Comparison of Acupressure Bands and Droperidol for Reducing Postoperative Nausea and Vomiting (PONV) in Gynecological Surgery Patients

2.50
Hdl Handle:
http://hdl.handle.net/10755/149413
Type:
Presentation
Title:
Comparison of Acupressure Bands and Droperidol for Reducing Postoperative Nausea and Vomiting (PONV) in Gynecological Surgery Patients
Abstract:
Comparison of Acupressure Bands and Droperidol for Reducing Postoperative Nausea and Vomiting (PONV) in Gynecological Surgery Patients
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:November 10 - 14, 2001
Author:Schultz, Alyce, PhD
P.I. Institution Name:Maine Medical Center
Title:Nurse Researcher
Objective: To compare the effectiveness of droperidol (DP), acupressure bands (AB) and a combination of droperidol and acupressure bands (DP/AB) for reducing postoperative nausea and vomiting (PONV) in gynecological patients when administered preoperatively. Design: A randomized, double blind, placebo controlled, IRB approved, experiment. Sample: 103 women, mean age 46.6 years, sd 10.8, completed the study. There were no statistically significant differences among the 4 groups in mean age, type of surgical procedure, or number of days the acupressure bands were in place. Setting: 606-bed tertiary care hospital. Variables/Concepts: This study is based on multiple sites of action for reducing PONV. The antiemetic effect of acupressure bands is based on the theory of acupuncture. Elastic bands with a plastic button, placed on both wrists, exert constant pressure on the Neiguan (P6) acupuncture point. Droperidol, acting within the CNS, has shown a postoperative antiemetic effect when given 30-60 minutes preoperatively. Measures/Instruments: Nausea was self-reported on a 4-point scale, vomiting was measured by the number of episodes of vomiting or retching within a 5 minute period, and pain was self-reported on an 11 point scale. Data were collected by staff nurses every four hours during the hospital stay and subjects maintained a diary after discharge. Findings: Although few subjects actually vomited, more than 50% of the participants experienced nausea on the day of surgery. Based on analysis of variance, the number of subjects experiencing nausea in the DP/AB group on the day of surgery approached significance (p = .056). Significantly more subjects in this group received antiemetics on the day of surgery (p = .026). Although pain scores over time were consistently higher in the DP/AB group, there was no statistically significant difference among the groups. Neither was there a significant difference among the groups in the dosage of opioids received. Conclusions: Findings do not support the effectiveness of acupressure bands, placed prior to surgery and left in place as long as comfortable, in reducing PONV in gynecological patients. Likewise, Droperidol administered prior to surgery did not significantly reduce nausea during the postoperative period. Patients who experienced none or mild PONV reported support for the acupressure bands. This support did not differ for those who received the actual bands when compared to those who received the placebo bands. Further exploration of this serendipitous finding is needed. Implications: Results of the study are disappointing and are not supportive of other studies where acupressure bands have been reported effective in reducing PONV. 72% of patients who report dissatisfaction with their surgical experiences are willing to exchange pain and increased cost to avoid PONV. In a baseline review of 31 patients, 84% were nauseated at some time postoperatively. In this study, 71% of the patients were nauseated at some time postoperatively. Other interventions for relieving PONV need to be explored.
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Nov-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleComparison of Acupressure Bands and Droperidol for Reducing Postoperative Nausea and Vomiting (PONV) in Gynecological Surgery Patientsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/149413-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Comparison of Acupressure Bands and Droperidol for Reducing Postoperative Nausea and Vomiting (PONV) in Gynecological Surgery Patients</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">November 10 - 14, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Schultz, Alyce, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Maine Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nurse Researcher</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">schula@mmc.org</td></tr><tr><td colspan="2" class="item-abstract">Objective: To compare the effectiveness of droperidol (DP), acupressure bands (AB) and a combination of droperidol and acupressure bands (DP/AB) for reducing postoperative nausea and vomiting (PONV) in gynecological patients when administered preoperatively. Design: A randomized, double blind, placebo controlled, IRB approved, experiment. Sample: 103 women, mean age 46.6 years, sd 10.8, completed the study. There were no statistically significant differences among the 4 groups in mean age, type of surgical procedure, or number of days the acupressure bands were in place. Setting: 606-bed tertiary care hospital. Variables/Concepts: This study is based on multiple sites of action for reducing PONV. The antiemetic effect of acupressure bands is based on the theory of acupuncture. Elastic bands with a plastic button, placed on both wrists, exert constant pressure on the Neiguan (P6) acupuncture point. Droperidol, acting within the CNS, has shown a postoperative antiemetic effect when given 30-60 minutes preoperatively. Measures/Instruments: Nausea was self-reported on a 4-point scale, vomiting was measured by the number of episodes of vomiting or retching within a 5 minute period, and pain was self-reported on an 11 point scale. Data were collected by staff nurses every four hours during the hospital stay and subjects maintained a diary after discharge. Findings: Although few subjects actually vomited, more than 50% of the participants experienced nausea on the day of surgery. Based on analysis of variance, the number of subjects experiencing nausea in the DP/AB group on the day of surgery approached significance (p = .056). Significantly more subjects in this group received antiemetics on the day of surgery (p = .026). Although pain scores over time were consistently higher in the DP/AB group, there was no statistically significant difference among the groups. Neither was there a significant difference among the groups in the dosage of opioids received. Conclusions: Findings do not support the effectiveness of acupressure bands, placed prior to surgery and left in place as long as comfortable, in reducing PONV in gynecological patients. Likewise, Droperidol administered prior to surgery did not significantly reduce nausea during the postoperative period. Patients who experienced none or mild PONV reported support for the acupressure bands. This support did not differ for those who received the actual bands when compared to those who received the placebo bands. Further exploration of this serendipitous finding is needed. Implications: Results of the study are disappointing and are not supportive of other studies where acupressure bands have been reported effective in reducing PONV. 72% of patients who report dissatisfaction with their surgical experiences are willing to exchange pain and increased cost to avoid PONV. In a baseline review of 31 patients, 84% were nauseated at some time postoperatively. In this study, 71% of the patients were nauseated at some time postoperatively. Other interventions for relieving PONV need to be explored.</td></tr></table>en_GB
dc.date.available2011-10-26T10:01:54Z-
dc.date.issued2001-11-10en_GB
dc.date.accessioned2011-10-26T10:01:54Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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