Acupuncture versus usual care for postoperative nausea and vomiting in children after tonsillectomy/adenoidectomy: a pragmatic, multicenter, double-blinded, randomized trial
Journal article, Peer reviewed
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Original versionLiodden, I.E., Sandvik, L., Valeberg, B.T., Borud, E.K. & Norheim, A.J. (2015). Acupuncture versus usual care for postoperative nausea and vomiting in children after tonsillectomy/adenoidectomy: a pragmatic, multicenter, double-blinded, randomized trial. Acupuncture in Medicine, 33. doi: 10.1136/acupmed-2014-010738 http://dx.doi.org/10.1136/acupmed-2014-010738
Objectives To investigate the effect of astandardised acupuncture on nausea andvomiting in children after tonsillectomy with orwithout adenoidectomy when possible placeboeffects were precluded.Methods A pragmatic, multicentre, doubleblinded,randomised controlled trial. The studywas conducted over 10 months in 2012–2013 atthree ambulatory clinics. Two hundred andeighty-two children, age 1–11 years, AmericanSociety of Anesthesiologists grade ≤II, wereincluded. To equalise expectancy effects, allparents were told that their child would receiveacupuncture. However, children were randomlyallocated to perioperative bilateral needlingacupuncture at PC6, depth 7 mm, mean time17 min (SD 5–45) during anaesthesia plus usualcare, or to usual care only. The regional ethicscommittee approved this approach. Primaryendpoints were nausea and vomiting 24 hpostoperatively.Results This study did not demonstrate anyeffect of acupuncture (95% CI) compared withstandard care. The overall vomiting in theacupuncture and usual-care groups was 44.2%and 47.9%, respectively. Nausea wasexperienced by 31.7% in the acupuncture groupand by 32.6% in the usual-care group. The testpower was acceptable for comparisons ofvomiting.Conclusions The findings suggest that whencontrolling for possible placebo effectsstandardised PC6 acupuncture needling duringanaesthesia without further stimulation of PC6 isnot effective in reducing nausea and vomiting in children after tonsillectomy with or withoutadenoidectomy. Future studies should investigateacupuncture treatment which balances adequatedose and technique and a feasible, child-friendlyacupuncture treatment.