None listed
Conditions
Brief summary
Post-operative nausea and vomiting (PONV) occurs in 30-50% of patients, and can prolong the hospital stay. Acupressure can safely and effectively reduce the incidence of PONV by up to 30%. Over 80% of surgical patients would be willing to try acupressure for PONV, however this intervention has not been incorporated into routine peri-operative care. This study is embedded in a large project that aims to systematically examine the barriers and enablers in the implementation of acupressure for PONV, and to develop and implement strategies for successful application of acupressure. The specific aim of this feasibility study was to identify the suitable form(s) of acupressure to be used in a peri-operative setting. We used FAME approach to study its feasibility, appropriateness, meaningfulness and effectiveness and safety. Our initial FAME analysis of the existing literature indicates moderate to strong support to the feasibility of per-operative acupressure for preventing and treating PONV. The two forms of acupressure identified from the literature were wristband and auricular acupressure. In this study, we trialled out these two forms of acupressure and to identify if, when and how acupressure could be implemented. We hypothesised that this simple, non-drug intervention would be well-accepted by patients and staff, and with modification could be integrated into the per-operative setting without any difficulties. Acupressure could reduce PONV incidents and / or medication use. Data from the study also helped us identify barriers and enablers for later implementation. This study was conducted among patients undergoing elective surgery at Northern Hospital.
Interventions
A combined acupressure interventions consisting of Wristband and auricular acupressure
Wristband (Sea-Band Limited, Leicestershire, England). An elasticised fabric band with a protruding button applies pressure to Nei Guan PC6; an acupuncture point known to reduce nausea and vomiting. This is applied to both wrists prior to surgery and retained in place for 24 hours.
Auricular acupressure using seeds (Earseeds com Inc. NJ, 07666 USA). 4 ear seeds are taped to ear acupuncture points related to t
A combined acupressure interventions consisting of Wristband and auricular acupressure Wristband (Sea-Band Limited, Leicestershire, England). An elasticised fabric band with a protruding button applies pressure to Nei Guan PC6; an acupuncture point known to reduce nausea and vomiting. This is applied to both wrists prior to surgery and retained in place for 24 hours. Auricular acupressure using seeds (Earseeds com Inc. NJ, 07666 USA). 4 ear seeds are taped to ear acupuncture points related to the reduction of nausea, vomiting, pain and anxiety on one ear, prior to surgery, and retained in place for 72 hours, with the patient applying manual pressure to the seeds 3 times daily. The points are Shen men, Point Zero, Lung and Subcortex. The choice of those points was based on published clinical trials. All participants will receive the same standardised acupressure intervention in conjunction with usual anaesthetic and perisurgical care. Compliance was monitored by the researchers who followed up with patients in person while patients were in the hospital and with phone calls after patients being discharged.
Sponsors
Northern Hospital
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
1. Adults 18-90 undergoing elective surgery 2. PONV risk factor at 2 or over, 3. Able to give informed consent 4. For patients whose English is not sufficient for daily communication, interpreting service is required. Only those for whom we can locate an interpreter for the consent will be included.
Exclusion criteria
1. PC6 wrist area, or the auricle of the ear, not accessible for any reason including previous trauma, local infection or inflammation, or the need for medical/surgical access. 2. Active carpel tunnel syndrome 3. Participants who find the wristbands painful when wearing them, or if the wristbands constrict their circulation, will be excluded. 4. Participants who develop emergency surgical complications may be discontinued. Standard medical care will take precedence.
Outcome results
None listed