P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting in children.
BACKGROUND
P6 acupuncture in adults is reported to be an effective preventive treatment for postoperative nausea and vomiting (PONV). It is not clear, however, whether this technique is effective as a preventive treatment for PONV in children.


METHODS
Children undergoing anesthesia and surgery were randomized to four groups: (a) intravenous saline + bilateral P6 acupoint injections (n = 50); (b) intravenous droperidol + bilateral P6 sham acupuncture (n = 49); (c) intravenous saline + bilateral sham point injections (n = 43); (d) intravenous saline +bilateral P6 sham acupuncture (n = 45). The perioperative anesthetic technique was standardized in all subjects. The incidence of postoperative nausea and vomiting (PONV) was evaluated in postanesthesia care unit (PACU) and 24 h after surgery.


RESULTS
Incidence of nausea in the PACU was significantly lower in the acupoint group as compared with the sham point group (32% vs. 56%, P = 0.029) and P6 sham group (32% vs. 64%, P = 0.002) but not as compared with the droperidol group (32% vs. 46%, P = ns). Similarly, subjects in the acupoint group had a significantly lower incidence of vomiting in the PACU as compared with the sham point group (12% vs. 33%, P = 0.026) and P6 sham group (12% vs. 31%, P = 0.029) but not as compared with the droperidol group (12% vs. 18%, P = ns). The combined incidence of early PONV was also lower in the acupoint group as compared with the sham point group (P = 0.045) and P6 sham group (P = 0.004) but not as compared with the droperidol group (42% vs. 51%, P = ns). Finally, significantly fewer subjects in the acupoint group required intravenous ondansetron as an initial rescue therapy (P = 0.024). At 24 h after surgery, however, the incidence of late PONV was similar among the four study groups (P = ns).


CONCLUSIONS
In children, P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting.
Wang
Shu-Ming
SM
Department of Anesthesiology, Pediatrics, and Child and Adolescent Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06520-8051, USA. shu-ming@yale.edu
Kain
Zeev N
ZN
D026881:Acupuncture / Q000379:methods*; D000293:Adolescent; D000768:Anesthesia, General; D000932:Antiemetics / Q000627:therapeutic use*; D002648:Child; D004311:Double-Blind Method; D004329:Droperidol / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy* / Q000517:prevention & control*; D016896:Treatment Outcome
D000932:Antiemetics; D004329:Droperidol