selection of studies, data extraction and risk of bias assessment. RevMan V.5.3 software will be used for data synthesis with either a fixed effects model or random effects model depending on the heterogeneity test. Evidence quality will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation system (GRADE). The primary outcome is incidence of postoperative nausea (PON), postoperative vomiting (POV) and PONV events during 0 to 6 hours and after 6 hours of the treatment. The secondary outcome is the number of people who use emergency drugs and the number of people with adverse reactions. A meta-analysis will be conducted if no considerable heterogeneity is detected. The results will be presented as risk ratios with 95% confidence interval (CIs) for dichotomous data and weighted mean differences or standardized mean differences with 95% CIs for continuous data.

          Results:

          This study will provide a high-quality evidence to assess the effectiveness and safety of acupressure PC6 point for patient with PONV.

          Conclusion:

          This review will provide up-date evidence of whether acupressure of PC6 point is an effective and safe intervention for PONV. PROSPERO registration number: CRD42019135598

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          Most cited references21

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          An update on the management of postoperative nausea and vomiting.

          Xuezhao Cao, Paul F. White, Hong Ma (2017)
          Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) remain common and distressing complications following surgery. PONV and PDNV can delay discharge and recovery and increase medical costs. The high incidence of PONV has persisted in part because of the tremendous growth in ambulatory surgery and the increased emphasis on earlier mobilization and discharge after both minor and major operations. Pharmacological management of PONV should be tailored to the patients' risk level using the PONV and PDNV scoring systems to minimize the potential for these adverse side effects in the postoperative period. A combination of prophylactic antiemetic drugs should be administered to patients with moderate-to-high risk of developing PONV in order to facilitate the recovery process. Optimal management of perioperative pain using opioid-sparing multimodal analgesic techniques and preventing PONV using prophylactic antiemetics are key elements for achieving an enhanced recovery after surgery. Strategies that include reductions of the baseline risk (e.g., adequate hydration, use of opioid-sparing analgesic techniques) as well as a multimodal antiemetic regimen will improve the likelihood of preventing both PONV and PDNV.
          Article 0 comments Cited 44 times – based on 0 reviews     Review now
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            Increased beta-endorphin but not met-enkephalin levels in human cerebrospinal fluid after acupuncture for recurrent pain.

            George S Tomlin, Jeffrey Rees, G Michael Besser … (1980)
            Low-frequency electroacupuncture effectively alleviated recurrent pain in 10 patients. Basal levels of beta-endorphin and met-enkephalin in the lumbar cerebrospinal fluid (CSF) of these patients were not different from those in pain-free control subjects. After electroacupuncture in the patients with pain CSF beta-endorphin levels rose significantly in all subjects, but met-enkephalin levels were unchanged. These results suggest that the analgesia observed after electroacupuncture in patients with recurrent pain may be mediated by the release into the CSF of the endogenous opiate, beta-endorphin.
            Article 0 comments Cited 33 times – based on 0 reviews     Review now
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              Acupuncture and related techniques during perioperative period: A literature review

              H Volkan Acar (2016)
              Acupuncture has been used in the Far East for more than 2000 years. Since the early 1970s, this technique has been gaining popularity among Western medical community. A number of studies suggest that its mechanism of effect can be explained in biomedical terms. In this context, a number of transmitters and modulators including beta-endorphin, serotonin, substance P, interleukins, and calcitonin gene-related peptide are released. For that reason, acupuncture can be used in a wide variety of clinical conditions. Studies showed that acupuncture may have beneficial effect in perioperative period. It relieves preoperative anxiety, decreases postoperative analgesic requirements, and decreases the incidence of postoperative nausea and vomiting. In this review article, we examine perioperative use of acupuncture for a variety of conditions.
              Article 0 comments Cited 32 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Medicine (Baltimore)
                Journal ID (iso-abbrev): Medicine (Baltimore)
                Journal ID (publisher-id): MEDI
                Title: Medicine
                Publisher: Wolters Kluwer Health
                ISSN (Print): 0025-7974
                ISSN (Electronic): 1536-5964
                Publication date Collection: August 2019
                Publication date (Electronic): 16 August 2019
                Volume: 98
                Issue: 33
                Electronic Location Identifier: e16857
                Affiliations
                Chengdu University of Traditional Chinese Medicine, Chengdu, China.
                Author notes
                [∗ ]Correspondence: Fan-rong Liang, Chengdu University of Traditional Chinese Medicine, Chengdu Province, China (e-mail: acuresearch@ 123456126.com ), QianHua Zheng, Chengdu University of Traditional Chinese Medicine, Chengdu Province, China (e-mail: zhengqianhua@ 123456cdutcm.edu.cn ).
                Article
                Publisher ID: MD-D-19-05706 Accession ID: 16857
                DOI: 10.1097/MD.0000000000016857
                PMC ID: 6831167
                PubMed ID: 31415419
                SO-VID: 775f347b-60df-46d2-b7e6-b2c8ffc00a35
                Copyright © Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc.
                License:

                This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0

                History
                Date received : 19 July 2019
                Date accepted : 24 July 2019
                Categories
                Subject: 3800
                Subject: Research Article
                Subject: Study Protocol Systematic Review
                Custom metadata
                OPEN-ACCESS TRUE

                Keywords: acupressure,pc6 point,ponv,protocol,systematic review
                Data availability:
                Keywords: acupressure, pc6 point, ponv, protocol, systematic review

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