내관지압이 슬관절 전치환술 받은 노인 환자의 오심, 구토 및 통증에 미치는 효과
Effects of the Nei-Guan (P6) Acupressure on Nausea, Vomiting, and Pain in Geriatric Patients after Total Knee Replacement Arthroplasty
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본 연구는 슬관절 전치환술후 경막외 자가통증 조절기를 사용하는 노인환자 99명을 대상으로 내관지압의 오심,;구토 감소와 통증에 미치는 효과를 확인하고자 시도하였다. 연구도구는 Rhodes& McDaniel(1999)이 개발한 도구를 Kim(2003)이 한국형으로 수정보완한 Index of Nausea and Vomiting and Retching (INVR)을 이용하였고 통증정도는 진통제 사용횟수로 측정하였다. 실험처치로 실험군에 내관지압(P6)을 회복실에서 20분, 12시간시점에 10분, 24시간 시점에 10분 적용하여 총 40분 실시하였다. 연구결과 가설 1 내관(P6)지압을 실시한 실험군은 실시하지 않은 대조군보다 오심, 구토, 헛구역질 정도가 낮을 것이다는 부분 지지되었다. 가설2 내관(P6)지압을 실시한 실험군은 실시하지 않은 대조군보다 통증이 낮을 것이다는 기각되었다. 결론적으로 슬관절 전치환술후 PCEA를 적용한 노인대상자에게 내관지압의 간호중재를 적용한 결과 24시간시점에서 오심,구토,헛구역질의 감소효과가 있었으며 특히 구토영역의 감소가 유의미하게 나타났다.
Abstract
Purpose: Patient-controlled epidural analgesia (PCEA) is an effective method for controlling post surgical pain. However, it is associated with adverse drug reactions such as nausea and vomiting. In this, study we tested the effects of Nei-Guan (P6) acupressure on PCEA-associated nausea, vomiting, and pain in geriatric patients after total knee replacement arthroplasty (TKRA). Methods: Ninety-nine patients who had TKRA for the first time were randomly assigned to either, experiment group (n=50) or control groups (n=49). All patients received PCEA immediately after surgery, but acupressure on Nei-Guan (P6) point was applied to experiment group only. Ten minutes of finger acupressure on Nei-Guan (P6) acupressure point was applied twice with 15 minute-interval in the experiment group. The incidence of nausea, vomiting, and retching as well as pain intensity were assessed at 12 and 24 hours after surgery. Nausea, and vomiting were assessed by Index of Nausea, Vomiting and Retching (INVR) questionnaire. Pain intensity was measured with frequency of analgesics. Results: Vomiting both was significantly different between two groups at 12 hours (t=-2.18, p=0.03) and 24 hours (t=-2.64, p=0.01) after surgery. Total scores of nausea, vomiting and retching in experimental group was significantly lower than control group 24hours after surgery (t=-2.18, p=0.03). However, pain was not different between two groups. Conclusion: Nei-Guan (P6) acupressure may be considered as an effective nursing intervention to decrease PCEA-associated nausea and vomiting in older patients after TKRA.
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