Transcutaneous Pericardium 6 Acupoint Electrical Stimulation Provides Comparable Antiemetic Effect to Granisetron When Combined With Dexamethasone in Patients Undergoing Breast Cancer Surgery

Introduction

Perioperative transcutaneous pericardium 6 (P6) electrical stimulation is effective for prevention of postoperative nausea and vomiting (PONV). The patients undergoing breast cancer surgery have a high PONV prevalence; however, the effectiveness of P6 stimulation in this surgical population has not been investigated.

Materials and methods

A total of 198 patients undergoing mastectomy under general anesthesia were enrolled. They were randomly assigned to the one of three treatments: P6 stimulation + dexamethasone (group PD, n = 66), granisetron + dexamethasone (group GD, n = 66), and dexamethasone alone (group DM, n = 66). The primary endpoint was the incidence of postoperative vomiting (POV) within postoperative 48h. The secondary endpoints included the use of rescue antiemetic, severity of POV, and the incidence of postoperative nausea and other adverse events.

Results

The incidence of POV in group PD (9.1%) was similar to group GD (10.6%, P = 0.770), but significantly lower than that in the group DM (28.8%, P = 0.004) within postoperative 48 h. And, the incidence of postoperative nausea was similar between group PD and group GD but lower than that in group DM. The use of rescue antiemetics had no statistical differences among the three groups. The median (interquartile range) scores of POV severity were higher in group GD [6.0 (5.0, 7.0)] than in group DM [4.0 (3.0, 6.0), P = 0.012] within postoperative 48 h, but similar to group PD [5.5 (4.0, 6.3), P = 0.208].

Conclusions

Combined with dexamethasone, P6 stimulation has similar effectiveness for PONV prophylaxis with 5- hydroxytryptamine 3 antagonist granisetron but lower cost of antiemetic use. Moreover, both groups had a lower incidence of PONV and higher satisfaction than dexamethasone alone in patients undergoing breast cancer surgery.