P6 Acupressure Does Not Prevent Emesis During Spinal Anesthesia for Cesarean Delivery

Abstract

ABSTRACT Vomiting during cesarean delivery is reported in up to half—or even more—of parturients who have spinal anesthesia and who receive no antiemetic drugs prophylactically. Routine antiemetic treatment is problematic because of adverse events, suggesting the possibility of using acupuncture or acupressure instead. Results of a meta-analysis indicated that stimulation at the P6 acupoint near the wrist may prevent postoperative nausea and vomiting in adults. This study evaluated the antiemetic efficacy of P6 acupressure in 110 parturients 23 to 40 years of age, all ASA physical status I–II, who were to have cesarean delivery on an elective basis. Those having nausea or vomiting within 24 hours before surgery were not included. Using a prospective, randomized, double-blind design, the women were randomized 30 minutes before spinal anesthesia (with 0.5% hyperbaric bupivacaine) to have acupressure or placebo bands (Sea Band) placed bilaterally on the P6 acupoint by a licensed acupuncturist. One of 55 women given acupressure and 2 of 55 in the control group were given intravenous metoclopramide as treatment for intractable vomiting—not a significant difference. Similar numbers of women in the 2 groups received fentanyl to relieve pain during surgery, meperidine because of shivering, and ephedrine to treat hypotension. Nausea occurred during surgery in 64% of women given acupressure and 71% of the control group. The respective figures for intraoperative vomiting were 22% and 27%. These differences were not statistically significant. The wrist bands were well tolerated and caused no adverse effects. The use of P6 acupressure failed to prevent nausea and vomiting in these parturients who underwent cesarean delivery under spinal anesthesia.