Efficacy of PC6 electroacupunture in the prevention of nausea vomiting in caesarean patient under spinal anesthesia

Abstract

PC6 stimulation is a well-known technique to reduce nausea and vomiting during pregnancy. In current clinical practice, antiemetic medication is the most commonly used method for preventing post-operative nausea and vomiting. Although antiemetic medications have no significant side effects, their efficacy and safety profile among parturients are still not well established. Consequently, the PC6 stimulation technique has gained more popularity to prevent nausea vomiting in post-operative parturients. In this prospective, randomised, interventional study, we hypothesised that the combination of PC6 electroacupuncture stimulation with granisetron would reduce the incidence of IONV and PONV and reduce the need for rescue antiemetic drugs in patients undergoing caesarean section. One hundred patients who underwent elective caesarean section were randomly allocated to either EA or sham groups. All surgeries were performed under spinal anaesthesia, which includes the addition of 0.1mg intrathecal morphine during induction. EA group patient received EA stimulation; on the other hand, the sham group patient received sham acupuncture as control. The incidence of intraoperative and post-operative nausea vomiting was assessed for up to 24hours. The requirement fr rescue antiemetic drug for post-operative nausea vomiting was also assessed. Post-operatively, there was a significant reduction in the incidence of nausea and vomiting (50 per cent to 22 per cent and 24 per cent to 11 per cent respectively 0-12 hours after the surgery) in the PC6 group instead of the sham group (p= 0.004 and 0.01 respectively). There was no difference in the incidence of intraoperative vomiting in both groups. However, there was a partial significance for intra-op nausea incidence (p=0.06), with the sham group having double the figures compared to the PC6 group. The PC6 required nearly 2 times less metoclopramide than the sham group (p=0.04). A combination of PC6 and granisetron effectively reduces post-operative nausea vomiting, and the usage of rescue antiemetic drugs compared to granisetron alone in patients undergoing caesarean section under spinal anaesthesia.