Effect of intravenous granisetron combined and acupuncture point injection at PC6(Neiguan) with 0.9% sodium chlorideon postoperative nausea and vomiting after gynecological laparoscopy

Abstract

Objective: To observe the effects of intravenous granisetron and acupuncture point injection at PC6(Neiguan) with 0.9% sodium chloride on postoperative nausea and vomiting (PONV) after gynecological laparoscopic surgery. Methods: Qualified cases were collected according to prospective randomized controlled clinical trial design. 94 cases patients undergoing gynecological laparoscopic surgery without postoperative intravenous analgesia were selected from February 2017 to November 2018 in Beijing Aerospace General Hospital and The Affiliated Hangzhou Hospital of Nanjing Medical University. The patients were randomly divided into three groups: bilateral PC6 sham injection of 0.9% sodium chloride+ intravenous granisetron(group A, n=31); bilateral acupuncture point injection at PC6 of 0.9% sodium chloride+ intravenous 0.9% sodium chloride(group B, n=33); bilateral acupuncture point injection at PC6 of 0.9% sodium chloride+ intravenous granisetron(group C, n=30). The indexes including age, body mass index(BMI), type of surgery, surgery time, anesthesia time, liquid intake and output volume, the time from the completion of the operation to the removal of the tracheal catheter, the time from the completion to follow the instruction, respiratory depression, restlessness, arrhythmias and other adverse reactions during anesthesia recovery were recorded. Evaluated the nausea and vomiting according to the visual analogue scales (nausea visual analog scale, NVAS) 12 hours after the operation. Not only the dose and the related frequency of antiemetic drugs for rescue, but also the time of the first anal exsufflation and the pain 24 hours after the operation were recorded. Detected the concentration of motilin (MTL), when the operation started/awake after extubation/12 hours after the operation Results: The incidence of nausea and vomiting 12 hours after the operation in group A, B and C was 35.5%, 33.3%, 10.0%. The difference was statistically significant (χ(2)=0.654, P<0.05). The motilin after 12 hours of operation in group A, B and C was (564±76),(559±84),(472±69) ng/L. The difference was statistically significant (F=14.033, P<0.05). The incidence of nausea and vomiting and the motilin after 12 hours of operation in group C were lower than group A and B. The time for the first anal exsufflation in group A, B and C was (19±8),(19±7),(14±8)h.The difference was statistically significant (F=4.523, P<0.05). The time for the first anal exsufflation in group C was earlier than group A and B. Conclusion: Either intravenous granisetron or acupuncture point injection at PC6 of 0.9% sodium chloride can effectively reduce the incidence of postoperative nausea and vomiting after gynecological laparoscopic surgery. Intravenous granisetron combined with acupuncture point injection at PC6 of 0.9% sodium chloride has better effect and promotes the first anal exsufflation time, which is conducive to the rapid postoperative recovery of patients.