An-Najah Staff

Background: Anaesthetic and surgical procedures influence the incidence of postoperative symptoms. Patients with no postoperative symptoms have a faster return to normal daily life than those with symptoms.
Purpose: to examine the effectiveness of P6-acupressure for controlling postoperative disturbing symptoms, such as nausea, vomiting, headache, fatigue and pain perception
Material and methods: one hundred and eighty women undergoing general anaesthesia for elective abdominal surgery were included in a prospective, consecutive, randomized, multicentre, placebo-controlled, double-blind clinical trial. One group was given bilateral P6 acupressure (n = 60), a second group similar pressure on bilateral non-acupressure points (n = 60), and a third group (n = 60) served as control group. Nausea/ vomiting, incision pain, headache, abdominal pain, difficulties with accommodation, drowsiness, fatigue, and satisfaction with the treatment were recorded. Post-operative symptoms were followed for 36- h using a questionnaire. Symptoms were analyzed both according to their intensity and in a dichotomous fashion.
Results:
Incidence of pain 63%( 38/60), nausea 30%(18/60), vomiting 45% (27/60), headache 22% (13/60), abdominal pain 63% (38/60) and drwosiness 40% (24/60) given in a dichotomous fashion (0-4h) were significantly lower in acupressure group as compared to placebo 97% (58), 68% (41/60), 67% (40/60), 55% (33/60), 87% (52/60) and 62% (37/60) respectively (p<0, 05).
Incidence of moderate to very severe ( ≥ 3 on 0-6 scale) (0- 4h) pain and headache were significantly lower in acupressure group as compared to placebo (p<o,o5) and incidence of fatigue was significantly lower in acupressure group as compared to control group (p= ,0411).
Significantly fewer patients needed rescue antiemetic and opioid medication in acupressure group as compared to the placebo (p<o, o5).
Incidence of pain and fatigue given in a dichotomous fashion (4-12h) were significantly lower in acupressure group as compared to control group and to placebo (p<o, o5) and incidence of vomiting was significantly lower in acupressure group as compared to placebo (p=, 0133)
Incidence of moderate to very severe ( ≥ 3 on 0-6 scale- (4-12h) pain, nausea and fatigue were significantly lower in acupressure group as compared to placebo and to control (p<o,o5)
Incidence of nausea given in a dichotomous fashion (12-36h) was significantly lower in acupressure group as compared to placebo and to control (p<o, o5) and incidence of fatigue was significantly lower in acupressure group as compared to placebo (p=, 0114).
Incidence of moderate to very severe ( ≥ 3 on 0-6 scale- (12-36h) pain and fatigue were significantly lower in acupressure group as compared to control (p<o,o5) and incidence of nausea was significantly lower in acupressure group as compared to placebo and to control (p<0,05).
The percentage of the patients who had slept well are significantly higher in acupressure group as compared to placebo and to control group (p<o, o5). 80% (48/60)) of the patients in acupressure group were significantly satisfied with P6-acupressure as compared to placebo 42% (25/60), p=, 0000 and to control 27% (10/60), p=, 0015. 75% (45/60)) of the patients in acupressure group would recommend P6-acupressure to another patients as compared to placebo 47% (28/60), p= ,0015, and to control 25% (15/60) p= ,0000.
Conclusion: P6 acupressure is a non-invasive method that may have a place as prophylactic postoperative disturbing symptoms therapy to promote the comfort of female patients who undergone elective abdominal surgery. Acupressure can be used to prevent postoperative nausea and vomiting, reduce postoperative pain, fatigue and headache.
Keywords: acupressure, PONV, no pharmacologic prevention, abdominal surgery