Acupressure using Ondansetron versus Metoclopramide on Reduction of Postoperative Nausea and Vomiting after Strabismus Surgery

Objective: To compare the clinical efficacy of acupressure with treatment induced by ondansetron and metoclopramide on reduction of the severity of postoperative nausea and vomiting (PONV) after strabismus surgery. Methods: There were 200 patients with ASA classes I-II, ages 10 to 60 years old, who underwent strabismus surgery that were included in this randomized, prospective, double-blind, placebo-controlled trial. Group I was the control, group II received metoclopramide 0.2 mg/kg, and group III received ondansetron 0.15 mg/kg intravenously immediately prior to anesthesia induction. In Group IV, acupressure wristbands were applied at the P6 points. Acupressure wrist bands were not placed appropriately for subjects of groups I-III. The acupressure wrist bands were applied 30 minutes before anesthesia induction and removed six hours after surgery completion. Anesthesia was standardized. PONV was evaluated within 0 - 2 hours and 2 - 24 hours after surgery by a blinded observer. Results were analyzed by the Chi-square or Fisher exact test. A P value of <0.05 was considered significant. Results: The incidence of PONV was not significantly different among acupressure, metoclopramide and ondansetron groups during 24 hours. Also, the severity of PONV was not significantly different between acupressure, metoclopramide, and ondansetron in the recovery and ward. Conclusion: Acupressure at the P6 point causes a significant reduction in the incidence and severity of PONV 24 hours after strabismus surgery as well as metoclopramide (0.2 mg/kg) and ondansetron (0.15 mg/kg) intravenous for patients aged 10 or older. (Irct ID: IRCT138807152556N1)