Comparing the effects of acupuncture and pharmacologic therapies on delayed gastric emptying : a prospective, block-randomized, single-blinded, parallel clinical trial

الملخص EN

Background: Nutritional therapy in the forms of parenteral or enteral nutrition is an important factor of care and appears to positively impact the clinical outcomes of critically ill patients.

Objectives: This study aimed to compare the effects of acupuncture and prokinetic drugs on delayed gastric emptying (DGE) in intensive care unit patients.

Methods: In a prospective, block-randomized, single-blinded, parallel group trial, 60 fully sedated, mechanically ventilated surgical patients were enrolled in two groups with 30 patients in each group in Besat hospital in Hamadan, Iran from February 2011 to October 2012.

Patients in the drug treatment group received 10 mg of IV metoclopramide every eight hours.

For patients with whom persistent DGE was seen, 500 mg of IV erythromycin every 24 hours was added.

Patients in the acupuncture group received bilateral prolonged intermittent transcutaneous electrical acupoint stimulation of acupuncture point Neiguan.

The intervention was performed for six consecutive days or until the cessation of gradual residual volume.

Results: A demographic analysis of the participants revealed no significant differences between groups (P > 0.05).

Although the results of the RANOVA model for DGE did not show a significant time trend (P > 0.05) in both acupuncture and drug groups, comparing means of the both acupuncture and drug groups in all the time points after the intervention were significant (P = 0.024): 711.83 ± 193.28 vs.

755.00 ± 166.79 (P = 0.358), 564.17 ± 672.35 vs.

628.50 ± 176.77 (P = 0.614), 324.00 ± 146.49 vs.

472.00 ± 188.47 (P < 0.001), 209.00 ± 136.34 vs.

340.00 ± 211.89 (P < 0.006), 152.67 ± 118.93l vs.

276.17 ± 202.43 (P < 0.006), and 119.67 ± 101.59 vs.

225.67 ± 184.22 (P < 0.008) from the first to last steps, respectively.

Conclusions: Although neither acupuncture nor the drug interventions had significant effects on the improvement and obviation of DGE, the acupuncture had greater effects than prokinetic drugs on the reduction of DGE.