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Postoperative Nausea and VomitingAcuPONVNCT02509143

Acupuncture for Postoperative Nausea and Vomiting in Patients Undergoing Colorectal Surgery

A study testing High-dose acupuncture with intravenous infusion of ramosetron, P6 stimulation with intravenous infusion of ramosetron and Intravenous infusion of ramosetron in people with Postoperative Nausea and Vomiting and Colorectal Neoplasms, run by Pusan National University Yangsan Hospital at 2 sites in South Korea.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Background: PONV is one of the prevalent discomforts in the early phase of recovery after surgery. Evidence suggests that the stimulation of the P6 acupuncture point can reduce the occurrence of PONV. Read more about this study

Who is it for?
Ages 18 to 80 years
What is being tested?
High-dose acupuncture with intravenous infusion of ramosetron, P6 stimulation with intravenous infusion of ramosetron and Intravenous infusion of ramosetron
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
2 sitesSouth Korea
Study dates
Jul 2015to Dec 2016
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients undergoing elective laparoscopic surgery of colorectal cancer resection (right hemicolectomy, left hemicolectomy, anterior resection with primary anastomosis, and low anterior resection with loop ileostomy for fecal diversion)
  • Patients aged 18 to 80
  • American Society of Anesthesiologists Grade 1 to 2
  • Written informed consents

Who cannot join

  • Pregnancy
  • Inflammatory bowel disease
  • Comorbidities that may affect outcomes of surgery (e.g., chronic kidney disease, chronic liver disease, cardiopulmonary failure, and diabetes with complications)
  • Use of emetogenic / antiemetic medication within 24 hours before surgery
  • Previous history of emetic episodes after administration of antibiotics
  • Expected use of mechanical ventilation
Show all 14Show fewer
  • Cognitive impairment that may affect the patient's ability to complete the outcome assessments
  • Previous history of stroke
  • Previous history of sensitive reaction to acupuncture
  • Patients unable to cooperate with acupuncture treatments
  • Pacemaker implantation
  • Previous history of epilepsy
  • Patients who have received Korean medicine treatments (acupuncture, moxibustion, cupping, or herbal medicine) within 2 weeks
  • Patients who have participated in other trials within 3 months

Trial locations and contacts

2 sites in 1 country.

South Korea2 sites
  • National Clinical Research Center, Korean Medicine Hospital, Pusan National University

    Yangsan, Kyung Sang South Province, 626-770

  • Pusan National University Yangsan Hospital

    Yangsan, Kyung Sang South Province, 626-770

Other trials in South Korea

About this study

Official title: High-dose Acupuncture for Prevention of Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Colorectal Surgery: A Randomized Controlled Pilot Study

Background: PONV is one of the prevalent discomforts in the early phase of recovery after surgery. Evidence suggests that the stimulation of the P6 acupuncture point can reduce the occurrence of PONV. What remains unclear is whether a higher dose of acupuncture produces more benefits compared with P6 stimulation alone or whether acupuncture combined with standard antiemetic medication yields better outcomes.

Objectives: This study aims to assess the effectiveness, safety, and feasibility of intensive acupuncture treatments combined with standard antiemetic medication as compared with P6 acupoint stimulation combined with standard antiemetic medication or with standard antiemetic medication alone.

Read the detailed description

Background: PONV is one of the prevalent discomforts in the early phase of recovery after surgery. Evidence suggests that the stimulation of the P6 acupuncture point can reduce the occurrence of PONV. What remains unclear is whether a higher dose of acupuncture produces more benefits compared with P6 stimulation alone or whether acupuncture combined with standard antiemetic medication yields better outcomes. This study aims to assess the effectiveness and safety of different acupuncture regimen for the prevention of PONV: high-dose acupuncture treatments combined with standard antiemetic medication, P6 acupuncture-point stimulation combined with standard antiemetic medication, or medication alone.

Objectives: This study aims to assess the effectiveness, safety, and feasibility of intensive acupuncture treatments combined with standard antiemetic medication as compared with P6 acupoint stimulation combined with standard antiemetic medication or with standard antiemetic medication alone, to prevent postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic colorectal surgery.

Being tested
High-dose acupuncture with intravenous infusion of ramosetron, P6 stimulation with intravenous infusion of ramosetron, Intravenous infusion of ramosetron
Keywords
Postoperative Nausea and Vomiting, Colorectal Neoplasms
Medical subject headings
Postoperative Nausea and Vomiting, Colorectal Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • High-dose acupuncture with intravenous infusion of ramosetronProcedure or surgery

    Also called Acupuncture

    Three sessions of acupuncture will be provided within 48 hours after surgery. Electrical stimulation with an alternating frequency of 2 to 100 Hz will be applied to selected points (PC6 to LI4, ST36 to ST37, and bilateral SP6).

    An embedded acupuncture technique for preoperative anxiety will be applied to the bilateral acupuncture points of Liver (LI4), Heart 7 (HT7), Stomach (ST36), Yin-Tang, ear Shen-Men,and ear sympathetic and will be removed the next day. Treatments will be provided by qualified hospital staff (Korean medical doctors) with more than 10 years of clinical experience. The same stimulation of P6 points and antiemetics will be provided to the P6 acupuncture-point stimulation group.

  • P6 stimulation with intravenous infusion of ramosetronDevice

    Also called PC6

    Stimulation of P6 points will be maintained from one hour before and for 48 hours after surgery by wearing a wristband that produces pulse-type transcutaneous electrical stimulation. Antiemetics will be provided, the same as the standard antiemetic medication alone group.

  • Intravenous infusion of ramosetronDrug

    Also called Antiemetics

    Intravenous infusion of (oxycodone 20mg, ketorolac 120mg, ramosetron 0.3mg) as standard antiemetic medication will be provided. A dose of continuous infusion will be reduced by 0.1 ml/hr when a patient complaints of nausea.

    When vomiting occurs, a dose of continuous infusion will be reduced by 0.2 ml/hr and a bolus infusion of ramosetron 0.3 mg will be provided. A bolus infusion of ramosetron 0.3 mg will be also given if a patient feels greater than or equal to six points of nausea as measured on a 0 to 10 numeric rating scale (NRS) (nausea-severity scale) or by the patient's request, regardless of the severity of the nausea.

Study groups in NCT02509143
Study groupRoleWhat they receive
High-dose acupuncture with intravenous infusion of ramosetronExperimentalThree sessions of acupuncture on the points of Stomach 36 (ST36), Stomach 37 (ST37), Liver 3 (LR3), Large Intestine 11 (LI11), Large Intestine 4 (LI4), Spleen 6 (SP6), Spleen 4 (SP4), Pericardium 6 (PC6), Heart 8 (HT8), and Gall Bladder 41 (GB41) within 48 hours after surgery
Receives: Procedure: High-dose acupuncture with intravenous infusion of ramosetron; Device: P6 stimulation with intravenous infusion of ramosetron; Drug: Intravenous infusion of ramosetron
P6 stimulation with intravenous infusion of ramosetronActive comparatorP6 stimulation by wearing a study wristband within 48 hours after surgery
Receives: Device: P6 stimulation with intravenous infusion of ramosetron; Drug: Intravenous infusion of ramosetron
Intravenous infusion of ramosetronActive comparatorA mixture of standard antiemetic medication (5-Hydroxytryptophan receptor antagonist; ramosetron hydrochloride 0.3 mg) and analgesics, including anon-steroidal anti-inflammatory drug (NSAID) (ketorolac tromethamine 120 mg), and a semi-synthesized opioid (oxycodone 20 mg), will be infused by intravenous patient-controlled analgesia (1ml bolus/20 min lockout, 1ml/hr continuous infusion).
Receives: Drug: Intravenous infusion of ramosetron

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of patients who experience moderate or severe level nausea or vomiting

    Number of patients who experience moderate or severe level nausea (i.e, at least 4 points of nausea on 0 to 10 numeric rating scale) or vomiting during the first 24 postoperative hours

    Measured: at 24 hours after surgery

Secondary outcomes (23)
  1. Nausea scores on a numeric rating scale

    Score ranges from 0 (no nausea at all) to 10 (the worst nausea imaginable)

    Measured: at baseline (the discharge of recovery room), 6, 12, 24, 48 hours from baseline and at discharge (until discharge, an expected average of 7 days after surgery)

  2. Number of vomiting

    Number of vomiting

    Measured: from the discharge of recovery room to 6 hours, 6 to 12 hours, 12 to 24 hours, 24 to 48 hours, 48 hours to the discharge (until discharge, an expected average of 7 days after surgery)

  3. Cumulative incidence of vomiting

    Cumulative incidence of vomiting

    Measured: at baseline to 24 and 48 hours

  4. Number of patients who experience nausea

    Number of patients who experience nausea

    Measured: from the discharge of recovery room to 6 hours, 6 to 12 hours, 12 to 24 hours, 24 to 48 hours, 48 hours to the discharge (until discharge, an expected average of 7 days after surgery)

  5. Cumulative number of patients who experience nausea

    Cumulative number of patients who experience nausea

    Measured: at baseline to 24 and 48 hours

  6. Number of patients who experience vomiting

    Number of patients who experience vomiting

    Measured: from the discharge of recovery room to 6 hours, 6 to 12 hours, 12 to 24 hours, 24 to 48 hours, 48 hours to the discharge (until discharge, an expected average of 7 days after surgery)

  7. Cumulative number of patients who experience vomiting

    Cumulative number of patients who experience vomiting

    Measured: at baseline to 24 and 48 hours

  8. Pain scores on a numeric rating scale

    Score ranges from 0 (no nausea at all) to 10 (the worst nausea imaginable)

    Measured: at 6, 12, 24, 48 hours from the discharge of recovery room and at discharge (until discharge, an expected average of 7 days after surgery)

  9. Patient's global assessment of recovery after surgery

    Response options include very much improved, somewhat improved, no change, somewhat worsened, and very much worsened.

    Measured: at 2 weeks after surgery

  10. Time to first flatus

    Time to first flatus

    Measured: until discharge, an expected average of 7 days after surgery

  11. Time to tolerate soft diet

    Time to tolerate soft diet

    Measured: until discharge, an expected average of 7 days after surgery

  12. Time to first defecation

    Time to first defecation

    Measured: until discharge, an expected average of 7 days after surgery

  13. Time to independent walk

    Time to independent walk

    Measured: until discharge, an expected average of 7 days after surgery

  14. Number of insertions of nasogastric tube

    Number of insertions of nasogastric tube

    Measured: until discharge, an expected average of 7 days after surgery

  15. Time to first removal of Foley catheter

    Time to first removal of Foley catheter

    Measured: until discharge, an expected average of 7 days after surgery

  16. Number of reinsertions of Foley catheter

    Number of reinsertions of Foley catheter

    Measured: until discharge, an expected average of 7 days after surgery

  17. Number of clean intermittent catheterizations

    Number of clean intermittent catheterizations

    Measured: until discharge, an expected average of 7 days after surgery

  18. Quality of life measured by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) C30

    Quality of life measured by European Organization for Research and Treatment

    Measured: at 2 weeks after surgery

  19. Preoperative anxiety

    measured by 0 to 10 numeric rating scale (0: no anxiety, 10: extreme anxiety)

    Measured: just before the induction of anaesthesia

  20. Patient-reported satisfaction for management of PONV

    measured by 0 to 10 numeric rating scale (0: very unsatisfactory, 10: very satisfactory)

    Measured: at 48 hours after surgery

  21. Use of medication

    Use of medication

    Measured: at 2 weeks after surgery

  22. Postoperative complications

    • wound infection
    • urinary tract infection
    • urinary retention
    • chest infection
    • other infection
    • paralytic ileus

    Measured: within 4 weeks after surgery

  23. Serious adverse events

    • respiratory failure requiring ventilation
    • renal failure requiring dialysis
    • cardiac failure
    • myocardial infarction
    • anastomotic leakage requiring surgery
    • anastomotic leakage requiring drainage
    • bowel obstruction/stricture requiring surgery
    • abdominal wall dehiscence requiring surgery
    • readmission within 30 days after surgery
    • reoperation within 30 days after surgery
    • mortality during surgery or within 30 days after surgery

    Measured: within 4 weeks after surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Jul 2015 (estimated)
  2. Study startJul 2015
  3. Primary completionNov 2016
  4. Study completionDec 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
60 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02509143
Sponsor's protocol ID
03-2015-010
Acronym
AcuPONV
Status last verified
Aug 2024
First submitted
17 Jul 2015
Last updated
12 Aug 2024
Results posted
No
Data monitoring committee
No

Publications

  • Kim KH, Kim DH, Bae JM, Son GM, Kim KH, Hong SP, Yang GY, Kim HY. Acupuncture and PC6 stimulation for the prevention of postoperative nausea and vomiting in patients undergoing elective laparoscopic resection of colorectal cancer: a study protocol for a three-arm randomised pilot trial. BMJ Open. 2017 Jan 4;7(1):e013457. doi: 10.1136/bmjopen-2016-013457.

    PubMed 28052910

Questions about this trial

What is this clinical trial studying?

A study testing High-dose acupuncture with intravenous infusion of ramosetron, P6 stimulation with intravenous infusion of ramosetron and Intravenous infusion of ramosetron in people with Postoperative Nausea and Vomiting and Colorectal Neoplasms, run by Pusan National University Yangsan Hospital at 2 sites in South Korea.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 Aug 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in South Korea. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of patients who experience moderate or severe level nausea or vomiting (time frame: at 24 hours after surgery). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02509143, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Aug 2024.

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