Transcutaneous Electrical Acupoint Stimulation for Prevention of Postoperative Nausea and Vomiting
Condition: Postoperative Nausea and Vomiting
MeSH terms: Nausea; Vomiting; Postoperative Nausea and Vomiting
Study type: Interventional

Summary: 
      Postoperative nausea and vomiting(PONV) refers to at least one nausea, retching or vomiting
      after operation, or any combination of the above symptoms. The incidence of PONV in high-risk
      patients can reach 61%-79%. PONV can not only cause dizziness and headache, but also cause
      disturbance of acid-base balance of water and electrolyte, wound dehiscence, formation of
      incisional hernia, aspiration, and aspiration pneumonia, leading to prolonged
      hospitalization, increased medical expenses, and reduced surgical satisfaction. At present,
      the guidelines for prevention and treatment of PONV and the consensus of experts suggest that
      identifying high-risk patients according to Apfel risk score ≥3 points, reducing baseline
      PONV risks, and implementing multimodal PONV prophylaxis. However, the incidence of PONV in
      high-risk patients is still as high as 20% even if 2-3 drugs are combined used for prevention
      and treatment. It is difficult to further reduce the incidence of PONV by adding different
      kinds or dosages of drugs, while drug-related side effects are increasing gradually.
      Acupuncture (electroacupuncture, transcutaneous electrical acupoint stimulationTEAS,
      transcutaneous electrical nerve stimulation, etc.) is a safe, effective, non-toxic
      side-effect non-drug treatment method. A large number of studies have confirmed that
      acupuncture can reduce the incidence of PONV, and it is expected to become an important
      supplement to drug treatment of PONV, but there are quality defects such as small sample
      size, inaccurate intervention and so on. At the same time, most acupuncture studies aim to
      compare the efficacy of PONV with drug therapy, without considering the clinical situation,
      using acupuncture treatment based on drug standard treatment to further reduce the incidence
      of PONV, thus limiting the clinical application value of acupuncture. On the basis of
      standardized drug prevention and treatment of PONV, TEAS will be used to further reduce the
      incidence of PONV and promote rapid recovery of patients. This study will strongly
      demonstrate that acupuncture can break through the bottleneck of drug treatment and provide
      evidence for the application of acupuncture in modern perioperative clinical medicine.
    

Detailed description: 
      This study intends to carry out a high-quality clinical research with design specifications,
      large sample, multi-center, evaluator blinded, randomized and controlled methods. From
      September 1, 2019 to October 30, 2020, patients undergoing laparoscopic non-gastrointestinal
      surgery under general anesthesia will be recruited, based on the combination of dexamethasone
      and 5-HT3 antagonist, the efficacy of TEAS stimulation Neiguan (P6) and Zusanli (ST36) in the
      prevention and treatment of PONV will be verified. In TEAS group, bilateral P6 and ST36 TEAS
      intervention after removal tracheal intubation and on the first day after surgery, a total of
      2 times, 30 minutes each time, 2/10 Hz low frequency sparse wave, 6-9 mA. The patients will
      be given maximum intensity stimulation at all points during the intervention.To ensure the
      blindness of the evaluator, the time of evaluation will be on the afternoon of the first and
      the second day, and the 30 days after the operation, and three evaluations will be made. The
      main indicators are the incidence of PONV 24 hours after operation, and the secondary
      indicators are the quantitative indicators of PONV and the indicators of rapid recovery after
      operation.
    

Intervention name(s): TEAS; TEAS without electrical stimulation
Intervention type(s): Device; Device
Intervention description(s): Bilateral Neiguan and Zusanli acupuncture points, 2/10Hz Dense wave , 6-9mA,30min; Bilateral Neiguan and Zusanli acupuncture points, with no electrical stimulation
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Prevention
Keywords: Postoperative Nausea and Vomiting;TEAS