An-Najah Staff

Purpose: To examine the efficacy of P6-acupressure in preventing chemotherapy- induced nausea and emesis associated with highly emetogenic chemotherapy (i.e. doxorubicin as adjuncts to standard 5-HT3 receptor antagonist (granisetron) and dexamethasone as antiemetic given as part of routine care in reducing acute nausea (during the day of treatment) and delayed nausea (2-5 days) following the day of chemotherapy. The second aim is to examine the efficacy of the acupressure bands with stimulation of P6 in reducing vomiting and in maintaining Quality of Life(QOL). Patients and methods: A randomized, double-blind, placebo controlled trial. One group received acupressure with bilateral stimulation of P6 (n=42), a second group received bilateral placebo stimulation, (n=42) and a third group received no acupressure wrist band and served as a control group, (n=42). Acupressure was applied using a Sea-Band (Sea- Band UK Ltd., Leicestershire, England) that patients to wear for the 5 days following the chemotherapy administration. Assessments of acute and delayed nausea and emesis, quality of life(OOL), patients’ satisfaction, recommendation of treatment and requirement of rescue antiemetic were obtained Results: Significant difference was found in the severity of early nausea >3 (0-6 scale) in the acupressure group M (SD) 1.62 (2.04) as compared to placebo group 2.17 (2.09), p=0.0006. Astatically significant decrease was found with the proportion of patients who had a moderate to very sever nausea 24hs following chemotherapy>3(0-6) scale in the acupressure group,43%(18/42)as compared to placebo group,67%(28/42), p=.0284. Table 4.3 The acupressure group had a statistically significant reduction in the incidence of delayed nausea 40% (17/42) as compared to the control group 62% (26/42) (p= 0.0495). Further analyses indicated that significant difference existed in the intensity of delayed nausea by acupressure group M (SD) 1.45 (1.73), p= 0.0002 as compared to control 2.03 (1.91). Significant difference also existed in the intensity of delayed nausea by placebo group 1.33 (1.66), p= 0.0010 as compared to control 2.03 (1.91). Here a placebo effect was noted.Astatically significant decrease was found with the proportion of patients who had a moderate to very sever nausea days 2-5 >3(0-6) scale, in the acupressure group,55%(23/42),(p=0.0206),and in the placebo group52% (22/42), p= 0.0116,as compared to the control group79% (33/42). Aplacebo effect was noted.The mean number of delayed emetic episodes days 2-5 was significally less in the acupressure groupM(SD) 2.7(1.87) as compared to placebo 3.3(1.9), p= 0.0022 and control group 2.07(1.20), p= 0.0005 Requirement of rescue antiemetic was significantly lower in P6- acupressure (55%, 23/42), as compared to control group (76%, 32/42) (p= 0.0389).Eight one percent (35/42) of the patients in acupressure group were significantly satisfied with P6-acupressure as compared to placebo group 64% (27/42), p= 0.0471. Seventy nine percent (34/42) of the patients in acupressure group would recommend P6-acupressure to another patients as compared to placebo group 62% (26/42), p= 0.0533 . CONCLUSIONS: P-6 Acupressure is efficacious for the control of delayed chemotherapy induced nausea and emesis and is a value-added method in addition to pharmaceutical management for women undergoing treatment for breast cancer.