Effect of acupressure application to the P6 acupoint before laparoscopic cholecystectomy on postoperative nausea-vomiting: A randomized controlled clinical study

• Published in: International journal of nursing studies 2018-11, Vol.87, p.40-48
• Main Authors: Yilmaz Sahin, Sibel, Iyigun, Emine, Can, Mehmet Fatih
• Format: Article
• Language: English
• Subjects: Acupressure; Acupuncture; Adolescent; Adult; Aged; Analgesics; Application; Beds; Cholecystectomy; Cholecystectomy, Laparoscopic - adverse effects; Clinical medicine; Clinical practice guidelines; Clinical standards; Female; Humans; Intervention; Keyhole surgery; Laparoscopic; Laparoscopy; Longitudinal Studies; Middle Aged; Nausea; Nursing; Pain; Perioperative care; Perioperative nursing; Placebos; Postoperative morbidity; Postoperative nausea; Postoperative nausea and vomiting; Postoperative Nausea and Vomiting - prevention & control; Postoperative period; Severity; Stimulation; Vomiting; Young Adult
• ISSN: 0020-7489; 1873-491X
• DOI: 10.1016/j.ijnurstu.2018.07.011

Nausea and vomiting are common postoperative complications that occur within the first 24 h in adults. Clinical practice guidelines and a Cochrane review recommend stimulating the P6 acupoint to prevent or reduce postoperative nausea and vomiting. However, there are currently no standards and optimal timing is not known. The purpose of this study was to evaluate the effect of acupressure application on the P6 acupoint, using acupressure wristbands, in the prevention of postoperative nausea and vomiting and the antiemetic drug requirement in patients who had high postoperative nausea and vomiting risk related to laparoscopic cholecystectomy. This was a longitudinal, randomized controlled clinical study. The study was conducted in the general surgery department of a training and research hospital (105 beds), from March 2015 to March 2016. A total of 111 female patients who underwent laparoscopic surgery were divided into three groups of 37, using a block randomization method. Training on acupressure wristband use was provided to the intervention group and an acupressure wristband with a plastic cap was placed at the P6 acupoint. A wristband with the same appearance as the acupressure wristband, but without a cap, was used in the placebo group. No intervention was used in the control group. The wristband was placed approximately one hour before the surgery and removed six hours after the surgery in both the intervention and placebo groups. The data were collected at the 2nd, 6th, and 24th postoperative hours. The application of the acupressure wristband to the P6 acupoint in patients who underwent laparoscopic cholecystectomy was found to be more effective in decreasing the severity of nausea at the 2nd postoperative hour and the nausea incidence at 2–6 h, postoperatively, when compared to the placebo group (p  0.05). We did not find the stimulation of the P6 acupoint with an acupressure wristband to be clinically effective in reducing postoperative nausea and vomiting or antiemetic drug requirement in patients who underwent laparoscopic cholecystectomy.