The Effect of Acupressure on Preoperative Anxiety and Postoperative Pain and Nausea-Vomiting (Acupress)

The Effect of Acupressure on Preoperative Anxiety and Postoperative Pain and Nausea-Vomiting in ENT Surgery

The study was conducted in the ENT Clinic of Mersin Şehir Training and Research Hospital between June 1 and December 1, 2021, with a total of 60 adult patients, 30 in the study group and 30 in the control group, who met the inclusion and exclusion criteria.

Study Overview

• Status: Completed
• Conditions: Pain; Nausea; Vomiting; Anxiety State
• Intervention / Treatment: Other: Acupressure

Detailed Description

In the study, 60 patients were randomly assigned to the study and control groups. The study group (n = 30) included Shen Men, the 7th acupuncture point (HT7) of the heart meridian located between the ulna and pisiform bones on the radial side of the flexor carpi ulnaris tendon, EX-HN3 (Yintang) located in the middle of the beginning of both eyebrows and the thumb and the LI4 points located in the space between the index finger (between the 1st and 2nd metacarpal bones of the hand, in the middle of the 2nd metacarpal bone on the radial side) were applied for an average of 15 minutes. No intervention didn't made to the control group (n = 30). The primary outcome of the study is the effect of acupressure on the state and trait anxiety level of patients. The secondary outcome of the study is the effect of acupressure on pain and nausea and vomiting level in patients. Anxiety levels of the patients were evaluated before and 15 minutes after acupressure application; pain levels were evaluated at the 4th postoperative hour, before going to bed at night (22.00), waking up in the morning (08.00) and at discharge; nausea and vomiting levels were evaluated in the first 24 hours after surgery.

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Mersin
    • Yeni̇şehi̇r, Mersin, Turkey, 33120
      • Tuğba ÇAM YANIK

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Emergency ENT surgery,
• Refused to participate in the research,
• Did not sign the Informed Consent Form,
• Have a physical problem that prevents the application of acupressure to EX-HN3 (Yintang), LI4 and HT7 points,
• Diagnosed with anxiety, panic attacks and taking medication for anxiety,
• Previous surgical experience,
• Under 18 and over 65,
• People with vision, hearing and perception problems,
• unable to read and write Turkish,
• Have any problem that prevents them from communicating cognitively, emotionally and verbally,
• Experience in acupressure,
• Patients who have received sedative medication before surgical intervention didn't be included in the study.

Exclusion Criteria:

• Emergency ENT surgery,
• Refused to participate in the research,
• Did not sign the Informed Consent Form,
• Diagnosed with anxiety, panic attacks and taking medication for anxiety,
• Previous surgical experience
• Under 18 and over 65,
• People with vision, hearing and perception problems,
• unable to read and write Turkish,
• Have any problem that prevents them from communicating cognitively, emotionally and verbally,
• Experience in acupressure,
• Patients who have received sedative medication before surgical intervention didn't be included in the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Study Group (experimental); The order of application was determined by lottery. HT7, LI4 and EX-HN3 points were applied respectively. Before starting the application, the area around to be pressurized was gently rubbed with the palm of the hand for 20-30 seconds. The surrounding tissue was relieved by rubbing gently. After rubbing, pressure was applied to the point determined based on the pain threshold level of each individual with a depth of 1-1.5 cm with the thumb for 5 seconds, rested for 2 seconds and the application was continued for 2 minutes. Acupressure was applied to each point for 2 minutes and the total application time was 15 minutes on average (for 5 points).	Other: Acupressure; Acupressure was applied to each point for 2 minutes and the total application time was 15 minutes on average (for 5 points). During the application, the most appropriate position in which the individual would be comfortable was preferred, taking into account the privacy of the individual. First of all, the supine position was preferred, and alternatively, the sitting position was preferred. At the end of the application, it was ensured that the person was in a position that he/she was comfortable.; Other Names: Acupress
No Intervention: Standard of care; Standard care was given.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Anxiety evaluated using the State Anxiety Scale	Scores ranging from 20 to 80 points are obtained in the scale. In the total score obtained from the scale in scoring the scale, 0-19 points indicate the absence of anxiety, 20-39 points indicate mild anxiety, 40-59 points indicate moderate anxiety, and 60-79 points indicate severe anxiety level. Higher state anxiety scores indicate that anxiety level is also high	Change from before implementation and immediately after, 15th minutes after implementation

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Numerical Pain Scale	In this scale, the patient is asked to describe the severity of his/her pain in numbers, and the scale consists of a horizontal line, with "0" or "no pain" at the starting point and "10" or "unbearable pain" at the end point. The numbers from 0 to 10 are equally spaced on the horizontal line and 1-3 is defined as mild pain, 4-6 as moderate pain and 7-10 as severe pain.	Change from the 4th hour after surgery, through the discharge, an average of 2 days
Nausea and vomiting	The responses for each item are scored between zero (least discomfort) and four (most discomfort). The scores obtained from the eight items are summed to obtain a total score. The maximum score that can be obtained from the index is 32, which is also considered as the most severe symptom occurrence experience score.	Change from surgery to the first 24 hours

Collaborators and Investigators

• Sponsor: Mersin University
• Investigators: Study Director: Gülay Altun Ugras, PhD, Mersin University; Principal Investigator: SERPİL YÜKSEL, PhD, Necmettin Erbakan University; Principal Investigator: Bahar TAŞDELEN, PhD, Mersin University; Principal Investigator: Seda TÜRKİLİ, Doctor, Mersin City Hospital; Principal Investigator: Serkan TÜRKİLİ, Doctor, Mersin City Hospital; Principal Investigator: Ahmet KARAMAN, PhD, Mersin University

Study record dates

Study Major Dates

• Study Start (Actual): June 1, 2021
• Primary Completion (Actual): June 1, 2021
• Study Completion (Actual): December 1, 2021

Study Registration Dates

• First Submitted: August 22, 2023
• First Submitted That Met QC Criteria: September 13, 2023
• First Posted (Actual): September 15, 2023

Study Record Updates

• Last Update Posted (Actual): September 15, 2023
• Last Update Submitted That Met QC Criteria: September 13, 2023
• Last Verified: September 1, 2023

More Information

Terms related to this study

• Keywords: pain; ENT patients
• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Postoperative Complications; Pain; Neurologic Manifestations; Signs and Symptoms, Digestive; Pain, Postoperative; Nausea; Vomiting; Anxiety Disorders
• Other Study ID Numbers: Mersin University.

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No