Nausea and vomiting is first of all defense mechanisms occurring when the body wants to defend itself from a strange substance. Nausea is a common and often unplea-sant condition in connection with surgery but also during radiation and chemotherapy. Studies show that TENS is a successful method in treating nausea and in comparison with drugs doesn’t have any negative side effects.
The reasons for nausea can vary. Postoperative nausea
• The correct acupuncture point, PC6: Studies show that
can for instance be caused by the anesthesia itself, the
it is important that stimulation takes place on this acu-
method of surgery or be the result of the medication of
various morphine drugs. While treating cancer, chemo-
• Stimulation bilaterally or unilaterally: No difference in
therapy can cause nausea and radiation is also likely to
release substances that will trigger nausea.
• Treatment time: Several studies show that a treatment
Today it is established that TENS treatment on acu-
time between 5-10 minutes gives the best effect.
puncture point PC6 reduces the sensation of nausea,
• Enhanced effect: Studies show that TENS in combina-
but the theoretical explanation is still not fully establis-
tion with Ondansetron (i.e. Zofran) give an enhanced
hed. TENS treatment has for instance the following
effects: increased sympathetic activity, influence on the serotonin level and inhibition of the vagal activity.
• Treatment start-up: The best results are achieved on
These effects influence the sensation of nausea on their
a conscious patient with a well functioning nervous
system. Start the first treatment session before nausea occurs.
How does the treatment works?• Concentrate stimulation to acupuncture point PC6,
a well-known location for treating nausea. It is situa-ted on the inside of the lower arm, 2 cun (approx. 3 fingers widths) from the wrist between the flexor tendons. Place the black (the most active) electrode here. The red electrode is preferably placed on TE5, the corresponding point on the outside of the same
1. JW Dundee, RG Ghaly, KM Bill, WN Chestnutt, KJ Fitzpatrick,
• Set the frequency to 10 Hz and increase the current
AGA Lynas Effect of stimulation of the P6 antiemetic point on posto-
strength until the stimulation is felt in the fingers
perative nausea and vomiting. Br J Anaesth 1989,63, 612-618.
(Median nerve), without being painful. A light vibra-
2. PF White, T Issioui, J Hu, SB Jones, JE Coleman, JP Waddle,
tion of the fingers will often occur.
SD Markowitz, M Coloma, AR Macaluso, CH Ing Comparative efficiacy of acustimulation (Relief Band) versus Ondansetron Zofran
• Stimulate for about 10 minutes per session. Repeat
in combination with droperidol for preventing nausea and vomiting.
the treatment more often in the beginning. Start for
Anesthesiology 2002 Nov; 97 (5) 1075-81.
instance by stimulating every second hour and then
3. CM McMillan, JW Dundee The role of transcutaneous electrical
slowly reduce the number of treatments. stimulation of Neiguan anti-emetic acupuncture point in controlling
• IMPORTANT! Start the first treatment session befo-
sickness after cancer chemotherapy. Physiotherapy, July 1991, vol
re nausea occurs (before operation or chemotherapy).
CEFAR Medical AB | Murmansgatan 126 | SE-212 25 Malmö | Sweden
Tel +46 (0)40 39 40 00 | Fax +46 (0)40 39 40 99 | E-mail [email protected] | www.cefar.se
Please read this agreement carefully before you begin using the Software. By using any part of the Software, you accept all the terms and conditions of this agreement. You agree that this agreement is enforceable like any written contract. If you do not agree, you may not use any part of the Software. Swiss Academic Software (“we”) means Swiss Academic Software GmbH, a Swiss limited
Common Interests in the Ocean Rüdiger Wolfrum INTRODUCTION Oceans (the high seas, the deep- ocean floor, and its subsoil) differ funda-mentally from territories or spaces under national jurisdiction. Whereas the management of the latter rests in the responsibility of a given state, activities in the former are governed by international law, implemented and enforced by individual states or or