A feasibility trial comparing acupressure wristbands plus usual care versus placebo plus usual care in ambulatory surgery patients at risk for post-discharge nausea and vomiting

Abstract

Introduction/Background: Postoperative nausea and vomiting (NV) can occur after surgery, leading to complications like pain and bleeding. In ambulatory surgery patients, NV can begin or persist after discharge as post-discharge NV and impacts 40-80% of patients at risk for this phenomenon, including those undergoing laparoscopically assisted vaginal hysterectomy (LAVH). Studies suggest pericardium 6 (PC6) acupressure may prevent postoperative NV, but little is known regarding its effect on post-discharge NV. This study examined the feasibility of conducting a randomized controlled trial (RCT) to test the effects of bilateral PC6 acupressure wristbands plus usual care on post-discharge NV in ambulatory LAVH patients. Methods: A randomized controlled parallel-arm feasibility trial was employed. The primary outcome was feasibility, including rates of consent, randomization, intervention/placebo delivery and continuous wear, and retention. The secondary outcomes were preliminary estimates of PC6 acupressure’s effects on post-discharge NV. Twenty participants undergoing ambulatory LAVH were randomized to either a) usual post-discharge NV care (prophylactic antiemetics) plus bilateral PC6 acupressure wristbands, or b) usual care with bilateral placebo wristbands. Wristbands were placed on arrival to the recovery room and worn until 24 hours post-discharge. Follow-up calls were made to gather outcome data. Results: It was feasible to conduct a trial where a registered nurse delivered wristbands to participants in the recovery room following LAVH. There were ten patients randomized in each group. Three of the five criteria met a priori criteria for feasibility success (rates of randomization, intervention/placebo delivery [continuous wear], and retention). Rates of consent and intervention/placebo delivery in the recovery room did not meet the 90% a priori criteria. The preliminary estimates of intervention effect suggest acupressure may not impact post-discharge NV. Conclusions: This feasibility study found that it was feasible to conduct an RCT examining the effects of PC6 acupressure wristbands on post-discharge NV in ambulatory LAVH patients.