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AMBULATORY ANESTHESIA

The Use of Transcutaneous Acupoint Electrical Stimulation for Preventing Nausea and Vomiting After Laparoscopic Surgery

Eduardo Zárate, MD^*, Melinda Mingus, MD, Paul F. White, PhD, MD^*, Jen W. Chiu, MD^*, Phillip Scuderi, MD, William Loskota, MD^§, and Venus Daneshgari, MD^*

*Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas; Department of Anesthesiology, Mount Sinai Medical Center New York, New York; Department of Anesthesiology, Wake Forest University School of Medicine, Winston Salem, North Carolina; and §Department of Anesthesiology, University of Southern California, Los Angeles, California

Address correspondence to Dr. Paul F. White, Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., F2.208, Dallas, TX 75390-9068. Address e-mail to paul.white{at}utsouthwestern.edu

Nonpharmacologic techniques may be effective in preventing postoperative nausea and vomiting (PONV). This sham-controlled, double-blinded study was designed to examine the antiemetic efficacy of transcutaneous acupoint electrical stimulation (TAES) in a surgical population at high risk of developing PONV. We studied 221 outpatients undergoing laparoscopic cholecystectomy with a standardized general anesthetic technique in this randomized, multicenter trial. In the TAES group, an active ReliefBand^® (Woodside Biomedical, Inc., Carlsbad, CA) device was placed at the P6 acupoint, whereas in the Sham and Placebo groups, an inactive device was applied at the P6 acupoint and at the dorsal aspect of the wrist, respectively. The ReliefBand was applied after completion of electrocautery and remained in place for 9 h after surgery. The incidence of PONV and need for "rescue" medication were evaluated at predetermined time intervals. TAES was associated with a significantly decreased incidence of moderate-to-severe nausea as denoted on the Functional Living Index—Emesis score for up to 9 h after surgery (5%–11% for the TAES group vs 16%–38% [P < 0.05] and 15%–26% [P < 0.05] for Sham and Placebo groups, respectively). TAES was also associated with a larger proportion of patients free from moderate to severe nausea symptoms (73% vs 41% and 49% for Sham and Placebo groups, respectively; P < 0.05). However, there were no statistically significant differences among the three groups with regard to incidence of vomiting or the need for rescue antiemetic drugs. We conclude that TAES with the ReliefBand at the P6 acupoint reduces nausea, but not vomiting, after laparoscopic cholecystectomy.

Implications: Transcutaneous acupoint electrical stimulation at the P6 acupoint reduced postoperative nausea, but not vomiting, in outpatients undergoing laparoscopic cholecystectomy procedures.

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