Clinical uses of P6 acupuncture antiemesis.

Having seen pregnant women pressing the P6 point as a preventative for morning sickness, stimulation of this point for 5-10 minutes by invasive (manual or electrical acupuncture) or non-invasive (transcutaneous electrical stimulation or acupressure) means was studied as an antiemetic. In well controlled studies it was shown that acupuncture administered before the opioid premedication significantly reduced postoperative sickness for 6-8 hours. Non-invasive methods were effective for a shorter period of time, with nausea and/or vomiting often occurring after 2 hours. To be effective the treatment has to be given before the opioid. Its effect can be abolished by local anesthesia. Stimulation of a dummy point near the elbow is ineffective. While acupressure reduces morning sickness, the pressure has to be applied for 5 minutes every 2 hours. There is probably a large psychological element in this. The most rewarding results are obtained when P6 stimulation is used in conjunction with standard antiemetics before cancer chemotherapy. Here again the invasive approach is more effective than non-invasive. Recent studies have involved self-stimulation using a portable battery-operated square wave stimulator fixed at 10 Hz, and a large EKG surface electrode on the P6 point. Stimulation is applied for 5 minutes every two hours. While modern antiemetics can control vomiting, they are relatively ineffective against nausea, but this can be controlled by regular use of the stimulator. The results are most promising.