title: Wrist acupressure for post-operative nausea and vomiting (WrAP): A pilot study.
abstract: Post-operative nausea and vomiting are undesirable complications following anaesthesia and surgery. It is thought that acupressure might prevent nausea and vomiting through an alteration in endorphins and serotonin levels. In this two-group, parallel, superiority, randomised control pilot trial we aimed to test pre-defined feasibility outcomes and provide preliminary evidence for the efficacy of PC 6 acupoint stimulation vs. placebo for reducing post-operative nausea and vomiting in cardiac surgery patients. Eighty patients were randomly assigned to either an intervention PC 6 acupoint stimulation via beaded intervention wristbands group (n=38) or placebo sham wristband group (n=42). The main outcome was assessment of pre-defined feasibility criteria with secondary outcomes for nausea, vomiting, rescue anti-emetic therapy, quality of recovery and adverse events. Findings suggest that a large placebo-controlled randomised controlled trial to test the efficacy of PC 6 stimulation on PONV in the post-cardiac surgery population is feasible and justified given the preliminary clinically significant reduction in vomiting in the intervention group in this pilot. The intervention was tolerated well by participants and if wrist acupressure of PC 6 acupoint is proven effective in a large trial it is a simple non-invasive intervention that could easily be incorporated into practice.
authors.affiliation: NHMRC Centre for Research Excellence in Nursing Interventions, Menzies Health Institute Queensland, Centre for Health Practice Innovation, Australia. Electronic address: m.cooke@griffith.edu.au.
authors.forename: Marie
authors.initials: M
authors.lastname: Cooke
authors.affiliation: Department of Anaesthesia and Perfusion, Critical Care Research Group, The Prince Charles Hospital, Australia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Rapchuk
authors.affiliation: Research School of Population Health, Australian National University, Australia.
authors.forename: Suhail A
authors.initials: SA
authors.lastname: Doi
authors.affiliation: Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Australia.
authors.forename: Amy
authors.initials: A
authors.lastname: Spooner
authors.affiliation: Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Australia.
authors.forename: Tameka
authors.initials: T
authors.lastname: Wendt
authors.affiliation: Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Australia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Best
authors.affiliation: Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Australia.
authors.forename: Melannie
authors.initials: M
authors.lastname: Edwards
authors.affiliation: Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Australia.
authors.forename: Leanda
authors.initials: L
authors.lastname: O'Connell
authors.affiliation: Critical Care Research Group, Adult Intensive Care Services, The Prince Charles Hospital, Australia.
authors.forename: Donna
authors.initials: D
authors.lastname: McCabe
authors.affiliation: Microbiology and Immunology Research Group, Griffith University, Australia.
authors.forename: John
authors.initials: J
authors.lastname: McDonald
authors.affiliation: Critical Care Research Group, The Prince Charles Hospital and University of Queensland, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Fraser
authors.affiliation: NHMRC Centre for Research Excellence in Nursing Interventions, Menzies Health Institute Queensland, Centre for Health Practice Innovation, Australia.
authors.forename: Claire
authors.initials: C
authors.lastname: Rickard
mesh_terms: D019050:Acupressure / Q000009:adverse effects / Q000379:methods*; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D014953:Wrist / Q000502:physiology*
keywords: Acupressure; Cardiac surgery; Postoperative nausea and vomiting