Metaanalysis of acustimulation effects on postoperative nausea and vomiting in children.
OBJECTIVE
Using metaanalysis, we sought to determine acustimulation (AS) effects on postoperative nausea and vomiting (PONV) in children.


METHODS
Metaanalyses were performed on various acupoint AS effects including acupressure, acupuncture, laser acupuncture, and electrical stimulation (ETS) on PONV in children. On-line databases were searched for randomized controlled trials (RCTs) from 1966 through May 2005. In addition, the reference lists of reviewed papers were scanned for additional trials. The identified RCTs were evaluated for methodological quality using the Quality Reporting of Meta-analyses (QUOROM) guidelines, and results were pooled using the fixed-effects model.


RESULTS
Twelve RCTs were pooled for the outcomes of 24-hour PONV including 12 trials for vomiting and two trials for nausea. Compared with the control groups, all AS modalities reduced vomiting (RR = 0.69, 95% CI: 0.59-0.80, P < .0001) and nausea (RR = 0.59, 95% CI: 0.46-0.76, P < .0001). Acupressure (two trials) and acupuncture (six trials) modalities were effective in reducing vomiting (P < .005); however, ETS (two trials) did not show significant effects in reducing the vomiting (P = .118) in children. Compared with the controls, medications (three trials) reduced vomiting (RR = 0.42, 95% CI: 0.22-0.7, P = .0056). There were no differences between the medication and AS treatments (three trials) in reducing vomiting (RR = 1.25, 95% CI: 0.54-2.93, P = .6025).


CONCLUSIONS
This metaanalysis demonstrated that acupressure and acupuncture are effective treatment modalities to reduce postoperative vomiting in children. Acupuncture treatment is as effective as medications to reduce vomiting in children. Acupuncture had the greatest impact on reducing vomiting when compared with acupressure and ETS in children.
Dune
Linda S
LS
University of Texas School of Nursing at Houston, Houston, TX, USA. Linda.S.Dune@uth.tmc.edu
Shiao
Shyang-Yun Pamela K
SY
D019050:Acupressure / Q000379:methods; D015670:Acupuncture Therapy / Q000379:methods*; D000932:Antiemetics / Q000627:therapeutic use; D015982:Bias; D002648:Child; D002669:Child Welfare; D016001:Confidence Intervals; D015671:Electroacupuncture / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D009325:Nausea / Q000628:therapy; D016017:Odds Ratio; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D016896:Treatment Outcome; D014839:Vomiting / Q000628:therapy
D000932:Antiemetics