(S-180) Sim, C.K., Saturday 9:15

OBJECTIVE: Despite major advances in surgery and anaesthesia, PONV remains a significant problem. The incidence varies widely among different patient groups, ranging from 39%- 73%. Concerns regarding the side effects associated with the use of traditional antiemetics and the high cost of the newer drugs have led us to reexamine the use of nonpharmacologic techniques. Specifically, we studied the effect of stimulating the acupoint P6 (Neiguan) with electroacupuncture using needle; transcutaneous electrical nerve stimulation (TENS) and compared its effect with placebo TENS and ondansetron.
METHODOLOGY: 186 female patients who underwent gynecologic laparoscopic procedure under general anaesthesia (GA) were recruited into the study. They were randomized into 6 groups. Group 1: control group, mock TENS for 10 mins before GA. Group 2: electroacupuncture (EA) at 10Hz (HAN ACUTENS, CHINA), started 10 mins before and continued till end of GA. Group 3: EA at 10Hz duration same as group 1. Group 4: TENS at 10Hz (HAN ACUTENS in TENS mode) duration same as group 2. Group 5: TENS using intermittent (12s interval) Train of Four (TOF) stimulation at 2Hz (Innervator, Fisher & Paykel), duration same as group 2. Group 6: Ondansetron 4mg i.v. before GA. P6 is located at 2 "cun" above the wrist crease between the tendons of the palmaris longus and flexor carpi radialis muscles of the forearm.
RESULTS: There was no difference in the incidence of PONV between groups during the first 1 hr after operation (Figure 1). All treatment group (Group 2 to group 6) had significant lower incidence of PONV during 1-6 hr after operation when compared to group 1 (control) (P<0.05) (Figure 2). Nonpharmacological methods were as effective as i.v. ondansetron.
CONCLUSION: Patients who received stimulation with EA and TENS at P6 point, and Ondansetron were significantly more effective in reducing PONV as compared to control subjects. Acupuncture therapy was as effective as Ondansetron prophylaxis.