Effects of Acu-TENS to PC6 in patients after cardiac surgery

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Effects of Acu-TENS to PC6 in patients after cardiac surgery


Author: Ng, Chui-san Maggie
Title: Effects of Acu-TENS to PC6 in patients after cardiac surgery
Degree: M.Sc.
Year: 2007
Subject: Hong Kong Polytechnic University -- Dissertations.
Heart -- Surgery -- Patients.
Postoperative period.
Department: Dept. of Rehabilitation Sciences
Pages: xi, 75 leaves : ill. (some col.) ; 31 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2090264
URI: http://theses.lib.polyu.edu.hk/handle/200/611
Abstract: Nausea and vomiting is a common post-operative side effect and is associated with vagal modulation of the autonomic nervous system. It has been shown that stimulation of PC6 (Neiguan), an acupuncture point along the pericardium meridian, provided effective normalization of sympathetic and parasympathetic activities, and through vagal modulation, demonstrated a stabilization effect on heart rate as well as relief of nausea and vomiting. Needle acupuncture however is invasive and application of needle acupuncture to patients after surgery in hospitals is not always practical. Transcutaneous Electrical Stimulation over acupuncture point (Acu-TENS) is a non-invasive and easier means of stimulation of acu-puncture points but there is a lack of evidence on its effect on patients with cardiac surgery. This study aimed to investigate whether Acu-TENS could reduce nausea and vomiting and has any effect on the resting heart rate, blood pressure and pain score during the early post-operation period in patients after cardiac surgery. This study adopted a randomized two-group pretest-posttest clinical trial. Forty patients admitted for elective open heart surgery for coronary artery bypass grafting (CABG) or valve replacement (VR) were recruited. Subjects were randomly allocated to either the acu-TENS treatment (Rx) group or the placebo group. Each subject received one 40-minute of either acu-TENS or placebo-TENS session to acupuncture point PC6 on the day before operation (day 0) and then one session daily at the same time of the day, from day 1 to day 4 post-operation (D1 to D4). Resting heart rate (HR) and blood pressure (RBP) were recorded before and at five minutes intervals during and after each stimulation session. The nausea and vomiting score (PONV), resting heart rate (RHR) and blood pressure (RBP) recorded by the nursing staff daily at 7:00, 15:00 and 23:00 from day 0 to day 5, as well as the frequency of the antiemetic medication during these days were also included as data variables. Results showed that post-operatively the nausea and vomiting score and the antiemetic use were significantly lower in the Acu-TENS Rx group (p<0.05). The heart rate and rate pressure product were also showed significantly lower value in the Acu-TENS Rx group (p<0.05) compared to the Placebo group. Subjects in the Acu-TENS Rx group also demonstrated a significant trend of decreasing RHR (p=0.007), while the subjects in the placebo group showed a significant trend of increasing RHR (p=0.022) over the post-operative days. The results of the present study provide evidence that Acu-TENS is effective in reduction of nausea and vomiting sensation and the potential to protect myocardiac work in patients after open heart surgery. Acu-TENS to PC6 could be a useful adjunct in optimizing post-operative physiotherapy management.

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