A 25 year-old woman with a history of severe PONV, despite multi-modal therapy, is scheduled for an open appendectomy. Which of the following acupressure points is most appropriate for PONV prophylaxis in this patient?
Acupuncture and acupressure have their origins in Chinese medicine, and are based on the theory that there is a life force energy called qi, which flows from the body's primary organs to the superficial body tissues of the skin, muscles, tendons, bones, and joints, through channels called meridians. Acupuncture/pressure points are mainly found at locations along the meridians.
Most scientific studies have failed to demonstrate the efficacy of acupuncture, however, the prophylaxis and treatment of PONV is an exception. Stimulation of the Nei Guan ("inner gate") Pericardium 6 point intraoperatively reduces PONV, and N&V in pregnancy. The location is 3 finger-breaths above the wrist, on the palmar forearm, between the palmaris longus and flexor carpi radialis tendons.
Shaofu Heart 8 is for pruritis and palpitations. Quchi Large Intestine 11 is for fever, headache, hemiplegia, psychosis and many others. Laogong Pericardium 8 is for aphthous ulcers, coma, and halitosis.