High versus low frequency transcutaneous acupoint electrical stimulation as an adjunct therapy to prevent nausea and vomiting in the first 24 hours after infusion of high-grade emetic chemotherapy: A randomized controlled trial

Abstract

Background: Transcutaneous acupoint electrical stimulation (TAES) has been tested as antiemetic therapy. Objective: Evaluation of the effectiveness of two different frequencies of the electrical current as adjunctive therapy in the prevention of nausea and vomiting. Methods: This placebo-controlled clinical trial compared the incidence of nausea and vomiting (within the first 24 hours after high-grade emetic chemotherapy infusion) of 61 women (54 ± 11 years) with breast cancer undergoing three modes of TAES: high frequency (HF:150 Hz), low frequency (LF:10 Hz), and placebo (P). Electrodes were fixed at the acupuncture point PC6 and a symmetric bipolar current (pulse width 200 μs) was applied in a single 30-minute session prior to the start of chemotherapy infusion. All patients receive fixed antiemetic treatment infusions (ondansetron 8 mg) and rescue medication instructions, if necessary, according to the routine for infusions of cyclophosphamide associated with anthracycline. Results: The incidence of nausea was 47% in P, 45% in HF and 26% in LF. Although not significant, the intervention with LF-TAES at PC6 acupoint reached relevant values in reducing the relative risk of developing nausea (RR = 0.51; CI 95% = 0.18 to 1.44; p = 0.18) and a trend toward improved reported well-being (p = 0.06) and a lower Edmonton Symptom Rating Scale score (p = 0.08). The incidence of vomiting and the consumption of rescue antiemetic doses were very similar between the groups. Conclusion: New studies with LF and HF of TAES as adjuvant therapy for the prevention of nausea and vomiting should be carried out to confirm this hypothesis.