metoclopramide was given only if the PONV symptoms per-
sisted for 15 min or longer after treatment was initiated. A
blinded observer recorded the recovery times, emetic symp-
toms, rescue antiemetics, maximum nausea scores, completeresponse to study treatment, and time to achieve discharge
criteria. Postdischarge side effects, as well and patient sat-
Margarita Coloma, Paul F. White, Babatunde O. Ogunnaike,
isfaction and quality of recovery scores, were assessed at
Scott D. Markowitz, Philip M. Brown, Alex Q. Lee,
24 and 72 hr after surgery. The combination group had a
Sally B. Berrisford, Cynthia A. Wakefield, Tijani Issioui,
markedly greater complete response rate than the acustimu-
lation group (73% vs. 40%), In addition, fewer patients (8 vs. 18) in the combination vs. the acustimulation group expe-
rienced subsequent antiemetic events. However, there wereno marked differences between the three groups in patient
Departments of Anesthesiology and Pain Management Surgery, University
satisfaction and quality of recovery scores. Acustimulation
of Texas Southwestern Medical Center at Dallas, Dallas, Texas.
with the ReliefBand1 can be used as an alternative to on-
n 2003 by Lippincott Williams & Wilkins
dansetron for the treatment of established PONV. However,the use of ondansetron (4 mg intravenously) in combinationwith the ReliefBand1 device improved the complete response
Transcutaneous electrical acupoint stimulation (acustimu- rate totheacustimulation therapy.
lation) was evaluated using the ReliefBand1 compared
with ondansetron for the treatment of established postoper-
ative nausea and vomiting (PONV) after outpatient laparo-
It is possible to identify those at high risk for post-
scopic surgery. With institutional review board approval and
operative nausea and vomiting (PONV) and to provide
written informed consent, 268 outpatients were enrolled in
antiemetic prophylaxis to these patients. This paper is
a randomized, double-blind, placebo- and sham-controlled
concerned with how to treat high risk patients who fail this
study. All patients were given antiemetic prophylaxis with
approach and have PONV despite treatment in the operating
metoclopramide, 10 mg intravenously, or droperidol, 0.625 mg
room. The finding that PONV outcome in those patients
intravenously, after induction of anesthesia. A total of 90 pa-
treated with the acustimulation band was not significantly
tients developed PONV in the recovery units and were ran-
different from those treated with ondansetron is interesting.
domized to one of three treatment groups: (1) the ondansetron
That the combination of the acustimulation band and ondan-
group received 4 mg of intravenous ondansetron and a sham
setron produced superior results compared to the band alone
ReliefBand1; (2) the acustimulation group received 2 mL of
suggests that the band may have a role in a multimodal
intravenous saline and a ReliefBand;1 and (3) the combi-
nation group received 4 mg of intravenous ondansetron anda ReliefBand.1 A rescue antiemetic of 10 mg intravenous
Survey of Anesthesiology Volume 47, Number 5, October 2003
Copyright ' Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
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