Nausea and vomiting are two of the most common postoperative complications. While they may seem to be moderate problems, they can be very dangerous, particularly for children. Severe postoperative nausea and vomiting may lead to aspiration of stomach contents, wound re-opening, bleeding, dehydration and electrolyte imbalance.1 In order to address this, a group of researchers from Norway designed a pilot study to determine a way to introduce acupuncture and acupressure into the surgical environment to reduce postoperative nausea and vomiting for children.2
In the May issue of Acupuncture in Medicine, Norheim and colleagues discussed the design of their pilot program. They randomized a group of 20 pediatric patients undergoing tonsillectomy and/or adenoidectomy to either receive acupuncture during surgery (10 patients) or standard control treatment (10 patients). Parents were contacted to obtain informed consent two to four weeks prior to the scheduled surgery date.
A licensed acupuncturist trained the four-person anesthesiology team to provide the acupuncture during the procedure (approximately 20 minutes) so that anesthetic time would be kept to a minimum. The Pericardium 6 (P 6) point on each forearm was needled. Points were located on the anterior forearm at a distance of the combined width of the child's three middle fingers, proximal to the wrist crease and between the palmaris longus and flexor carpi radialis. Needling depth was at 0.7 cm. Once the patient was transferred to the recovery unit, the needles were removed and replaced with acupressure wristbands at the P 6 location to be worn for the following 24 hours. Both duration of acupuncture and time of wristband application were noted.
Ten of the children in the control group experienced nausea and vomiting after surgery. In comparison, five patients in the acupuncture group experienced those symptoms; a reduction of 50 percent.
Despite the small sample size from this pilot study, researchers felt confident enough in the results that a larger study would be warranted using this basic protocol. They noted, "According to results from the pilot study, it seemed feasible to perform the main study to explore the effectiveness of acupuncture/acupressure for children undergoing tonsillectomy and/or adenoidectomy. The effectiveness of acupuncture and acupressure ... could not be demonstrated in this pilot, but the results encourage further research in the field. The pilot study was easy to conduct and provided crucially important data for designing the main study."
- Rose JB, Watcha MF. Postoperative nausea and vomiting in paediatric patients. Br J Anaesth 1999 Jul;83(1):104-17.
- Norheim AJ, Liodden I, Howley M. Implementation of acupuncture and acupressure under surgical procedures in children: a pilot study. Acupunct Med 2010 May 10. [Epub ahead of print]