This randomized clinical trial studies how well neuromuscular electrical stimulation of acupoint pericardium (P) 6 works in preventing nausea and vomiting after surgery in female patients undergoing breast surgery. Acupoint P6 is a specific spot on the wrist area where an electrical stimulator may be inserted to control pain and other symptoms. Giving neuromuscular electrical stimulation of acupoint P6 before and during surgery may prevent and treat nausea and vomiting following surgery in female patients undergoing breast surgery.
Study sponsor and potential other locations can be found on ClinicalTrials.gov for NCT02473042.
PRIMARY OBJECTIVE:
I. Examine the efficacy of electrical stimulation of P6 combined with prophylactic anti-emetics versus pharmacological prophylaxis alone in preventing the incidence of post-operative nausea and vomiting (PONV) following breast surgery in patients at high-risk for PONV.
SECONDARY OBJECTIVES:
I. Determine the study feasibility and effects on severity of PONV of anesthesiologist-provided intraoperative neuromuscular blockade monitor (NMBM) electrical stimulation of P6 combined with prophylactic anti-emetics in women at high-risk for PONV undergoing breast surgery.
II. Examine the effects of intra-operative NMBM stimulation of P6 on need for rescue anti-emetics compared to the control group.
III. Examine group differences in post-operative patient satisfaction with PONV management.
IV. Explore if intra-operative NMBM stimulation of P6 results in decreased post-anesthesia care unit (PACU) length-of-stay and decreased rate of unplanned hospital admission.
V. Explore the associations between genetic polymorphisms in COMT, 5-hydroxytryptamine type 3 (5HT3), OPRM1, and DRD2 and response to P6 stimulation.
VI. Explore the associations between expectancy and response to P6 stimulation.
OUTLINE: Patients are randomized to 1 of 2 treatment groups.
GROUP I. Patients undergo neuromuscular electrical stimulation after induction, before incision, and continuing throughout the surgery. Patients also receive standard of care prophylactic antiemetics consisting of ondansetron hydrochloride intravenously (IV), dexamethasone IV, promethazine hydrochloride IV, and famotidine.
GROUP II: Patients receive standard of care prophylactic antiemetics as in Group I.
Trial PhaseNo phase specified
Trial Typesupportive care
Lead OrganizationM D Anderson Cancer Center
Principal InvestigatorAlicia M Kowalski