Effect of Acupressure Application on Patients' Nausea, Vomiting, Pain, and Sleep Quality
Condition: Postoperative Complications
MeSH terms: Nausea; Vomiting; Postoperative Complications
Study type: Interventional

Summary: 
      This study was conducted to determine the effect of acupressure on nausea, vomiting, pain,
      and sleep quality after laparoscopic cholecystectomy. This was a randomized controlled
      experimental study with a placebo group. The sample comprised 188 patients who underwent
      laparoscopic cholecystectomy (control:64; experimental:64; and placebo:60). Acupressure was
      performed on the experimental and placebo groups with a wristband for 24 hours.
    

Detailed description: 
      Despite scientific developments and the antiemetic and analgesic drugs used, postoperative
      nausea, vomiting, and pain continue to be major problems affecting patients today. Many
      different pharmacological approaches have been developed to minimize postoperative nausea,
      vomiting, and pain. However, the side effects associated with traditional antiemetics and
      analgesics and the high cost of drugs have resulted in an increase in the use of
      non-pharmacological methods. Acupressure, one of such non-pharmacological methods, is based
      in traditional Chinese medicine. It is a treatment method that ensures proper functioning of
      energy channels through the application of pressure to the acupressure points on the
      meridians carrying energy in the body using palms, fingers, or special stimulation bands.
      Acupressure is an application included in the classification of nursing interventions. In the
      classification of nursing interventions, it is stated that acupressure is effective in
      relief, reduction of pain, elimination and prevention of nausea, and it is recommended to be
      applied to patients. Acupressure supports the independent role of nurses and provides
      evidence-based practice for nurses in symptom management.

      Acupressure is a noninvasive, easy-to-apply, safe, low-cost application with no side effects.
      Thus, it is a complementary alternative treatment method that is increasingly used in the
      prophylaxis and treatment of postoperative nausea and vomiting due to the absence of
      drug-related side effects and pain and better tolerability in patients. Most of the
      non-pharmacological studies on the reduction of nausea and vomiting focus on the stimulation
      of the Pericardium 6 (PC6) acupressure point at the wrist. The nervous system is activated by
      the stimulation of the PC6 point on the pericardium meridian, and this system sends signals
      to the brain, which results in an antiemetic effect. After the brain is stimulated,
      neurotransmitters such as serotonin, dopamine, and endorphins are secreted. These substances
      prevent nausea and vomiting by blocking chemicals that can cause nausea. Acupressure is also
      a frequently used non-pharmacological method for reducing pain and regulating sleep. The
      endorphins and serotonin secreted by the stimulation of acupressure points create a calming
      response in the body, reduce anxiety, induce relaxation, and improve sleep quality. In
      addition, acupressure stimulation regulates parasympathetic nervous system activity. This
      situation increases sleep quality by providing an increase in autonomous responses and a
      decrease in psychological stress.

      This study was conducted to determine the effect of acupressure on nausea, vomiting, pain,
      and sleep quality after laparoscopic cholecystectomy. This was a randomized controlled
      experimental study with a placebo group. The sample comprised 188 patients who underwent
      laparoscopic cholecystectomy (control:64; experimental:64; and placebo:60).

      IMPACT STATEMENT What is already known on this subject? Nausea, vomiting, pain and insomnia
      in the postoperative period may cause discomfort, and this may adversely affect the patient's
      compliance with the treatment. Managing nausea, vomiting and pain in the postoperative period
      and improving the quality of sleep are among the important responsibilities of nurses. Thus,
      acupressure, as a complementary alternative method, can be recommended to reduce nausea and
      vomiting and improve sleep quality after surgical intervention. Acupressure is effective in
      relief, reduction of pain, and relief and prevention of nausea and vomiting. Acupressure
      supports the independent roles of nurses, provides evidence-based practice to nurses in
      symptom management, and improves patient-nurse relationships.

      What the implications are of these findings for clinical practice and/or further research?
      This study is important because it shows that acupressure can be used as a complementary and
      alternative method in the postoperative period. Although it is reported that acupressure,
      which is a safe and effective method, can reduce the rate of complications, increase patient
      comfort, and thus affect the success of the surgical process when applied before or after
      surgical intervention, more evidence-based studies are needed to clearly demonstrate its
      effectiveness.
    

Intervention name(s): acupressure wristband; placebo wristband
Intervention type(s): Device; Device
Intervention description(s): acupressure after surgery; acupressure after surgery
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: acupressure; nausea-vomiting; nurse; pain; PC6; sleep