Stern RM, Jokerst MD, Muth ER, Hollis C.
"Acupressure relieves the symptoms of motion sickness and reduces abnormal gastric activity"
Gastrointestinal Psychology Laboratory, Pennsylvania State University, University Park, Pa., USA.
Altern Ther Health Med 2001; 7(4):91-4

CONTEXT: Acupuncture at the P6 or Neiguan point to treat nausea and vomiting has been practiced in China for many years. More recently, acupressure at P6 has been used successfully to decrease the symptoms of pregnancy sickness and with mixed results to decrease motion sickness. OBJECTIVE: To determine whether an Acuband, a commercially available acupressure wristband, would relieve the symptoms of motion sickness. METHOD: 25 healthy subjects, aged 18 to 22 years, prescreened for susceptibility to motion sickness, were tested on 3 separate occasions in a rotating optokinetic drum with the following conditions: wearing an Acuband on the wrist, wearing an Acuband on the arm, and wearing no Acuband. MAIN OUTCOME MEASURES: Subjective symptoms of motion sickness and abnormal gastric activity, as recorded via electrogastrography, were obtained throughout the procedure. RESULTS: Subjects reported significantly fewer symptoms of motion sickness on days when wearing the Acuband on the wrist or the arm than they did on control days (when they wore no Acuband). Subjects also showed less abnormal gastric activity on the days when wearing an Acuband than they did on control days. CONCLUSION: An Acuband worn on the wrist or forearm decreases the symptoms of motion sickness and the gastric activity that usually accompanies motion sickness.

Hu S, Stritzel R, Chandler A, Stern RM.
"P6 acupressure reduces symptoms of vection-induced motion sickness"
Department of Psychology, Humboldt State University, Arcata, CA 95521, USA.
Aviat Space Environ Med 1995; 66(7):631-5

PURPOSE: The purpose of the study was to examine the effectiveness of P6 acupressure on nausea associated with visually-induced motion sickness. METHOD: There were 64 subjects randomly divided into 4 groups: P6 acupressure, dummy-point acupressure, sham P6 acupressure, and control. Each subject sat in an optokinetic drum for a 12-min baseline and 12-min drum rotation period. Subjects' electrogastrograms (EGG's) and subjective symptoms of motion sickness were obtained. RESULTS: The results indicated that the subjects in the P6 acupressure group reported significantly less nausea [F(3,60) = 8.16, p < 0.0001] during drum rotation period than those in the dummy-point acupressure, sham acupressure, and control groups. The scores for symptoms of motion sickness of the P6 acupressure group were significantly lower than those in the sham acupressure and control groups [F(3,60) = 3.49, p < 0.02]. Also, the subjects in the P6 acupressure group showed significantly less abnormal gastric myoelectric activity, tachyarrhythmia, than those in the sham acupressure and control groups [F(3,60) = 2.78, p < 0.04]. However, the subjects in the dummy-point acupressure group did not report significantly fewer symptoms and show less tachyarrhythmia than those in the sham acupressure and control groups. CONCLUSION: We conclude that P6 acupressure reduces the severity of symptoms of visually-induced motion sickness and gastric tachyarrhythmia.

Prof. Canova G
"Relazione sull'uso di un metodo antichinetosico denominato Sea Band rispetto ad una vasta casistica infantile"
Divisione Pediatrica Ospedale San Carlo Borromeo, Milano, Italia

OBIETTIVO: sperimentare metodo antichinetosico denominato Sea Band su una vasta casistica infantile. OGGETTO: Pazienti non selezionati approdati al servizio ambulatoriale o di degenza della Divisione Pediatrica dell'Ospedale San Carlo Borromeo di Milano, in età fra 2 e 15 anni, dal 31.1 al 31.3 1990, per i quali veniva riferita facilità a nausea e vomito durante i viaggi. MATERIALI E METODO: Sono state distribuite 106 coppie di bracciali in tessuto elasticizzato con inserito il bottoncino da fissare al polso; allegati uno schema chiarificatore su come applicarlo e un questionario. CONCLUSIONI: Dopo tre mesi sono stati restituiti 62 questionari (58.4%). Le risposte riguardano esclusivamente viaggi in macchina (salvo un solo caso di nave): in 55 casi (88.7%) I risultati sono da considerare ottimi, a detta dei genitori, che li hanno valutati rispetto alle esperienze precedenti. In 7 casi (11.2%) si ha avuto che: in 4 casi (6.4%) vomito nel primo o secondo dei cinque viaggi riferiti, mentre si è avuta nausea nei restanti (di questi, però, un ragazzo di 10 anni presentava epigastralgia, una ragazza di 10 anni era cefalalgica e una ragazza di 13 anni presentava disfunzione ovarica: a detta dei genitori di questi ragazzi, in occasione dei viaggi precedenti, il vomito era sempre presente. Altri 3 casi (4.8%) hanno presentato nausea in quasi tutti i viaggi effettuati, ma anche qui i genitori considerano i risultati buoni rispetto alle precedenti esperienze. CONCLUSIONI: in taluni casi si potrebbe ammettere, almeno per le prime esperienze da parte dei genitori, una imprecisa applicazione del bracciale, ma anche non volendo tener conto di errori o imprecisioni, i risultati sono da considerare ottimi. Tanto più in quanto ottenuti su casistica in cui la sola selezione era rappresentata dalla costante comparsa di vomito o nausea intensa in occasione di qualsiasi spostamento di durata anche breve. Ove si aggiunga il dato positivo dell'efficacia in così alta percentuale di casi alla assoluta, e peraltro ovvia dato il metodo impiegato, mancanza di danno o di effetti collaterali, si ritiene che il "Sea Band" possa trovare utile impiego nelle prevenzione della chinetosi infantile.

Dundee JW, Ghaly RG, Bill KM, Chestnutt WN, Fitzpatrick KT, Lynas AG.
"Effect of stimulation of the P6 antiemetic point on postoperative nausea and vomiting"
Department of Anaesthetics, Queen's University of Belfast, Ireland.
British Journal of Anaesthesia, 1989

The antiemetic action of stimulation of the P6 (Neiguan) acupuncture (ACP) point has been studied in women, premedicated with nalbuphine 10 mg, undergoing minor gynaecological operations under methohexitone-nitrous oxide-oxygen anaesthesia. Invasive ACP--manual or electrical at 10 Hz--applied for 5 min at the time of administration of the premedication markedly reduced the incidence of vomiting and nausea in the first 6 h after operation, compared with untreated controls. This did not occur with stimulation of a "dummy" ACP point outside the recognized ACP meridians. Non-invasive methods (stimulation via a conducting stud or by pressure) were equally as effective as invasive ACP during the early postoperative period. However, both these non-invasive approaches were less effective than invasive ACP in the 1-6 h postoperative period, although each was as effective as two standard antiemetics (cyclizine 50 mg, metoclopramide 10 mg). In view of the total absence of any side effects in more than 500 ACP procedures, the clinical applications of this finding are worthy of further study.

Harmon D, Ryan M, Kelly A, Bowen M.
"Acupressure and prevention of nausea and vomiting during and after spinal anaesthesia for caesarean section"
Department of Anaesthesia, Rotunda Hospital, Dublin, Ireland.
Br J Anaesth 2000; 84(4):463-7

The efficacy of acupressure at the P6 point in the prevention of nausea and vomiting during and after Caesarean section was studied. A double-blind, randomized controlled study of acupressure vs placebo was designed. Ninety-four patients scheduled for Caesarean section were included. The anaesthetic technique and postoperative analgesia were standardized. The use of acupressure reduced the incidence of nausea or vomiting from 53% to 23% compared with placebo (95% confidence interval (CI) 0.34-0.25; P = 0.002) during the operation and from 66% to 36% compared with placebo (95% CI 0.34-0.19; P = 0.003) after the operation. Other variables were similar between the groups.

lkaissi A, Stalnert M, Kalman S.
"Effect and placebo effect of acupressure (P6) on nausea and vomiting after outpatient gynaecological surgery"
Department of Anaesthesiology and Intensive Care, University Hospital in Linkoping, Sweden.
Anaesth Acta Anaesthesiol Scand 1999; 43(3):270-4

BACKGROUND: Acupuncture and acupressure have previously been reported to possess antiemetic effect. We wanted to investigate the "true" and placebo effect of acupressure in prevention of postoperative nausea and vomiting (PONV). PATIENTS AND METHODS: Sixty women undergoing outpatient minor gynaecological surgery were entered into a double-blind and randomised study. One group received acupressure with bilateral stimulation of P6 (A), a second group received bilateral placebo stimulation (P) and a third group received no acupressure wrist band and served as a reference group (R). PONV was evaluated as number of patients with complete response (no PONV), nausea only or vomiting. In addition, the need for rescue antiemetic medication and nausea after 24 h was registered. RESULTS: Complete response was obtained in 11, 11 and 9 patients in groups, A, P and R, respectively. Nine, 7 and 6 patients had nausea before discharge home, and 1, 1 and 8 patients were nauseated (8 vs 1 patient: P < 0.05) 24 h after operation in A, P and R groups, respectively. When compared to placebo acupressure (2 patients vomited and 5 needed rescue), significantly (P < 0.05) fewer needed rescue antiemetic medication after acupressure at P6 (no vomiting or rescue medication). When compared to the observation group (5 vomited and 4 needed rescue antiemetics), significantly fewer vomited after acupressure (P < 0.05) CONCLUSION: In patients undergoing brief gynaecological surgery, placebo effect of acupressure decreased nausea after 24 h but vomiting and need of rescue antiemetics was reduced only by acupressure with the correct P6 point stimulation.

Fan CF, Tanhui E, Joshi S, Trivedi S, Hong Y, Shevde K.
"Acupressure treatment for prevention of postoperative nausea and vomiting"
Department of Anesthesiology, Maimonides Medical Center, Brooklyn, New York 11219, USA.
Analg 1997; 84(4):821-5

Postoperative nausea and vomiting are still common problems after general anaesthesia, especially in ambulatory surgery. Drug therapy is often complicated with central nervous system symptoms. We studied a nonpharmacological method of therapy--acupressure--at the Pericardium 6 (P.6) (Nei-Guan) meridian point. Two hundred consecutive healthy patients undergoing a variety of short surgical procedures were included in a randomized, double-blind study: 108 patients were in the acupressure group (Group 1) and 92 patients were in the control group (Group 2). Spherical beads of acupressure bands were placed at the P.6 points in the anterior surface of both forearms in Group 1 patients, while in Group 2 they were placed inappropriately on the posterior surface. The acupressure bands were placed before induction of anaesthesia and were removed 6 h postoperatively. They were covered with a soft cotton wrapping to conceal them from the blinded observer who evaluated the patients for presence of nausea and vomiting and checked the order sheet for any antiemetics prescribed. In both groups, the age, gender, height, weight, and type and duration of surgical procedures were all comparable without significant statistical difference. In Group 1, only 25 of 108 patients (23%) had nausea and vomiting as compared to Group 2, in which 38 of 92 patients (41%) had nausea and vomiting (P = 0.0058). We concluded that acupressure at the P.6 (Nei-Guan) point is an effective prophylaxis for postsurgical nausea and vomiting and therefore a good alternative to conventional antiemetic treatment.

Gieron C, Wieland B, von der Laage D, Tolksdorf W.
"Acupressure in the prevention of postoperative nausea and vomiting"
Klinik fur Anasthesiologie, Medizinische Fakultat, RWTH Aachen.
Anaesthesist 1993; 42(4):221-6

Despite modern anaesthetic procedures, postoperative nausea and vomiting are still the side-effects most often mentioned: acupressure is reported to be an additional method of preventing these effects in minor gynaecological surgery. We investigated the effectiveness of acupressure in patients undergoing gynaecological operations of longer duration (6-8 h) in a verum acupressure group compared to a placebo group. Before beginning the study we investigated a control group to find out the frequency of emesis. In the worst case of nausea that we encountered, 80% in the 0-6 h postoperative period, the number of random samples for the acupressure and placebo groups was calculated (30 patients in each group). The error for alpha was established at 5% and the reduction of nausea was 50%. METHODS. The female patients were 18 to 65 years old (ASA group I and II). Acupressure was carried out by fastening small metal bullets at the point P 6 to each forearm by means of an elastic bandage. The bullets were left there for 24 h. The premedication anaesthesia, postoperative analgesia, and antiemetic treatment were standardized. During a 24-h period we investigated the incidence of nausea and vomiting. RESULTS. The anthropometric data, the duration of surgery and the amount of postoperative analgesia were comparable between the three groups. Verum acupressure obtained a statistically significant and relevant reduction in nausea up to the 6th postoperative hour in comparison with the placebo group (P = 0.03). Nausea was reduced from 53% in the placebo group to 23% in the acupressure group. CONCLUSION. As demonstrated in this group of longer gynaecological surgery patients as well as in chemotherapy-induced nausea and vomiting, we were able to demonstrate that acupressure is an effective method of preventing nausea and vomiting without any side-effects. It is a valuable addition to the prevention of postoperative nausea and vomiting. Further studies should be conducted to investigate this possibility further.

Sacco JJ, Grant WD, Kamps CA
"Evaluation of acupressure in the reduction of post-surgical nausea and vomiting"
St. Joseph's Hospital Health Care, Syracuse, New York, USA.

OGGETTO E METODO: Nel presente studio sono state valutate le tecniche non invasive di acupressione nella riduzione di nausea, vomito e mal di testa in seguito a chirurgia, in 73 pazienti trattate in ordine consecutive, sottoposte a dilatazione e curettage mediante laparoscopia, oppure sottoposte a chirurgia ginecologica con laser, in ambiente ambulatoriale. OBIETTIVO: Lo scopo dello studio era quello di valutare l'utilità di un dispositivo per applicazione di acupressione in punti specifici sulla superficie volare dei polsi, in modo da ridurre l'entità di nausea e diminuire il vomito e il mal di testa, in pazienti sottoposte a questo tipo di procedura chirurgica. RISULTATI: confrontate con le pazienti che non hanno adoperato il dispositivo, o che hanno utilizzato un dispositivo simile ma privo di acupressione attiva, nel gruppo di acupressione attiva ci furono considerevolmente meno donne che hanno riferito nausea, vomito e mal di testa. Dopo il controllo degli effetti post-chirurgia (dopo 24 ore), analisi dei gruppi sperimentali e altri fattori, è stato possibile stabilire che l'uso di questo dispositivo riduce alcuni sintomi negativi che si verificano in seguito ad interventi chirurgici.

Ghaly RG, Lynas AGA, Dundee JW
"Acupuncture also reduces the emetic effect of pethidine"
Department of Anaesthetics, The Queen's University of Belfast, EIRE
Pubblicato negli "Atti della Società di Ricerca in Anestesia" pp. 135p

Precedenti studi effettuati presso questo reparto hanno dimostrato che l'agopuntura manuale al punto di agopuntura P6 (Neiguan) riduce significativamente l'incidenza di nausea/vomito pre-chirurgia, in pazienti pre-anestetizzati con 100 mg di Meptazinol (Chestnutt e Dundee 1985), e Nalbufina 10 mg (Lynas, Ghaly e Dundee 1986), prima di essere sottoposti a brevi interventi chirurgici di routine, mediante l'ausilio di un anestetico standard. Meptazinol e Nalbufina sono oppiacei altamente emetici, poco utilizzati come pre-anestetici. Comunichiamo qui di seguito i risultati di un'indagine randomizzata simile, sull'utilizzazione di Petidina 100 mg, un farmaco più ampiamente adottato, la cui azione emetica insorge precocemente ma è di durata più breve (Dundee, Clarke e Loan, (1965). È stato adoperato lo stesso metodo degli studi sopraccitati, ad eccezione del numero dei pazienti ammessi che è stato di 30 per ciascuno gruppo. Dopo somministrazione i.m. della pre-anestesia, uno dei due gruppi è stato sottoposto a 5 minuti di agopuntura manuale, mentre l'altro è stato utilizzato come controllo (senza cioè alcun trattamento associato). L'anestetico somministrato in seguito era composto da: metoessitone-ossido nitroso-ossigeno. È stata riscontrata una significativa riduzione globale (P<0.05) per quanto riguarda i postumi emetici sia pre-chirurgici che post-chirurgici, nei pazienti sottoposti ad agopuntura, rispetto a quelli nel gruppo di controllo. Questo risultato è stato riscontrato anche per quanto concerne i postumi emetici pre-chirurgici, che si sono verificati in 17 pazienti trattati solo con Petidina, mentre tali effetti si sono evidenziati in 9 pazienti soltanto quando la somministrazione del farmaco è stata associata all'agopuntura.

Dundee JW, Chestnutt WN, Ghaly RG, Lynas AG.
"Traditional Chinese acupuncture: a potentially useful antiemetic?"
Department of Anaesthetics, The Queen's University of Belfast, EIRE
British Medical Journal 1986 Sept

Two consecutive studies were undertaken to evaluate the effectiveness of acupuncture as an antiemetic used in addition to premedication with opioids in patients undergoing minor gynaecological operations. In the first study 25 of the 50 patients underwent acupuncture immediately after premedication with 100 mg meptazinol, the rest receiving the drug alone, and in the second 75 patients were allocated randomly to one of three groups: a group receiving 10 mg nalbuphine and acupuncture, a group receiving premedication and dummy acupuncture, and a group receiving premedication alone. Manual needling for five minutes at the P6 acupuncture point (Neiguan) resulted in a significant reduction in perioperative nausea and vomiting in the 50 patients who underwent acupuncture compared with the 75 patients who received no acupuncture. These findings cannot be explained, but it is recommended that the use of acupuncture as an antiemetic should be explored further.

Prof. Palmieri B
"Incidenza di nausea e vomito in una popolazione sottoposta ad interventi chirurgici e sua profilassi con un metodo alternative non farmacologico, non invasivo"
Cattedra di Semiotica Chirurgica, Università degli Studi di Modena, Italia

MATERIALI E METODI: Lo studio si è articolato su un gruppo di 150 pazienti operati press oil Policlinico di Modena dal 1.1.1990 al 15.7.1991 con tecniche chirurgiche di durata breve. I pazienti furono suddivisi in 3 gruppi secondo un protocollo di randomizzazione, preliminarmente venne indagata nella anamnesi recente e remota, la presenza di facilità alla nausea ed al vomito, spontanea, mattutina o in relazione a gravidanza, stress o precedenti interventi chirurgici. Il protocollo anestesiologico per tutti i pazienti trattati è consistito nella induzione di pentotal seguita da miscele di protossido ed ossigeno più forane all'1%. Ai pazienti del gruppo A venne fatto indossare il bracciale Sea band; ai pazienti del gruppo B venne fatto indossare un bracciale in tutto simile al primo, ma arrovesciato in modo che nessuna pressione venisse esercitata nel punto P6 di ogni avambraccio. I pazienti del gruppo C, infine, non venivano sottoposti ad alcun trattamento. L'osservazione del paziente era procrastinata fino a 24 ore, anche durante e dopo il suo ritorno in corsia, ogni 20 minuti per le prime 4 ore e successivamente ogni 8 ore per le successive 18. Furono registrate: l'assenza di sintomi, la presenza di nausea, conati di vomito, vomito franco. RISULTATI: Si elaborarono sui risultati alcune semplici indagini statistiche in chi-quadrato e l'analisi della varianza per i tre gruppi: la significatività statistica fu posta allo 0,05. I tre gruppi di pazienti esaminati risultarono simili per età, altezza, peso e durata del procedimento anestesiologico medio, parametri vitali. 5 pazienti del gruppo trattato hanno sviluppato sintomi, contro i 28 del gruppo placebo e i 22 del gruppo di osservazione; il chi-quadrato è di stao di 27,08; il p è inferiore a 0,01; il trattamento con Sea Band non ha indotto alcun fenomeno di intolleranza o alcuno spiacevole side-effect e si è dimostrato in grado di controllare, prevenendoli, i sintomi chinetosici legati all'anestesia. I sintomi, una volta innescati, non sono stati in alcun modo attenuati dal trattamento ed è stato necessario, nei casi di forte vomito e nausea, intervenire con sedativi antiemetici.

Bill Km, Dundee JW
"Acupressure for post-operative nausea and vomiting"
Department of Anaesthetics, the Queen's University of Belfast, EIRE

PURPOSE: To investigate the effect of P6 acupressure (ACPx) on post-operative nausea and vomiting after minor gynaecological surgery. METHOD: 31 fit women were premedicated with nalbuphine 10 mg IM and given a standard methohexitone-nitrous oxide-oxigen anaesthetic, for a 7-15 min minor gynaecological operation. After the premdicant had been administered, a commercially available "Sea Band" band was placed on the right P6 point and pressure was immediately applied for 5 min to the stud. The patients were assessed for nausea and vomiting at 1 and 6 h postoperatively. RESULTS: The results demonstrate a highly significant reduction in sickness in the first post-operative hour (p<0.001), ACPx being as effective as standard anti-emetics in this period. The benefit over the next 5 h was not marked (p<0.1). In a few patients the nausea was abolished by pressure on the stud.

Barsoum G, Perry EP, Fraser IA.
"Postoperative nausea is relieved by acupressure"
Department of Surgery, Walsgrave General Hospital, Coventry.
Journal of The Royal Society of Medicine, Volume 83, February 1990

One hundred and sixty-two general surgical patients were prospectively randomized to one of three treatments for postoperative nausea and vomiting: (1) acupressure using elasticated bands containing a plastic button to apply sustained pressure at the P6 (Neiguan) point above the wrist, (2) control dummy bands without the pressure button and (3) antiemetic injections of prochlorperazine with each opiate given and as required. All patients received papaveretum injections as required for pain, and additional prochlorperazine injections were prescribed if nausea was not controlled in groups 1 and 2. The severity of nausea was assessed using a linear analogue scale and was significantly (P = 0.002) reduced by acupressure on both days 1 and 2, in comparison to both controls and drug treated patients. The incidence of postoperative vomiting, and the need for unplanned antiemetic injections was also reduced by acupressure but this was not statistically significant. Acupressure can work and should be investigated in other clinical situations.

Phillips K.
"The use of simple acupressure bands reduces post-operative nausea"
Leicester Gill. B. Sc. (England), M.Sc.

PURPOSE: a trial of the use of Sea-Bands to off set post operative nausea. OBJECTIVES and METHOD: a randomised trial using 80 gynaecological surgery cases, since tha patients are anecdotally regarded as "sick". 40 of the patients were invited to have sustained acu-pressure using Sea Bands and the remaining 40 were matched on age and type of operation and used as a control group. They were not offered any alternative pre-operative treatment. Those taking part in the study were asked to asses their level of nausea on a linear analogue scale 2 days post operatively i.e. to make a mark on a scale going from "terrible sick" (value 10) to "not sick at all" (value 0). The level of sickness was assessed by measuring the total reduction in the amount of anti-emetic drugs used post-opeartively. RESULTS: After statistical analysis the study clearly demonstrated that patients wearing the bands had significantly reduced nausea and vomiting, were sick for a shorter time and had fewer doses of anti-emetics than the control group. Those patients wearing Sea Bands receveid 15.5% less doses of anti-emetics drugs

Harmon D, Gardiner J, Harrison R, Kelly A.
"Acupressure and the prevention of nausea and vomiting after laparoscopy"
Department of Anaesthesia, Rotunda Hospital, Dublin, Ireland.
Br J Anaesth 1999; 82:387-90

The efficacy of currently available antiemetics remains poor. Concern with their side effects and the high cost of the newer drugs has led to renewed interest in non-pharmacological methods of treatment. We have studied the efficacy of acupressure at the P6 point in the prevention of nausea and vomiting after laparoscopy, in a double-blind, randomized, controlled study of acupressure vs placebo. We studied 104 patients undergoing laparoscopy and dye investigation. The anaesthetic technique and postoperative analgesia were standardized. Failure of treatment was defined as the occurrence of nausea and/or vomiting within the first 24 h after anaesthesia. The use of acupressure reduced the incidence of nausea or vomiting from 42% to 19% compared with placebo, with an adjusted risk ratio of 0.24 (95% CI 0.08-0.62; P = 0.005). Other variables were similar between groups.

Alkaissi A, Ledin T, Odkvist LM, Kalman S.
"P6 acupressure increases tolerance to nauseogenic motion stimulation in women at high risk for PONV."
Department of Anaesthesiology and Intensive Care, University Hospital in Linkoping, SE-581 85 Linkoping, Sweden.
Can J Anaesth. 2005 Aug; 52(7): 703-9

PURPOSE: In a previous study we noticed that P6 acupressure decreased postoperative nausea and vomiting (PONV) more markedly after discharge. As motion sickness susceptibility is increased by, for example, opioids we hypothesized that P6 acu-pressure decreased PONV by decreasing motion sickness susceptibility. We studied time to nausea by a laboratory motion challenge in a group of volunteers, during P6 and placebo acupressure. METHODS: 60 women with high and low susceptibilities for motion sickness participated in a randomized and double-blind study with an active P6 acupressure, placebo acupressure, and a control group (n = 20 in each group). The risk score for PONV was over 50%. The motion challenge was by eccentric rotation in a chair, blindfolded and with chin to chest movements of the head. The challenge was stopped when women reported moderate nausea. Symptoms were recorded. RESULTS: Mean time to moderate nausea was longer in the P6 acu-pressure group compared to the control group. P6 acupressure = 352 (259-445), mean (95% confidence interval) in seconds, control = 151 (121-181) and placebo acupressure = 280 (161-340); (P = 0.006). No difference was found between P6 and placebo acupressure or placebo acupressure and control groups. Previous severity of motion sickness did not influence time to nausea (P = 0.107). The cumulative number of symptoms differed between the three groups (P < 0.05). Fewer symptoms were reported in the P6 acupressure compared to the control group P < 0.009. Overall, P6 acupressure was only marginally more effective than placebo acupressure on the forearms. CONCLUSION: In females with a history of motion sickness P6 acu-pressure increased tolerance to experimental nauseogenic stimuli, and reduced the total number of symptoms reported.

Alkaissi A, Evertsson K, Johnsson VA, Ofenbartl L, Kalman S.
"P6 acupressure may relieve nausea and vomiting after gynecological surgery: an effectiveness study in 410 women"
Department of Anaesthesiol. and Intensive Care, Univ. Hospital in Linkoping, Linkoping, Sweden.
Can J Anaesth. 2002; 48:1034-1039

PURPOSE: To investigate the effect of sensory stimulation of the P6 point on postoperative nausea and vomiting (PONV) after gynecological surgery in the everyday clinical setting (effectiveness study). METHODS: Four hundred and ten women undergoing general anesthesia for elective gynecological surgery were included in a prospective, consecutive, randomized, multicentre, placebo-controlled, double-blind clinical trial with a reference group. One group was given bilateral P6 acupressure (n = 135), a second group similar pressure on bilateral non-acupressure points (n = 139), and a third group (n = 136) served as reference group. Nausea (scale 0-6), vomiting, pain, and satisfaction with the treatment were recorded. Primary outcome was complete response, i.e., no nausea, vomiting or rescue medication for 24 hr. Results were analyzed by applying logistic regression with indicators of treatments, type of operation and risk score for PONV as explanatory variables. RESULTS: Complete response was more frequent in the P6 acupressure group than in the reference group (P = 0.0194) Conversely, the incidence of PONV was 46% in the reference group, 38% after pressure on a non-acupoint and 33% after P6 acupressure. The decrease from 46% to 33% was statistically significant. When considering vaginal cases separately, the decrease in PONV was from 36% to 20% (P = 0.0168). The corresponding decrease from 59% to 55% in the laparoscopic surgery group was not statistically significant. CONCLUSION: P6 acupressure is a non-invasive method that may have a place as prophylactic antiemetic therapy during gynecological surgery.

Dundee JW, Sourial FB, Ghaly RG, Bell PF.
"P6 acupressure reduces morning sickness"
Department of Anaesthetics, Queen's University, Belfast, EIRE
JR Soc Med 1988, 81:456-7

OGGETTO E METODO: 350 donne nella fase iniziale della gravidanza sono state divise in tre gruppi: (1) acupressione esercitata su PC 6, (2) acupressione esercitata su un punto placebo, (3) nessuna terapia. RISULTATI: Dopo quattro giorni di osservazione sono stati valutati i risultati: il gruppo 1, sottoposto a vera acupressione, mostrava una significativa riduzione della sintomatologia rispetto al gruppo 2 (p<0-01). Tale riduzione era ancor più evidente nei confronti del gruppo 3 non sottoposto ad alcuna terapia (p<0.0005). la significatività della differenza tra i risultati dei gruppi 1 e 2 dimostra l?effetto antiemetico dell'acupressione.

Colleen Stainton M, Neff JA
"The efficacy of Seabands for the control of nausea and vomiting in pregnancy"
Faculty of Nursing, University of Calgary, Canada
School of Nursing, East Carolina University, USA
Pregnancy Healthcare Women Int, 1994; 15:563-75

OGGETTO E METODO: 27 donne gravide (tra la 5° e la 22° settimana di gestazione) sono state sottoposte ad applicazione di Sea Band allo scopo di controllare la sintomatologia dell'iperemesi gravidica. RISULTATI: I risultati evidenziano una netta riduzione della nausea (50%), del vomito (50%) e dei conati (33%). Nel 31% delle donne vi è stata la scomparsa della sintomatologia, nel 60% il miglioramento e solamente nel 8% non si sono avute variazioni. La terapia si è dimostrata assai più efficace se praticata all'insorgere della sintomatologia.

De Aloysio D, Pennacchioni P
"Effetto antiemetico nella gravidanza al primo trimestre dell'acupressione sul punto Nei-Kuan"
Clinica Ostetrica e Ginecologica III, Università di Bologna, Italia
Obstet Gynaecol 1992; 80(5): 852-4

OGGETTO E METODO: Lo studio randomizzato e controllato, eseguito in cross-over, è consistito nell'osservazione di due gruppi di 30 donne nel primo trimestre di gravidanza. I due gruppi sono stati sottoposti per 12 giorni all'applicazione di Sea Band e, per un uguale periodo, all'applicazione di Sea Band placebo (con bottone limitato). RISULTATI: I risultati hanno evidenziato un significativo miglioramento (p<0.05) della sintomatologia nel periodo in cui è stato applicato Sea Band rispetto al placebo. Non si sono, invece, riscontrate differenze di risultato nei sottogruppi in cui Sea Band era stato applicato solamente a destra o sinistra rispetto a quello in cui era posizionato bilateralmente.

Hyde E
"Acupressure therapy for morning sickness"
American College of Nurse.Midwives, USA
J Nurse Midwifery 1989; 34:171-8

OGGETTO E METODO: Lo studio randomizzato e controllato è stato condotto in cross-over su 16 donne nei primi tre mesi di gravidanza, alle quali è stato applicato bilateralmente Sea Band una settimana alternativamente ai polsi (su Neiguan) e sui gomiti (placebo). RISULTATI: i risultati dimostrano una significativa riduzione della sintomatologia nel periodo in cui le pazienti erano sottoposte alla corretta applicazione Sea Band rispetto al placebo (p<0.25)

Bayreuther J, Lewith GT, Pickering R
"An evaluation of the use of Sea Bands in alleviating the nausea and vomiting of early morning sickness"
Faculty of Medicine Southampton University, England
Complement Ther Med 1994; 2:70-76

PURPOSE: to assess by means of a blindy evaluated crossover study if acupressure at the P6 wrist point (active) is more effective than acupressure at the elbow (placebo) in reducing the nausea and vomiting in pregnancy. METHOD: women were concacted through various Southampton G.P.s and women were given to pregnant women between 18-35 years. The women were randomly allocated to one of two groups, to wear Sea Bands on both wrists for seven days and then on both elbows for seven days, or visa-versa. Symptoms were recorded on daily visual analogue cards. There was a questionnaire to be completed at the beginning and the end of the two weeks. The credibility of the placebo was also assessed. RESULTS: results show a significant decrease in nausea with acupressure at P6 compared to the placebo. Women were initially equally hopeful of both treatments working. They were significantly more confident in recommending P6 acupressure after treatment. CONCLUSION: P6 acupressure is a good method of nausea control in pregnancy. A point further up the arm is a credible placebo.

Norheim AJ, Pedersen EJ, Fonnebo V, Berge L.
"Acupressure treatment of morning sickness in pregnancy. A randomised, double-blind, placebo-controlled study"
Havnegata General Practice, Harstad, Norway.
Scand J Prim Healthcare 2001(1); 19:43-7

OBJECTIVE: To find out whether acupressure wristband can alleviate nausea and vomiting in early pregnancy. DESIGN: Double-blind, placebo-controlled study. SUBJECTS: 97 women with mean gestational length completed 8-12 weeks. MAIN OUTCOME MEASURES: Symptoms were recorded according to intensity, duration and nature of complaints. RESULTS: 71% of women in the intervention group reported both less intensive morning sickness and reduced duration of symptoms. The same tendency was seen in the placebo group, with 59% reporting less intensity and 63% shorter duration of symptoms. However, a significance level of 5% was reached only in the case of duration of symptoms, which was reduced by 2.74 hours in the intervention group compared to 0.85 hours in the placebo group (p = 0.018). CONCLUSIONS: Acupressure wristband might be an alternative therapy for morning sickness in early pregnancy, especially before pharmaceutical treatment is considered.

Lin MH, Yang YC, Wang KG
"Effect of P6 acupressure on morning sickness"
Department of Obs. and Gyn., Mackay Memorial Hospital, Taipei, Taiwan

PURPOSE: A prospective study was undertaken to value the effectiveness of pressure at P6 (Neiguan) acupuncture point in preventing morning sickness. OBJECTIVES AND METHOD: Three groups of patients in early pregnancy recorded the severity and frequency of sickness over a period of 7 consecutive days following daily pressure at P6 point, pressure at other point of forearm and no treatment. RESULTS: A significant difference between the severity of sickness in the control group and those having P6 acupressure and a significant difference between the controls and the Dummy acupressure series. Sickness was significantly less severe in patients practising P6 acupressure than in those using a Dummy point. No side effect occurred in patients practising p6 acupressure and while anticipation of benefit may offer a partial explanation for the findings, pressure at the Neiguan point appears to have a specific therapeutic effect.

Werntoft E, Dykes AK.
"Effect of acupressure on nausea and vomiting during pregnancy. A randomized, placebo-controlled, pilot study"
Department of Nursing, Unit of Caring Sciences, Lund University, Lund, Sweden.
J Reprod Med 2001; 46:835-839

OBJECTIVE: To compare the antiemetic effect of acupressure at the Neiguan point (P6) in a group of healthy women with normal pregnancy and nausea and vomiting during pregnancy (NVP) with a similar group receiving acupressure at a placebo point and another, similar group not receiving any treatment. STUDY DESIGN: A randomized, placebo-controlled, pilot study involving 60 women. RESULTS: It is possible to reduce NVP significantly with acupressure at P6 as compared to acupressure at a placebo point or no treatment at all in healthy women with normal pregnancies. Relief from nausea appeared one day after starting treatment in both the P6 and placebo groups but lasted for only six days in the placebo group. The P6 group, however, experienced significantly less nausea after 14 days as compared to the other two groups. CONCLUSION: This study involved 60 healthy women with normal pregnancy and suffering from NVP. According to the results, in healthy women with normal pregnancy it is possible to reduce NVP significantly at P6 as compared to acupressure at a placebo point and to no treatment.

De Paoli F, Bossi C, Colombo F
"Gli effetti dell'acu-pressione sulla nausea ed il vomito in gravidanza: risultati di uno studio clinico prospettico randomizzato a doppio cieco"
Divisione Ostetrica e Ginecologica, Azienda Osped. Sant'Anna, Como, Italia
Estratto da terapie non Convenzionali nella Medicina della Riproduzione, Modena 23 Nov 2002

OBIETTIVO: confrontare l'effetto anti-emetico dell'acu-pressione nel punto P6 in un gruppo di giovani donne gravide. TIPO DI STUDIO: Studio prospettico randomizzato a doppio cieco. MATERIALI E METODI: Due differenti gruppi randomizzati di giovani gravide sono stati reclutati. Nel Gruppo A è stata esercitata acu-pressione nel punto p6 mentre nel gruppo B l'acu-pressione è stata esercitata in un punto, considerabile come "placebo". RISULTATI: nei 15 giorni di follow-up successivi al posizionamento del Sea-Band sono stati registrati i seguenti risultati: nel Gruppo A (attivo) il 74% delle gravide ha riferito una significativa (p<0.05) riduzione dlla frequenza di comparsa della nausea rispetto al solo 57% del gruppo placebo (Gruppo B). La scomparsa della nausea si è avuta rispettivamente nel 47% delle gravide del gruppo A, e nel 12% di quelle del Gruppo B (p<0.003). Similmente e soprattutto nel Gruppo A, si è riscontrato un marcato decremento sia della frequenza (83% vs 38% nel Gruppo B, p<0.001) sia della quantità (81% vs 34% nel Gruppo B, p<0.001) di vomito mattutino. CONCLUSIONI: si ritiene ragionevole concludere che l'acu-pressione di P6, mediante Sea-Band, possa considerarsi un adeguato trattamento della nausea e vomito mattutini nella gravida sia per la pressoché totale assenza di tossicità, sia per la sua facilità di utilizzo (correlata per altro ad un'elevata compliance da parte delle gravide).

Neri I, Blasi I, Facchinetti F
"Acupuncture versus pharmacological approach to reduce Hyperemesis gravidarum discomfort"
Departments of Obs and Gyn Universities Modena-Reggio Emilia and Turin, Italy
Minerva Ginecologica 2005; 57:471-5

OBIETTIVO: Numerosi studi hanno suggerito un possibile uso dell'agopuntura in caso di iperemesi gravidica, sottolineando in particolare gli effetti sulla riduzione della nausea. Lo scopo di questo è confrontare l'efficacia del trattamento agopuntura/agopressione con quella del trattamento con metoclopramide. METODI: In questo studio 88 pazienti gravide affette da iperemesi sono state randomizzate a ricevere un trattamento di agopuntura/agopressione (gruppo agopuntura) oppure un trattamento farmacologico a base di metoclopramide/vitamine del complesso B12 (gruppo metoclopramide). Sono stati valutati sia i sintomi fisici, sia la capacità delle pazienti di attendere alle attività quotidiane (functioning). L'agopuntura è stata praticata secondo i criteri e le prescrizioni della medicina tradizionale cinese: 2 sedute in ospedale a settimana per 2 settimane. Le pazienti sono state, inoltre, invitate a indossare a domicilio per 6-8 h al giorno i dispositivi Sea-Band in grado di esercitare agopressione.Il gruppo randomizzato a ricevere il trattamento farmacologico ha invece eseguito infusioni di metoclopramide (20 mg/500 fisiologica/60 min) sempre a scadenza bisettimanale per 2 settimane. Alle pazienti è stato, inoltre, consigliato di assumere a domicilio un complesso vitaminico B12 (30 mg/die). RISULTATI: I due tipi di trattamento si sono dimostrati ugualmente efficaci nel ridurre gli episodi di vomito e l'intensità della nausea con un conseguente aumento della quantità di cibo ingerito. L'effetto dell'agopuntura si è manifestato progressivamente con il raggiungimento dell'efficacia massima a fine trattamento, mentre la terapia farmacologia ha mostrato un effetto più immediato ma stabile nel tempo. Per quanto riguarda il functioning, l'agopuntura si è rivelata maggiormente efficace nel migliorare l'attività sia lavorativa che famigliare. CONCLUSIONI: Per la prima volta l'effetto dell'agopuntura è stato comparato a quello dei farmaci nel ridurre la sintomatologia in corso di iperemesi gravidica dimostrando che, per quanto riguarda i sintomi fisici, l'effetto dei due trattamenti è simile. L'agopuntura mostra, invece, una capacità superiore nel migliorare l'impatto della sintomatologia sulla vita famigliare e lavorativa.

Dundee JW, Yang J.
"Prolongation of the antiemetic action of P6 acupuncture by acupressure in patients having cancer chemotherapy"
Northern Ireland Radiotherapy Centre, Belvoir Park Hospital, Belfast.
J R Soc Med 1990; 83(6):360-2

Previous work from our department has shown that P6 acupuncture is an effective adjuvant to conventional antiemetic therapy for patients having cytotoxic drugs. However, its efficacy is limited to about 8 h. The current studies show that the application of an elasticized wrist band with a stud placed over the acupuncture point, and pressed regularly every 2 h, will prolong the antiemetic action for 24 h. This proved more effective in hospitalized patients (20/20) than in outpatients (15/20), presumably due to the encouragement given to regularly press the stud. Nausea and vomiting remain problems with cancer chemotherapy despite the use of antiemetics. Following encouraging results with P6 acupuncture (ACP) in postoperative sickness this has been shown to be effective in cancer chemotherapy in 105 patients who, despite the use of conventional antiemetics had been sick following the previous treatment. Electrical stimulation (10 Hz DC) of P6 point for 5 min before administration of the cytotoxic drugs was effective in preventing sickness in 66% and only 6% got no benefit. The ACP was given with the antiemetics which the patients had been receiving. Although there were no side effects with the ACP, the benefit only lasted 6-8 h. This was not important in hospitalized patients where the treatment could be repeated, but was a problem with outpatients. It has been shown that pressure on the P6 point (acupressure) has an antiemetic action. A commercially available elasticized band with a plastic stud (Sea Band) is an effective method of applying pressure to P6 point.(ABSTRACT TRUNCATED AT 250 WORDS)

Dundee JW, Ghaly RG et all.
"Acupuncture to prevent cisplatin-associated vomiting"
Department of Anaesthetics, The Queen's University of Belfast, EIRE.
Lancet, May 9, 1987

OBIETTIVO: dimostrare l'effetto antiemetico dell'agopuntura sul vomito e sulla nausea post-chirurgica. Il Cisplatino è un agente efficace nel trattamento del cancro, tuttavia la nausea ed il vomito associati a tale trattamento possono rivelarsi talmente gravi da indurre alcuni pazienti a rifiutare ulteriori terapie. STUDIO: studio sull'elettroagopuntura effettuato in pazienti affetti da nausea/vomito associati a Cisplatino. MATERIALI E METODI: lo studio è stato condotto in 10 pazienti trattati con una infusione contenente 30 mg di Cisplatino costituente parte di un regime posologico per il trattamento del cancro testicolare. Tutti i pazienti avevano già riscontrato nusea/vomito in seguito ad un precedente corso terapeutico, nonostante la somministrazione di Metoclopramide. I pazienti scelti in ordine randomizzato sono stati sottoposti ad agopuntura al punto P6 (Neiguan) oppure in un punto falso situato vicino al gomito destro. L'elettroagopuntura è stata praticata mediante uno stimolatore a corrente continua (frequenza 10 Hz, larghezza impulso 0,25 ms). Ad ogni paziente sono state praticate 5 o 6 agopunture durante un arco di 3 giorni, du cui una soltanto effettuata nel punto falso. L'agopuntura veniva praticata con intervalli di ameno 8 ore tra un'applicazione e l'altra. I pazienti ignoravano se la stimolazione venisse praticata nel punto P6 oppure nel punto falso. RISULTATI: È stata riscontrata una diminuzione significativa per quanto riguarda nausea/vomito dopo l'agopuntura al P6 rispetto all'applicazione nel punto falso (p<0.001). Non è stato riscontrato alcun effetto collaterale attribuibile all'agopuntura. CONCLUSIONI: si è certi che i risultati con l'agopuntura rappresentino una reale riduzione negli effetti emetici del Cisplatino. Nonostante l'efficacia, l'agopuntura al P6 richiede tempo. Possibile rendere tale pratica più semplice chiedendo al paziente di praticarla su se stesso, oppure adottando l'acupressione.

Dibble SL, Chapman J, Mack KA, Shih AS.
"Acupressure for nausea: results of a pilot study"
Institute for Health and Aging, University of California, San Francisco, USA.
Oncol Nurs Forum 200; 2781):41-7

PURPOSE/OBJECTIVES: To compare differences in nausea experience and intensity in women undergoing chemotherapy for breast cancer between those receiving usual care plus acupressure training and treatment and those receiving only usual care. DESIGN: Single-cycle, randomized clinical trial. SETTING: Outpatient oncology clinic in a major teaching medical center and a private outpatient oncology practice. SAMPLE: Seventeen women participated in the study. The typical participant was 49.5 years old (SD = 6.0), Caucasian (59%), not married/partnered (76%), on disability (53%), born a U.S. citizen (76%), and heterosexual (88%); lived alone (59%); had at least graduated from high school (100%); and had an annual personal income of $50,000 or greater (65%). METHODS: The intervention included finger acupressure bilaterally at P6 and ST36, acupressure points located on the forearm and by the knee. Baseline and poststudy questionnaires plus a daily log were used to collect data. MAIN RESEARCH VARIABLES: Nausea experience measured by the Rhodes inventory of Nausea, Vomiting, and Retching and nausea intensity. FINDINGS: Significant differences existed between the two groups in regard to nausea experience (p < 0.01) and nausea intensity (p < 0.04) during the first 10 days of the chemotherapy cycle, with the acupressure group reporting less intensity and experience of nausea. CONCLUSIONS: Finger acupressure may decrease nausea among women undergoing chemotherapy for breast cancer. IMPLICATIONS FOR NURSING PRACTICE: This study must be replicated prior to advising patients about the efficacy of acupressure for the treatment of nausea.

De Martini G, Bonomi P.
"Uso di Sea-Band nel paziente neoplastico terminale"
Ambulatorio Ospedale San Martino, Genova, Italia.
Studio per l'Associazione Gigi Ghirotti a Genova, Italia

Nel paziente neoplastico in fase terminale la nausea e il vomito si presentano con una frequenza che varia secondo le diverse casistiche: dal 38% di Twycross, al 55% di Doyle, al 60% di Cassileth. In uno studio compiuto su 734 nostri pazienti è risultato che nel 60% la causa era riferibile ai farmaci analgesici impiegati. (Atti del Congresso Nazionale della Società Italiana di Cure Palliative. Milano, 16 Dicembre 1989.) L'azione emetizzante degli oppiacei si manifesta per azione diretta sul centro del vomito ed i farmaci di scelta sono spesso quelli ad azione centrale. Tuttavia ciò comporta spesso un abbassamento ulteriore dello stato di coscienza dovuto all'interazione con i derivanti dell'oppio, cosa non sempre gradita dall'ammalato in quanto si trova impedito a svolgere quel minimo di attività di relazione rimaste: leggere il giornale, guardare la televisione, conversare, ecc. La possibilità di agire direttamente sul centro del vomito senza somministrare farmaci ma sfruttando la compressione di un punto classico dell'agopuntura tradizionale cinese a ciò deputato, ci è sembrata un'idea interessante da verificare clinicamente. * Il punto di NEIGUAN (letteralmente: passaggio interno) corrisponde al punto P6 del meridiano di ministro del cuore e si trova circa 8 cm al di sopra della piega del polso, tra il tendine del palmare lungo e quello del flessore radiale del carpo. * Il bracciale denominato SEA-BAND consiste in un braccialetto elastico contenente al centro una piccola sfera rigida che va a comprimere il punto di Neiguan. I pazienti a cui sono stati applicati bilateralmente i Sea-Band erano tutti portatori di neoplasia in fase terminale: 5 tumori polmonari, 1 melanoma del dorso, 2 tumori del massiccio facciale, 1 tumore della mammella, 1 tumore del pancreas. Tutti i dieci pazienti erano in trattamento con morfina per os a dosaggi variabili da 20 a 240 mg/die. Nessun farmaco antiemetico è stato somministrato durante il periodo di osservazione che si è protratto da un minimo di sei giorni a un massimo di trenta. La durata del periodo è stata influenzata o dalla morte del paziente o dal suo trasferimento in altra città. L'applicazione dei bracciali è avvenuta sempre in sostituzione di un trattamento farmacologico antiemetico in corso.

Dundee JW, Abram WP
"P6 Acupuncture, an effective non-toxic anti-emetic in cancer chemotherapy"
Northern Ireland Radiotherapy Centre, Montgomery House, Belvoir Park Hospital, Belfast, EIRE.

Nausea and vomiting, ever present problems in cancer chemotherapy, are often not controlled by standard anti-emetics. In 105 patients, receiving a variety of agents, whose sickness persisted despite anti-emetics, we proceeded the next course of therapy with P6 electro acupuncture (ACP) and continued the anti-emetics as before. Symptoms were completely relieved in 66 patients, with a further 33 having marked reduction in sickness i.e. 94% success. Three patients who had dropped out from cisplatin therapy because of sickness were persuaded to try ACP and completed their treatment with little sickness. A limited cross over showed a point at R elbow to be ineffective as anti-emetic. The anti-emetic action of invasive P6 ACP lasts 6-8 hours and this can be prolonged to 24 hours by application of a Sea Band, elasticated band with a stud which is placed over p6 point and pressed for 5 minutes every 2 hour by the patients. This has been effective in 21725 patients studied. There were no side effects associated with this simple anti-emetic therapy. To be effective, ACP must be applied 5-10 minutes before chemotherapy, which is much shorter than the time for standard anti-emetics.

Sergiou K
"An evaluation of the Sea-Band in alleviating nausea and vomiting in patients receiving chemotherapy"
Department of Medical Oncology University of Southampton.

PURPOSE: To assess by means of a single blind cross-over model if acupressure by Sea-Band on Wrist point (active) versus acupressure on an ankle point (sham) reduces nausea and vomiting in patients receiving chemotherapy. METHOD: Patients receiving chemotherapy at the RSH Hospital were asked to participate in the study during their next two treatments. For one treatment they wore the bands on both wrists continuously for seven days, and for the other treatment they wore the bans on both ankles. The ankle and wrist treatments were randomised. While wearing the bands the patients were asked to record their symptoms daily in a diary card. After wearing the bands at both sites the patients were asked to complete a questionnaire concerning their preference for the wrist versus ankle treatments. Throughout the study the patients still received their usual pharmacological anti-emetics. RESULTS: 105 patients entered the study; 67 patients completed the study, 38 patients withdrew. Questionnaire analysis found that 49% of patients found P6 acupressure provided better control of nausea and vomiting, 17% found sham acupressure provided better control and 34% found no difference between the two. The diary cards indicated that P6 was more effective than sham acupressure in alleviating sickness, nausea, mood and overall condition in the high emetic intensity group. CONCLUSION: P6 acupressure is a good method to complement conventional anti-emetic therapy for people having chemotherapy, particularly that of a high emetic intensity. It is recommended that it should be included into a standard anti-emetic protocol for chemotherapy, subject to further work on it.

Denise M Stannard SRN
"Use of acupressure bands in Chemotherapy"
Tehidy Hospital, Camborne, Cornwall

INTRODUCTION: Being a sailor and nurse he became aware of the comparison of sea sickness and the nausea and vomiting for chemotherapy patients and decided that maybe the acupressure bands his family successfully used for sea sickness could also be helpful to the patients of Hospital. TRIAL: 1) PLACEMENT OF BANDS: a) must be correct acupressure P6 position on the wrist using patients own 3 finger for measurement b) doctors need to place the I/V infusion needle above the bands c) if only one bend used ? not so effective. 2) NAUSEA ? this still remains at times with some patients but is greatly reduced. 3) VOMITING ? is reduced by 75% on most patients and some patients have no vomiting. 4) ? ANTIEMETICS DRUGS ? these still needed to some degree in most patients but may be taken orally and the amount of PRN I/M drug is reduced. 5) DEPRESSION ? less depression and on return for further courses have not dreaded the nausea and vomiting. 6) ORAL FLUIDS ? are tolerated in some cases light diet 7) ON DISCHARGE ? post chemotherapy nausea has been non existent on using Sea Band. Patient A ? used them for two weeks after treatment Patient D ? completely relieved after feeling nauseated for four months after previous treatments. 8) COSTINGS ? use of Sea Band has reduced a. Drug costs b. Laundry costs c. Nursing time ? due vomiting. 9) FUTURE USE ? in Hospice nursing, Anaesthesia, Pregnancy. CONCLUSION: The unit has found much greater nursing satisfaction in being able to help the patients and after apprehension by some staff, they are all convinced both scientifically and mentally that Sea Band are successful

Price MR
"An evaluation of the Sea-Band in alleviating nausea and vomiting in patients receiving chemotherapy"
Department of Medical Oncology University of Southampton.

PURPOSE: To assess by means of a single blind cross-over model if acupressure by Sea-Band on Wrist point (active) versus acupressure on an ankle point (sham) reduces nausea and vomiting in patients receiving chemotherapy. METHOD: Patients receiving chemotherapy at the RSH Hospital were asked to participate in the study during their next two treatments. For one treatment they wore the bands on both wrists continuously for seven days, recording symptoms on an identical diary card. After wearing the bands at both sites, each patient filled in a questionnaire for preference of ankle and wrist treatment. The ankle and wrist treatment were randomised. All patients received standard pharmacological anti-emetics as required throughout the study. RESULTS: 53 patients entered the study; 38 patients completed the study, 15 patients withdrew for various reasons. From the questionnaires of the patients completing the study, 54% found P6 provided better control of nausea and vomiting, 17% found the sham ankle point provided better control and 29 % found no difference between the points. The diary cards showed similar results (significant at p<0.05), during which P6 acupressure had a consistently better effect than shame ankle acupressure between days 1 and 4 of wearing the Sea-Band for controlling vomiting, nausea, mood and overall condition in the high emetic intensity chemotherapy group. CONCLUSION: P6 acupressure is a good method to complement conventional anti-emetic treatment in people having chemotherapy, particularly in the high emetic intensity group. It is recommended that it should be included into a standard anti-emetic protocol for chemotherapy, subject to further work on it.

G. Gardani, R. Cerrone, C. Biella, L. Mancini, E. Proserpio, M. Caisraghi, O. Travisi, M. Meregalli, P. Trabattoni, L. Colombo, L. Giani, M. Vaghi, P. Lissoni
"Effect of Acupressure on Nausea and Vomiting induced by Chemotherapy in Cancer Patients"
Department of Radiotharapy and Oncology San Gerardo Hospital, Monza, Milan, Italy
Minerva Med 2006; 97:391-4

OBIETTIVO: Cortisonici, anti-dopaminergici a anti-serotoninergici di tipo 3, sono I farmaci più comunemente impiegati nel trattamento del vomito indotto da chemioterapia. Agopuntura ed Acupressione si sono pure rivelati in grado di esercitare effetti anti-emetici. Lo scopo dello studio è stato quello di valutare l'efficacia dell'acupressione nel trattamento del vomito da chemioterapia resistente ai trattamenti anti-emetici convenzionali. METODO: Lo studio è stato condotto su 40 pazienti con neoplasia avanzata e con vomito da chemioterapia intrattabile. Le neoplasie più frequenti nei pazienti erano rappresentate da carcinoma del colon-retto, carcinoma polmonare e carcinoma mammario. In accordo con l'istotipo di neoplasia, i pazienti venivano trattati con schermi di chemioterapia comprendenti i principali agenti citotossici emetizzanti, vale a dire cisplatino e antracicline. L'acupressione veniva realizzata mediante stimolazione del punto P6 per almeno 6 ore/die a partire dall'inizio della chemioterapia. RISULTATI: L'approccio terapeutico è stato favorevolmente accettato da tutti i pazienti. Un miglioramento evidente della sintomatologia emetica è stato conseguito in 28/40 (70%) pazienti, senza differenze significative né in relazione all'istotipo di neoplasia, né al tipo di agente chemioterapico. CONCLUSIONE: Questo studio preliminare sembra suggerire che un approccio bioenergetico mediante acupressione sul punto P6, possa essere efficace nel trattamento del vomito da chemioterapia non responsivo ai trattamenti farmacologici convenzionali, come già precedentemente dimostrato nel caso del trattamento del vomito durante la gravidanza. PAROLE CHIAVE: Agopuntura - Acupressione - Agopressione - Chemioterapia - Vomito.

Barrett JM
"Sea-Bands: an application in Nephrology"
Copnor, Portsmouth

Seven patients took part in the trial, of whom six derived some benefit from the Sea-bands, and four are convinced that they are effective in the control of nausea and vomiting during haemodialysis. It would be unreascnable to try to draw the conclusion that more than 50% of patients would be helped by wearing Sea-Bands but, nevertheless, the results are very interesting and would seem to justify further research. It is a pity that it was not possible to conduct the trial over a longer period of time, including more dialysis sessions. This would have given a clearer picture. There is also the difficulty of most patients having forearm fistulas. As far as I am aware no research has been conducted into whether Sea-Bands are effective if only worn on one arm. One of the problems of the chosen method of research is the variable factors which are present from one dialysis session to the next. The type or quantity of food eaten, the amount of fluid removed, or the position of the patient (i.e. bed or chair) could all affect the results obtained. The other problem is the possible effect of my own enthusiasm for the product. Although I was very careful not to try to influence patients in favour of Sea-Bands, it is still likely that some patients were convinced simply because I was encouraging their use. Furthermore the extra attention that patients received through taking part in the trial may have contributed to the subjective feeling of relief reported by several patients. Nevertheless there are several possible advantages from the study: 1) patients will suffer less nausea and vomiting during haemodialysis. Consequently their quality of life will be improved. 2) patients will require fewer anti-emetic drugs. 3) there will be savings in the cost of anti-emetic drugs, and in the time spent by staff in prescribing, dispensing and administering them. 4) nursing time will be saved, because less time will be spent clearing up vomitus.