title: Could acupuncture be an adequate alternative to dexamethasone in pediatric tonsillectomy?
abstract: BACKGROUND
  Usage of nonpharmacological treatment contributes to an overall patient well-being, assisting in physical and emotional healing. Acupuncture has been reported to be useful in reducing early postoperative vomiting (POV) and attenuating postoperative pain.
  
  
  OBJECTIVE
  The aim of this study was to compare the effect of dexamethasone vs acupuncture at P6 bilaterally and CV13 on the incidence and severity of POV in children undergoing tonsillectomy with or without adenoidectomy.
  
  
  METHODS
  One hundred and twenty children, ASA I-III aged 2-8 years undergoing elective tonsillectomy were included in this prospective randomized double-blind study. Children were randomly divided into two equal groups (60 each). At induction of anesthesia, the dexamethasone group received 0.15 mg·kg(-1) dexamethasone IV plus sham acupuncture, and the acupuncture group received acupuncture at P6 bilaterally and CV13 plus 2 ml of normal saline IV. Vomiting was recorded at 0-6, 6-24, and 0-24 h postoperatively.
  
  
  RESULTS
  There was no difference in the incidence of vomiting between the acupuncture and dexamethasone groups. The mean difference in time to first oral intake (95% CI) was 4.3 (0.5-8.6) min between dexamethasone group and acupuncture group; P = 0.426. The mean difference in time until first vomit (95% CI) was 12 (9.5-13.8) min between both groups. No significant differences between Kaplan-Meier curves for time until first vomit (log-rank test) were obtained (P = 0.697).
  
  
  CONCLUSIONS
  Acupuncture at P6 bilaterally and CV13 provided similar antiemetic effect to dexamethasone in children undergoing tonsillectomy.
authors.affiliation: Anesthesia and Intensive Care Department, Faculty of Medicine, Assiut University, Asyut, Egypt.
authors.forename: Seham M
authors.initials: SM
authors.lastname: Moeen
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods*; D000932:Antiemetics; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000188:drug therapy; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011446:Prospective Studies; D012720:Severity of Illness Index; D014068:Tonsillectomy; D016896:Treatment Outcome
chemical_list: D000932:Antiemetics; D003907:Dexamethasone
keywords: acupuncture; dexamethasone; pain; tonsillectomy; vomiting