Seevaunnamtum, S Praveena D/O
(2015)
The effectiveness of electroacupuncture in reducing
postoperative pain, analgesic requirement and prevention of postoperative nausea and vomiting post total abdominal hysterectomy surgery.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction: We explored the use of intraoperative single session low frequency ( 2
Hertz) electroacupuncture stimulation to show an opioid sparing effect whilst having
better analgesic profile and reduction of postoperative nausea and vomiting (PONV) in
patients recovering from hysterectomies. The tiny focused electrical current is
postulated to modulate the pain pathway via release of endogenous opioid substances
and stimulation of descending pain inhibitory pathways.
Objectives: This was a prospective, double blinded randomized study of the effect of
intraoperative electroacupuncture on postoperative pain, analgesic requirement and
prevention of postoperative nausea and vomiting in patients scheduled for total
abdominal hysterectomy with or without bilateral salphingo oophorectomy. The study
was conducted in Hospital Raja Permaisuri Bainun, Ipoh.
Methodology: Sixty four (64) women were randomly allocated to receive or not
electroacupuncture. Electroacupuncture was started as a single continuous session
started intraoperatively till the end of surgery. All patients received similar general
anaesthesia and postoperative patient controlled analgesia morphine. Postoperative
Numerical Rating Scale, incidence of nausea, vomiting and usage of rescue antiemetics
at 30 minutes, 2 hours, 4 hours and 24 hours were recorded. Total morphine demand
and usage were also recorded in first 24 hours. Assessment was by a blinded nursing
staff. Data entry and analysis was conducted with PASW Statistics Data Editor(Statistical Package for Social Science SPSS Version 21)
Results: Postoperative pain score was numerically lower in the electroacupuncture
group with a significant reduction in the mean pain score at 30 minutes and 2 hours
postoperation, showing a mean pain score of 2.75 ± (2.34) and 2.25 ± (1.80) (p value
<0.05) respectively. In comparison, the mean pain score for the control group were
4.50 ± (2.37) and 3.88 ± (2.21) (p value < 0.05) respectively. The mean PCA morphine
demand within 24 hours was significantly lower in electroacupuncture group showing
27.28 ± (21.61) times pressed as compared to the control group which recorded 55.25 ±
(46.85) times pressed (p value < 0.05). The mean morphine dosage requirement within
24 hours showed a significant reduction in usage in electroacupuncture group showing
a mean of 21.38 ± (14.38) mg as compared to the control group which recorded a usage
of 33.94 ± (20.34) mg (p value < 0.05). Incidence of postoperative nausea was
significantly reduced in electroacupuncture group at 30 minutes with a rate of 15.6%
versus 46.9 % in control group (p value < 0.05).
Conclusion: This study concludes that in subjects receiving electroacupuncture
intraoperatively, there was a significant reduction in postoperative pain score up to the
first 2 hours, decrease in morphine demand and requirement in the first 24 hours and
reduction in incidence of postoperative nausea at 30 minutes postoperatively.
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