Prevention of PONV in Females Undergoing Laparoscopic Cholecystectomy: Metoclopramide Alone vs. with P-6 Acupressure

Aidah Alkaissi^1*, Dana Ewesat²

¹Faculty of Nursing, An-Najah National University, Nablus, Palestine

² Faculty of Graduate Studies, An-Najah National University, Nablus, Palestine

Introduction and Background:
Postoperative nausea and vomiting (PONV) are common complications following laparoscopic surgery under general anesthesia. P-6 acupressure is a complementary technique shown to reduce nausea and vomiting through peripheral nerve stimulation.

Objective:
This study aimed to assess the effectiveness of prophylactic metoclopramide (Pramin®) alone versus in combination with P-6 acupressure in preventing PONV among female patients undergoing laparoscopic cholecystectomy.

Methods:
In a prospective, randomized, double-blind, placebo-controlled trial, 116 female patients were assigned to four groups:

Combination group (n = 28): Received P-6 acupressure 30 minutes prior to induction and 10 mg metoclopramide.

Acupressure group (n = 30): Received P-6 acupressure and 1 ml of NaCl.

Pramin group (n = 29): Received 10 mg metoclopramide and placebo acupressure.

Placebo group (n = 29): Received placebo acupressure and 1 ml of NaCl.

PONV symptoms were evaluated using a 0–6 Likert scale during the first 24 hours postoperatively.

Results:
Significant differences in vomiting incidence were observed among groups (p < 0.001): Combination (44.3%), Acupressure (20%), Pramin (11.9%), and Placebo (17.6%). Nausea incidence was significantly lower in the Combination (17.9%) and Acupressure (26.7%) groups compared to Placebo (62.1%) (p < 0.05). Nausea severity was also significantly lower in the Combination group (0.17) than in Placebo (0.81) (p = 0.006). Rescue antiemetic use was lowest in the Combination group (14.3%) versus Placebo (51.7%) (p < 0.05).

Conclusion and Implications:
The combination of metoclopramide and P-6 acupressure is more effective in reducing PONV and the need for rescue medication than either treatment alone. These findings support the use of integrative approaches in perioperative care, offering a safe, accessible, and cost-effective strategy to improve patient outcomes after laparoscopic surgery.

Keywords: Laparoscopic Cholecystectomy; Metoclopramide; PONV; P-6 Acupressure; Non-Pharmacological Therapy

Conference Title

Advanced Health Care Research in the Arab Region: Towards a Collaborative Nursing Research Agenda

Conference Country

Lebanon

Conference Date

Oct. 29, 2025 - Oct. 30, 2025

Conference Sponsor

University

Additional Info

Conference Website