Transcutaneous Electrical Acupoint Stimulation of P6 to Prevent Postoperation Nausea and Vomiting

NCT ID: NCT02096835

Last Updated: 2015-10-12

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

157 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-01-31

Study Completion Date

2015-01-31

Brief Summary

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The purpose of this study is to access the effect of TEAS of P6 in the prevention of PONV in women scheduled for gynecologic laparoscopic surgery with general anesthesia.

Detailed Description

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150 female patients, aged between 18 to 60 y, who are scheduled for elective gynecological laparoscopic surgery requiring general anesthesia, will be randomly allocated by a computer generated randomization table to acustimulation group (Group Acu), tropisetron group (Group Trp),or dexamethasone group (Group Dxm).

In Group Acu, a surface electrode will be applied in the induction room to the P6 acupoint 30 min before induction.An operator will set electric stimulating current at 1mA with frequency at 2 Hz, and gradually increased the current intensity to a little below discomfort threshold.The stimulation will be maintained until the patient is discharged from the post-anesthesia care unit (PACU). In Group Trp and Group Dxm, the same protocol will be applied unless silicone covers attached to both electrodes.

A standardized anesthetic protocol will be followed. After induction, dexamethasone 10mg i.v. will be given in all groups. All patients will receive intravenous lactated Ringer's solution based on calculated preoperative deficits, surgical procedure, and estimated intraoperative blood loss. Parecoxib 40mg i.v. during surgery and incision infiltration of 0.5% ropivacaine at the end of surgery will be used for post-operative analgesia. After surgery, analgetic therapy will continue with morphine upon patient's request.After extubation, patients will be transported to PACU and observed for no less than 30 min. Metoclopramide 10mg i.v. will be administered as a rescue therapy to any patient who experiences an episode of moderate or severe nausea, an episode of vomiting, and requests rescue medication.

At the start of skin closure, a prefilled syringe which contains 5 ml of a solution will be administered intravenously to the patient. It will contain either saline (Group Acu and Group Dxm) or tropisetron 5mg (Group Trp).The syringe with the drug will be prepared by a study coordinator according to group allocation.

The patients, the anesthesiologists, and the nursing staff shall be unaware of the group assignments.

An anesthesiologist and an anesthetic nurse, who are trained for the study and blinded to the randomization, will collect the data.

Conditions

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Postoperative Nausea and Vomiting

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Acustimulation

Transcutaneous electrical acupoint stimulation (TEAS) starts 30 min before surgery and lasts until patient leaves the postanesthetic care unit.Dexamethasone 10mg i.v. after induction.

Group Type EXPERIMENTAL

Transcutaneous electrical acupoint stimulation

Intervention Type DEVICE

A surface electrode will be applied to the P6 acupoint on the dominant upper extremity, located approximately 3cm proximal to the distal wrist crease between the tendons of the flexor carpi radialis and the palmaris longus, and a negative surface electrode placed on the opposing dorsum aspect of the forearm.

Dexamethasone

Intervention Type DRUG

will be given after induction

Tropisetron

Tropisetron 5mg iv. at the start of skin closure.Sham transcutaneous electrical acupoint stimulation.Dexamethasone 10mg i.v.after induction.

Group Type ACTIVE_COMPARATOR

Sham transcutaneous electrical acupoint stimulation

Intervention Type DEVICE

The same TEAS protocol will be applied unless silicone covers will be attached to both electrodes. The device will also be turned on during the procedure.

Tropisetron

Intervention Type DRUG

will be given at the start of skin closure

Dexamethasone

Intervention Type DRUG

will be given after induction

Control

Sham transcutaneous electrical acupoint stimulation. Dexamethasone 10mg i.v.after induction.

Group Type SHAM_COMPARATOR

Sham transcutaneous electrical acupoint stimulation

Intervention Type DEVICE

The same TEAS protocol will be applied unless silicone covers will be attached to both electrodes. The device will also be turned on during the procedure.

Dexamethasone

Intervention Type DRUG

will be given after induction

Interventions

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Transcutaneous electrical acupoint stimulation

A surface electrode will be applied to the P6 acupoint on the dominant upper extremity, located approximately 3cm proximal to the distal wrist crease between the tendons of the flexor carpi radialis and the palmaris longus, and a negative surface electrode placed on the opposing dorsum aspect of the forearm.

Intervention Type DEVICE

Sham transcutaneous electrical acupoint stimulation

The same TEAS protocol will be applied unless silicone covers will be attached to both electrodes. The device will also be turned on during the procedure.

Intervention Type DEVICE

Tropisetron

will be given at the start of skin closure

Intervention Type DRUG

Dexamethasone

will be given after induction

Intervention Type DRUG

Other Intervention Names

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TEAS Electrical neuromuscular stimulation device,JNR-2 Tropisetron Hydrocloride Injection Batch number:131001

Eligibility Criteria

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Inclusion Criteria

* American Society of Anesthesiologists (ASA) physical status I or II
* aged between 18 to 60yr
* scheduled for elective gynecological laparoscopic surgery requiring general anesthesia

Exclusion Criteria

* pregnancy or breastfeeding
* mental retardation
* psychiatric or neurological disease
* use of antiemetics, emetogenic drugs, opioids or glucocorticosteroids within 3 days prior to surgery
* known allergy to tropisetron or dexamethasone
* nausea and/or vomiting within 24 hr prior to surgery
* implantation of a cardiac pacemaker, cardioverter, or defibrillator
* any skin problem at the acupoint stimulation area
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Huashan Hospital

OTHER

Sponsor Role lead

Responsible Party

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Xiao-Yu Yang, MD

MD.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jun Zhang, MD, PhD

Role: STUDY_CHAIR

Department of Anesthesiology, North Institute of Huashan Hospital,Fudan University

Locations

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Department of Anesthesiology, North Institute of Huashan Hospital,Fudan University

Shanghai, Shanghai Municipality, China

Site Status

Countries

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China

References

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Yang XY, Xiao J, Chen YH, Wang ZT, Wang HL, He DH, Zhang J. Dexamethasone alone vs in combination with transcutaneous electrical acupoint stimulation or tropisetron for prevention of postoperative nausea and vomiting in gynaecological patients undergoing laparoscopic surgery. Br J Anaesth. 2015 Dec;115(6):883-9. doi: 10.1093/bja/aev352. Epub 2015 Oct 27.

Reference Type DERIVED
PMID: 26507494 (View on PubMed)

Other Identifiers

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TEAS-PONV

Identifier Type: -

Identifier Source: org_study_id

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