Wrist acupressure for post-operative nausea and vomiting: A feasibility study

INTERVENTION: The PC6 acupoint is the meridian point in the pericardium channel and located on the inner forearm between the extensor carpi radialis and palmaris longus tendons one sixth of the distance from PC7 on the medial wrist crease to PC 3 in the cubital fossa (WHO, 2008). Participants in the intervention group (acupressure wristband) will have the Seaband (Registered Trademark) wristbands applied to both wrists ensuring the bead stimulates the Neiguan (PC 6) after establishment of IV access and invasive monitoring in the operating theatre. The wristbands will be covered with opaque bandaging to ensure blinding. The wristbands will be removed at 36 hours from admission time to ICU after final outcome measurement. CONDITION: post‐operative nausea and vomiting in cardiac surgery patients PRIMARY OUTCOME: Evaluate the feasibility of launching a full‐scale multisite efficacy trial, using pre‐defined feasibility criteria for recruitment, retention, protocol fidelity and use the pilot data to refine the protocol Patients in the acupressure group will experience less nausea and vomiting postoperatively compared with patients in the sham group. This will be assessed 6 hours from arrival to the ICU, at 8 hours post arrival, 4 hourly up to 24 hours and then at 36 hours on a bedside Case Report Form. Nausea will be assessed on a 10 point scale (“0 = no nausea” to “10 = severe nausea”). For vomiting, all episodes of retching or vomiting in the 36 hour time period will be recorded on the bedside Case Report Form. SECONDARY OUTCOME: Costs associated with PC 6 stimulation device, costs of antiemetic medication and hospital length of stay in the two groups will be assessed. Explore the different arms in relation to the need for rescue drug therapy. Participants need for rescue medication will be recorded on the bedside Case Report Form. Explore the different treatment arms in relation to dose effect at 8, 24 and 36 hours post application of the wristbands. Explore the different treatment arms in relation to the effect on severe nausea Patients in the acupressure group will have a greater quality of recovery at morning of day 3 than patients in the sham group. Participants will self assess the quality of the recovery on the morning of the 3rd postoperative day using a 15 item questionnaire (QOR15; Stark et al., in press). INCLUSION CRITERIA: ‐ Elective and urgent primary cardiac surgery (CABG; valve and double valve replacement; CABG + single valve replacement ‐ Able to understand, speak, read and write English ‐ Over 18 years of age and able to give informed consent