마취 중 내관 침 시술이 수술 후 오심구토 예방에 미치는 효과

Acupuncture on PC6 in Anesthesia also Shows Effect for Preventing Post Operative Nausea and Vomiting

  • 최덕화 (원광대학교 의과대학 마취통증의학과) ;
  • 이수경 (원광대학교 한의과대학 한방재활의학과)
  • Choi, Deok-Hwa (Department of Anesthesiology, Wonkwang University School of Medicine) ;
  • Lee, Su-Kyung (Department of Oriental Rehabilitation Medicine, Wonkwang University School of Oriental Medicine)
  • 투고 : 2011.11.04
  • 심사 : 2011.12.20
  • 발행 : 2011.12.25

초록

This study aims to investigate the effect of acupuncture on PC6 for preventing opioid-induced nausea and vomiting under circumstance whether the participants are conscious or non-conscious. 143 patients receiving intravenous patient controlled analgesia(PCA) with fentanyl were assigned to three groups. Two groups were given acupuncture on PC6 before anesthesia(PreAN) or after anesthesia(PoAN) respectively. One group was control group without acupuncture treatment(NC). Assessment of nausea and vomiting was obtained from all patients for 48hours after surgery. The incidence of nausea and vomiting was significantly lower in the PreAN group and PoAN group than in the NC group. The severity of nausea was the lowest in PreAN group, second to in PoAN group, and the highest in NC group. This results show that acupuncture on PC6 even without patients' consciousness has effect on preventing PONV.

키워드

참고문헌

  1. NIH Consensus Conference. Acupuncture. JAMA. 280: 1518-1524, 1998. https://doi.org/10.1001/jama.280.17.1518
  2. Berman, B.M., Lao, L., Langenberg, P., Lee, W.L., Gilpin, A.M.K., Hochberg, M.C. Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee. Annals of Internal Medicine. 141(12):901-911, 2004. https://doi.org/10.7326/0003-4819-141-12-200412210-00006
  3. Linde, K., Streng, A., Jurgens, S., Hoppe, A., Brinkhaus, B., Witt, C., et al. Acupuncture for patients with migraine. JAMA: the journal of the American Medical Association. 293(17):2118-2125, 2005. https://doi.org/10.1001/jama.293.17.2118
  4. Pariente, J., White, P., Frackowiak, R.S.J., Lewith, G. Expectancy and belief modulate the neuronal substrates of pain treated by acupuncture. Neuroimage. 25(4):1161-1167, 2005. https://doi.org/10.1016/j.neuroimage.2005.01.016
  5. Colloca, L., Benedetti, F. Placebos and painkillers: is mind as real as matter? Nature Reviews Neuroscience. 6(7):545-552, 2005. https://doi.org/10.1038/nrn1705
  6. Kaptchuk, T.J. The placebo effect in alternative medicine: can the performance of a healing ritual have clinical significance? Annals of Internal Medicine. 136(11):817, 2002. https://doi.org/10.7326/0003-4819-136-11-200206040-00011
  7. Lee, S., Lee, M.S., Choi, D.H., Lee, S.K. Electroacupuncture on PC6 Prevents Opioied-induced Nausea and Vomiting after Laparoscopic Surgery. Chinese Journal of Integrative Medicine. (in submission)
  8. Alkaissi, A., Evertsson, K., Johnsson, V., Ofenbartl, L., Kalman, S. P6 acupressure may relieve nausea and vomiting after gynecological surgery: an effectiveness study in 410 women. Can J Anaesth. 49(10):1034-1039, 2002. https://doi.org/10.1007/BF03017897
  9. Apfel, C.C., Laara, E., Koivuranta, M., Greim, C.A., Roewer, N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology. 91(3):693-700, 1999. https://doi.org/10.1097/00000542-199909000-00022
  10. Amir, S., Bano, S., Khan, R., Ahmed, M., Zia, F., Nasreen, F. Electro-stimulation at P6 for prevention of PONV. Journal of Anaesthesiology Clinical Pharmacology. 23: 383-386, 2007.
  11. Streitberger, K., Diefenbacher, M., Bauer, A., Conradi, R., Bardenheuer, H., Martin, E., et al. Acupuncture compared to placebo-acupuncture for postoperative nausea and vomiting prophylaxis: A randomised placebo-controlled patient and observer blind trial. Anaesthesia. 59(2):142-149, 2004. https://doi.org/10.1111/j.1365-2044.2004.03577.x
  12. Molassiotis, A., Helin, A., Dabbour, R., Hummerston, S. The effects of P6 acupressure in the prophylaxis of chemotherapy-related nausea and vomiting in breast cancer patients. Complementary Therapies in Medicine. 15(1):3-12, 2007. https://doi.org/10.1016/j.ctim.2006.07.005
  13. Lee, A., Done, M.L. Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2004(3).