A Feasibility Trial Examining Acupressure Wristbands in Ambulatory Surgery Patients at Risk for Post-Discharge Nausea and Vomiting.

Abstract

Purpose: Postoperative nausea and vomiting (NV) can lead to complications like pain and bleeding. In ambulatory surgery patients, post-discharge NV impacts 40% to 80% of patients undergoing laparoscopically assisted vaginal hysterectomy (LAVH). Pericardium 6 (PC6) acupressure may prevent postoperative NV in hospital, but little is known regarding its effect on post-discharge NV. The purpose of this study was to examine the feasibility of a trial to test the effects of bilateral PC6 acupressure wristbands plus usual care versus placebo plus usual care on post-discharge NV.

Design: A parallel-arm feasibility randomized controlled trial was employed.

Methods: Primary outcomes included rates of consent, randomization, intervention/placebo delivery, continuous wristband wear, and retention. Twenty participants undergoing ambulatory LAVH were randomized to either a) usual post-discharge NV care 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 after discharge. Follow-up calls were made to gather outcome data.

Findings: Three a priori criteria for feasibility success were met: rates of randomization, continuous wear, and retention.

Conclusions: It was feasible to conduct a trial where a registered nurse delivered acupressure wristbands versus placebo wristbands to patients in the recovery room following LAVH under general anesthesia. Post-discharge symptom management is an important component of nursing practice. If acupressure wristbands are found to be effective at preventing post-discharge NV in larger trials, registered nurses are well-positioned to educate patients about a cost-effective intervention with minimal risk of side effects.