The effect of acupuncture on postoperative nausea and vomiting after pediatric tonsillectomy: A meta-analysis and systematic review

Authors

  • Hwang Cheol Shin MD,

    1. Department of Anesthesiology and Pain Medicine, Chonbuk National University, Jeonju
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  • Jong Seung Kim MD,

    Corresponding author
    1. Department of Otolaryngology–Head and Neck Surgery, College of Medicine, Chonbuk National University, Jeonju
    2. Research Institute of Clinical Medicine of Chonbuk National University–Biomedical Research Institute of Chonbuk National University Hospital, Jeonju
    • Send correspondence to Jong Seung Kim, MD, Department of Otolaryngology–Head and Neck Surgery, College of Medicine, Chonbuk National University, 20, Geonji-ro, Deokjin-Gu, Jeonju-si, Chonbuk, 561-712, Republic of Korea. E-mail address: kjsjdk@gmail.com

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  • Sang Kyi Lee MD, PhD,

    1. Department of Anesthesiology and Pain Medicine, Chonbuk National University, Jeonju
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  • Sam Hyun Kwon MD, PhD,

    1. Department of Otolaryngology–Head and Neck Surgery, College of Medicine, Chonbuk National University, Jeonju
    2. Research Institute of Clinical Medicine of Chonbuk National University–Biomedical Research Institute of Chonbuk National University Hospital, Jeonju
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  • Min Su Kim MD,

    1. Department of Otorhinolaryngology–Head and Neck Surgery, Seoul National University College of Medicine and Seoul National University Hospital, Seoul, Republic of Korea
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  • Eun Jung Lee MD, PhD,

    1. Department of Otolaryngology–Head and Neck Surgery, College of Medicine, Chonbuk National University, Jeonju
    2. Research Institute of Clinical Medicine of Chonbuk National University–Biomedical Research Institute of Chonbuk National University Hospital, Jeonju
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  • Yong Joo Yoon MD, PhD

    1. Department of Otolaryngology–Head and Neck Surgery, College of Medicine, Chonbuk National University, Jeonju
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  • The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis

Tonsillectomy is one of the most frequently performed pediatric surgical procedures worldwide. The complications of this procedure include postoperative nausea and vomiting (PONV) and pain; therefore, both the treatment and prevention of PONV are important. Classical antiemetics include drug therapies such as ondansetron, which are undesirable because they often carry a high cost and several side effects. Therefore, in this study we aimed to evaluate the antiemetic effect of acupuncture after pediatric tonsillectomy.

Methods

We searched for eligible articles that reported on the antiemetic effects of acupuncture after tonsillectomy using the three databases, MEDLINE, Embase, and Cochrane, through July 2015. We included full-length original articles with adequate data for evaluating the antiemetic effects on pediatric tonsillectomy in the form of a relative ratio. The Newcastle-Ottawa scale was used to assess the quality of case control and cohort studies, and the Cochrane risk of bias tool was employed for randomized controlled trials (RCTs).

Results

The search identified 415 publications. After screening, we selected eight articles for review (4 RCTs, 3 prospective cohorts, and 1 pilot study). A meta-analysis of acupuncture in pediatric tonsillectomy revealed that the number of patients with PONV was significantly reduced with acupuncture compared to the control group, with a risk ratio of 0.77 (95% confidence interval: 0.63–0.94, P < 0.05).

Conclusion

When acupuncture at PC6 (neiguan) was used to prevent PONV after pediatric tonsillectomy, the risk ratio was significantly lower compared to that of conventional drug therapy. Although further randomized controlled trials are needed, acupuncture at PC6 is considered an economic and effective treatment for emesis after pediatric tonsillectomy. Laryngoscope, 126:1761–1767, 2016

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