Objective: To evaluate the effect of acupoint application combined with transcutaneous electrical acupoint stimulation (TEAS) on postoperative nausea and vomiting after laparoscopic cholecystectomy (LC).
Methods: A total of 130 patients undergoing LC under elective general anesthesia, 59 males and 71 females, aged 18-64 years, BMI 18.5-30.0 kg/m2, ASA physical status Ⅰ-Ⅲ, were selected. The patients were divided into four groups by random number table method: control group (n = 33), acupoint application group (n = 32), TEAS group (n = 33), and acupoint application combined with TEAS group (combined group, n = 32). Patients in the control group received general anesthesia as usual without any additional measures. Patients in the acupoint application group received general anesthesia and postoperative bilateral Hegu, Neiguan, and Zusanli acupoint application treatment. In the TEAS group, bilateral Hegu, Neiguan and Zusanli points were selected to perform TEAS 30 minutes before the start of general anesthesia induction until the end of the operation. In the combined group, the TEAS treatment was administered from 30 minutes before general anesthesia induction until the end of the operation, the selection of acupoints and the operation methods were the same as those in the TEAS group, acupoint application treatment was performed 30 minutes after the operation, the selection of acupoints and the operation methods were the same as those in the acupoint application group. The incidence of PONV and the use of postoperative antiemetic drugs were recorded. Serum gastrin concentration before surgery, 20 minutes after extubation, and 1 day after surgery were recorded. The time of the first postoperative anal exhaust and defecation, and the occurrence of adverse reactions after surgery were recorded.
Results: Compared with the control group, the incidence of PONV and the usage rate of postoperative antiemetic drugs were significantly decreased, and the concentration of serum gastrin 1 day after surgery was significantly increased, the time of first postoperative anal exhaust and defecation were significantly shortened in the acupoint application group, the TEAS group, and the combined group (P < 0.05). Compared with the acupoint application group and the TEAS group, the incidence of PONV and the usage rate of postoperative antiemetic drugs were significantly decreased, the concentration of serum gastrin 20 minutes after extubation and 1 day after surgery were significantly increased, the time of first postoperative anal exhaust and defecation were significantly shortened in the combined group (P < 0.05). Compared with the TEAS group, the incidence of PONV and the usage rate of postoperative antiemetic drugs in the combined group were significantly decreased, the concentration of serum gastrin 1 day after surgery was significantly increased, the time of first postoperative anal exhaust and defecation were significantly shortened in the combined group (P < 0.05).
Conclusion: Acupoint application, TEAS, and the combination of acupoint application and TEAS can all reduce the incidence of PONV in LC patients, decrease the usage rate of postoperative antiemetic drugs, increase the serum gastrin concentration, shorten the time of the first postoperative anal exhaust and defecation, promote the quality of recovery, and the combination of acupoint application and TEAS has a better effect. |
