OBJECTIVE: To explore clinical effect of acupoint application of Chinese herbal medicine in preventing postoperative nausea and vomiting after orthopaedic surgery under general anesthesia. METHODS: From January 2018 to December 2019, 168 patients who met inclusion criteria and were underwent selective spine surgery, were double-blind divided into two groups according to central random system, 84 patients in each group. In control group, there were 39 males and 45 females aged from 30 to 65 years old with an average of (53.83±9.17) years old, 37 patients were classified to typeⅠand 47 patients were typeⅡ according to American Society of Anesthesiologists (ASA) grading. In experiment group, there were 39 males and 45 females aged from 30 to 65 years old with an average of (54.08±9.00) years old; 32 patients were classified to typeⅠand 52 patients were typeⅡ according to ASA grading. Both of two groups were obtained acupoint application before anesthesia induction, and acupoint application were put on RESULTS: There were no statistical differences in incidence of nausea vomiting, VAS of narusea degree at 24 h after operation ( CONCLUSION The curative effect of acupoint application of traditional Chinese medicine on the prevention and treatment of postoperative nausea and vomiting is not obvious.
Acupuncture Points ; Adult ; Aged ; Anesthesia, General ; Drugs, Chinese Herbal/therapeutic use* ; Female ; Humans ; Male ; Middle Aged ; Orthopedic Procedures ; Postoperative Nausea and Vomiting/prevention & control* ; Quality of Life

BACKGROUND: Chemotherapy is the most important method for cancer treatment. However, chemotherapy induced nausea and vomiting (CINV) has a profound effect on patients. In recent years, there have been new antiemetic drugs, such as aprepitant. We review the curative effect of aprepitant with tropisetron and dexamethasone for prevention of nausea and vomiting in patients receiving Cisplatin chemotherapy. METHODS: Observation is divided into three stages. Whole study phase (0-120 h after chemotherapy administration), acute phases (0-24 h), and delayed phase (24 h-120 h). The primary endpoints were complete response (CR) and complete prevention (CP) during the three different study phase. RESULTS: In the whole study phase, 86.02% of patients achieved CR; in acute phases and delayed phases were 89.25%, 87.1%, respectively. CP were 46.22%, 83.87%, 45.16%, respectively. Anti-CINV effect was significantly associated with age distribution (P=0.008). CONCLUSIONS Aprepitant with tropisetron and dexamethasone prevented effectively CNIV for patients receiving Cisplatin chemotherapy. This combination could improve the quality of life and the compliance of patient with chemotherapy.
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; adverse effects ; Aprepitant ; Cisplatin ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Morpholines ; pharmacology ; Nausea ; chemically induced ; prevention & control ; Quality of Life ; Vomiting ; chemically induced ; prevention & control

OBJECTIVE: There is no research regarding the appropriate antiemetic agents for female patients, especially those receiving moderately emetogenic chemotherapy (MEC). We evaluated the antiemetic efficacy of a combination of 5-HT3 receptor with/without aprepitant in patients with gynecological cancer treated with the TC (paclitaxel and carboplatin) regimen of MEC. METHODS: We enrolled 38 patients diagnosed with gynecologic cancer and scheduled to receive the TC regimen. The patients were randomly assigned to receive a 5-HT3 receptor antagonist, either palonosetron in the first cycle followed by granisetron in the second cycle or vice versa. In the third cycle, all patients received a combination of the 5-HT3 receptor and dexamethasone with/without aprepitant. RESULTS: When three drugs were administered, palonosetron consistently produced an equivalent complete response (CR) rate to granisetron in the acute phase (89.5% vs. 86.8%, p=0.87) and delayed phase (60.5% vs. 65.8%, p=0.79). With regard to the change in dietary intake, palonosetron exhibited similar efficacy to granisetron in the acute phase (92.1% vs. 89.4%, p=0.19) and delayed phase (65.7% vs. 68.4%, p=0.14). However, in the delayed phase, the addition of aprepitant therapy with a 5-HT3 receptor antagonist and dexamethasone produced a higher CR rate than a 5-HT3 receptor antagonist with dexamethasone (93.3% vs. 47.8%, p<0.001) and allowed the patients to maintain a higher level of dietary intake (93.3% vs. 56.5%, p<0.001). CONCLUSION: The addition of aprepitant therapy was more effective than the control therapy of a 5-HT3 receptor antagonist, and dexamethasone in gynecological cancer patients treated with the TC regimen.
Adult ; Aged ; Antiemetics/*administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Carboplatin/administration & dosage/adverse effects ; Cross-Over Studies ; Diet ; Drug Administration Schedule ; Female ; Genital Neoplasms, Female/*drug therapy ; Granisetron/administration & dosage ; Humans ; Isoquinolines/administration & dosage ; Middle Aged ; Morpholines/administration & dosage ; Nausea/chemically induced/*prevention & control ; Paclitaxel/administration & dosage/adverse effects ; Quinuclidines/administration & dosage ; Serotonin 5-HT3 Receptor Antagonists ; Vomiting/chemically induced/*prevention & control

BACKGROUND/AIMS: Postprandial symptoms of fullness and abdominal discomfort are common after fatty meals. Gastric lipases hydrolyze 10% to 20% of dietary triglycerides during the stomach trituration period of digestion. The aim of this study was to evaluate the effects of acid-resistant lipase on upper gastrointestinal symptoms, including fullness and bloating, as well as on gastric myoelectrical activity after healthy subjects ingested a high-fat, liquid meal. METHODS: This study utilized a double-blind, placebo-controlled, crossover design with 16 healthy volunteers who ingested either a capsule containing 280 mg of acid-resistant lipase or a placebo immediately before a fatty meal (355 calories, 55% fat). Participants rated their stomach fullness, bloating, and nausea before and at timed intervals for 60 minutes after the meal. Electrogastrograms were obtained to assess the gastric myoelectrical activity. RESULTS: Stomach fullness, bloating, and nausea increased significantly 10 minutes after ingestion of the fatty meal (p<0.01), whereas normal gastric myoelectrical activity decreased and tachygastria increased (p<0.05). With lipase, reports of stomach fullness were significantly lower compared with placebo (p<0.05), but no effect on gastric myoelectrical activity or other upper gastrointestinal symptoms was observed. CONCLUSIONS: The high-fat meal induced transient fullness, bloating, nausea, and tachygastria in healthy individuals, consistent with post-prandial distress syndrome. Acid-resistant lipase supplementation significantly decreased stomach fullness.
Abdominal Pain/etiology/psychology ; Adult ; Cross-Over Studies ; Diet, High-Fat/*adverse effects/psychology ; *Dietary Supplements ; Double-Blind Method ; Dyspepsia/etiology/*prevention & control/psychology ; Female ; Gastrointestinal Motility/drug effects/physiology ; Healthy Volunteers ; Humans ; Lipase/*administration & dosage ; Male ; Meals ; Middle Aged ; Myoelectric Complex, Migrating ; Nausea/etiology/psychology ; Postprandial Period ; Stomach/*drug effects/physiology ; Young Adult

OBJECTIVETo evaluate the effects of wrist-ankle acupuncture combined with ginger moxibustion against gastrointestinal tract reactions (nausea, vomiting, and constipation) to chemotherapy in cancer patients.

METHODSA total of 60 patients with gynecological tumors treated by chemotherapy were randomly divided into two groups. The treatment group (30 cases) underwent wrist-ankle acupuncture and ginger moxibustion, whereas tropisetron hydrochloride and dexamethasone were intravenously administered to the control group (30 cases) during chemotherapy.

RESULTSThe frequency of nausea in the treatment group was significantly less than that of the control group from the 2nd to the 5th day of chemotherapy (P<0.01). The anti-emetic effect in the treatment group was significantly better than that in the control group on the 3rd day of therapy (P<0.05). The incidence rate of constipation was significantly lower in the treatment group than that in the control group (P<0.01). Furthermore, the cost of therapy for the treatment group was significantly lower than that of the control group (P<0.01). Only 1 patient manifested a post-acupuncture side effect in the form of subcutaneous blood stasis.

CONCLUSIONWrist-ankle acupuncture combined with ginger moxibustion could prevent gastrointestinal tract reactions to chemotherapy in cancer patients. In addition, the proposed method had fewer side effects, lower cost, and less risk.

Acupuncture Therapy ; adverse effects ; Ankle ; physiology ; Antineoplastic Agents ; adverse effects ; Constipation ; etiology ; therapy ; Female ; Gastrointestinal Diseases ; chemically induced ; prevention & control ; Ginger ; chemistry ; Humans ; Male ; Middle Aged ; Moxibustion ; adverse effects ; Nausea ; chemically induced ; therapy ; Vomiting ; etiology ; therapy ; Wrist ; physiology

Adult ; Anti-Inflammatory Agents ; therapeutic use ; Dexamethasone ; therapeutic use ; Facial Nerve Diseases ; surgery ; Female ; Hemifacial Spasm ; surgery ; Humans ; Male ; Microvascular Decompression Surgery ; adverse effects ; Middle Aged ; Postoperative Nausea and Vomiting ; prevention & control

OBJECTIVETo observe the clinical efficacy of transcutaneous acupoint electrical stimulation (TAES) combined intravenous injection and/or Neiguan (P6) injection with droperidol in preventing and treating post-operative nausea and vomiting (PONV) after thyroid tumor surgery.

METHODSRecruited were 120 female patients who underwent selective thyroid tumor surgery were randomly assigned to the control group, the TAES group, the IV group (intravenous injection of droperidol), and the P6 group [Neiguan point (P6) injection of droperidol], respectively, 30 cases in each group. Thirty min before anesthesia induction, 2 mL 0.9% normal saline injection was intravenously injected to those in the control group. Patients in the TAES group received TEAS at bilateral P6 points. 2.5 mg (1 mL) droperidol added in 1 mL 0.9 normal saline was intravenously injected to those in the IV group and injected at bilateral P6 points of those in the P6 group. The occurrence and severity of PONV were observed within 0 - 6 h and within 6 - 24 h after operation in each group.

RESULTSCompared with the control group, the incidence and the severity of PONV within 0 - 6 h and within 6 - 24 h after thyroid surgery were significantly reduced in the three treatment groups (P < 0.05). There was no statistical difference in the incidence or the severity of PONV among the TAES, IV and P6 groups (P > 0.05).

CONCLUSIONSTEAS at P6 could dramatically reduce the occurrence and the severity of PONV after thyroid tumor surgery. Besides, it got equivalent effect to that by intravenous injecting droperidol or by injecting droperidol at P6.

Acupuncture Points ; Adult ; Female ; Humans ; Middle Aged ; Postoperative Nausea and Vomiting ; prevention & control ; Prospective Studies ; Single-Blind Method ; Thyroid Neoplasms ; surgery ; Transcutaneous Electric Nerve Stimulation

OBJECTIVETo investigate the treatment time dependence of electroacupuncture (EA) on Neiguan (PC6) for preventing postoperative nausea and vomiting (PONV).

METHODSOne hundred and seventy-eight patients, who had received intravenous patient-controlled analgesia (PCA) with Fentanyl, were assigned randomly to three groups using random numbers: a pre-operative EA group (PrEA), a post-operative EA group (PoEA), and a non-acupuncture control group (NC). An anesthetist evaluated the incidence and severity of nausea and vomiting for 48 h after surgery blindly. The main outcomes were severity and freguency of PONV, which were measured with a self-reported questionnaire and a confirmation from the anesthetist. The data were analyzed with ANOVA and Z-test.

RESULTSThe incidence of nausea and vomiting was significantly lower in the PrEA group than the NC group during 48 h after surgery (P<0.01, P<0.05). The incidence of vomiting was also significantly lower in the PrEA group than the PoEA group (P<0.05). The PoEA subjects evidenced no significant differences compared with the NC subjects in terms of the incidence of nausea and vomiting (P<0.05). The severity of nausea was significantly lower in the PrEA group than in the NC and PoEA groups (P<0.05).

CONCLUSIONSEA on PC6 is effective in the prevention of PONV, and pre-operative acupuncture is more effective than post-operative acupuncture.

Acupuncture Points ; Adult ; Analgesics, Opioid ; adverse effects ; Electroacupuncture ; Female ; Humans ; Incidence ; Laparoscopy ; adverse effects ; Male ; Middle Aged ; Postoperative Nausea and Vomiting ; epidemiology ; etiology ; prevention & control

OBJECTIVETo observe the efficacy of intravenous scopolamine in the prevention of postoperative nausea and vomiting (PONV) after cesarean section (CS).

METHODSA total of 260 pregnant women with American Society of Anesthesiologists (ASA) Physical Status Classification class I-II who underwent elective CS under combined spinal-epidural anesthesia (CSEA) were randomly divided into four groups (n = 65): at the end of surgery, 0.3 mg/5 ml scopolamine (scopolamine group), 4 mg/5 ml ondansetron (ondansetron group), 0.3 mg scopolamine plus 4 mg ondansetron per 5 ml (combination group), or 0.9% normal saline 5 ml (control group) were intravenously infused, respectively. The episodes of PONV and adverse effects were observed within 24 hours after operation.

RESULTSThe incidences of PONV within 24 hours after surgery were 87.7%, 89.2%, and 92.3%, respectively, in scopolamine group, ondansetron group, and combination group, which were all significantly higher than that in control group (73.8%) (all P < 0.05). However, the incidences of PONV showed no significant difference among these three groups (P > 0.05). No significant difference in the incidence of adverse effects was observed among the four groups (P > 0.05).

CONCLUSIONIntravenous scopolamine (0.3 mg), with a comparable efficacy as ondansetron 4 mg, can effectively decrease the incidence of PONV after CS.

Administration, Intravenous ; Adult ; Cesarean Section ; Female ; Humans ; Middle Aged ; Ondansetron ; administration & dosage ; therapeutic use ; Postoperative Nausea and Vomiting ; prevention & control ; Scopolamine Hydrobromide ; administration & dosage ; therapeutic use ; Treatment Outcome

PURPOSE: We investigated the effect of total intravenous anesthesia (TIVA) with propofol on postoperative nausea and vomiting (PONV) after robot-assisted laparoscopic radical prostatectomy (RLRP) in patients at low risk of developing PONV, in comparison to balanced anesthesia with desflurane. MATERIALS AND METHODS: Sixty two patients were randomly assigned to the Des or TIVA group. Propofol and remifentanil were used for induction of anesthesia in both groups and for maintenance of the anesthesia in the TIVA group. In the Des group, anesthesia was maintained with desflurane and remifentanil. In both groups, postoperative pain was controlled using fentanyl-based intravenous patient controlled analgesia, and ramosetron 0.3 mg was administered at the end of surgery. The incidence of PONV, severity of nausea and pain, and requirements of rescue antiemetics and analgesics were recorded. RESULTS: The incidence of nausea in the post-anesthetic care unit was 22.6% in the Des group and 6.5% in the TIVA (p=0.001) group. The incidence of nausea at postoperative 1-6 hours was 54.8% in the Des group and 16.1% in the TIVA group (p=0.001). At postoperative 6-48 hours, there were no significant differences in the incidence of nausea between groups. CONCLUSION: In order to prevent PONV after RLRP in the early postoperative period, anesthesia using TIVA with propofol is required regardless of patient-related risk factors.
Aged ; Anesthesia, Intravenous/*methods ; Humans ; Laparoscopy/*methods ; Male ; Middle Aged ; Postoperative Nausea and Vomiting/*prevention & control ; Propofol/administration & dosage/*therapeutic use ; Prostatectomy/*methods ; Vomiting/*prevention & control