Page 31 - World Journal of Laparoscopic Surgery

Effect of Metatarsus Reflexology Massage in Laparoscopic Cholecystectomy Nausea: A Randomized Clinical Trial
along the canals in the legs to all organs of the body, and any applied by a researcher on a number of patients. After confirming
barrier to this flow ultimately leads to illness. Stimulating reflex the application of the acupressure method by the Chinese
points in the legs can break these dams in the path of the canal traditional medicine specialist, the researcher started. Content
and release energy. These canals from each part of the body are validity method was used to determine the validity of the visual
linked with metatarsus through the nerverouts. According to some scale of nausea and vomiting (VAS) and to determine its reliability,
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theories, massage can release endorphins and Enkephalin. Emeset Cronbach’s alpha test was used. This scale has also been used in
showed that reflexology is effective in reducing nausea and various research. 13,14 All patients were operated by an anesthetic
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vomiting in patients undergoing general surgery. Tadayon et al. team under a general anesthetic procedure and underwent one
showed that acupressure medicine has an effect on nausea and surgeon. Meanwhile, the technique and type of anesthetic drug
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vomiting of pregnancy. Regarding the fact that nausea following were also controlled as a variable, which included, for all patients,
laparoscopic cholecystectomy is one of the most important and anesthetic drugs: (1) Ndodone 2 μg/kg as a preoperative drug.
common complications among other operations of general surgery, (2) Fentanyl 2 μg/kg. (3) For rapid muscular relaxation of xoxinilcholine
and it has many complications despite the medical interventions and atherocurium at a dose of 0.5 mg/kg body weight.
and with respect to the fact that metatarsus reflexology massage (4) Anesthetizing gas of iso-fluoranes was used during the operation,
is an inexpensive, simple, and uncomplicated nonpharmacological then CO gas was pressurized to 15 mm Hg in the abdomen. The
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intervention, the aim of this study was to determine the effect of control group received only commonly used drug therapy and in
foot reflexology massage on postoperative nausea in patients intervention group in addition to commonly used drug therapy,
undergoing laparoscopic cholecystectomy. metatarsus reflexology massage was performed. In such a way
that by pushing the region of the solar network or the neural
MAterIAls And Methods network behind the stomach underwent the foot in the center of

The present study was an interventional (randomized clinical the region, at the midpoint of the attachment of the second and
third metatarsal bones, while the patient sleeping on the back,
trial), which was performed on patients admitted for laparoscopic tight pressure on the area for 20 minutes (10 minutes right leg
cholecystectomy in Imam Ali Hospital and Samen Alaemah and 10 minutes left leg) was performed by Thumbs. Massage was
Hospital in Bojnurd—2016. This randomized clinical trial was performed at the patient’s when they entrance from the recovery
performed on 60 patients aged 20–60 years old under laparoscopic to the department and the patient’s nausea and vomiting were
cholecystectomy in Bojnurd Hospitals. Sampling in this research measured. The severity of nausea and vomiting of patients was
was randomized. In this way, the researcher, referring to the measured in recovery after the patient’s consciousness (while the
surgery department of Imam Ali Hospital and Samen Alaemah, patient is completely alert) just prior to the transfer of the patient
selected each patient diagnosed with a Colette Cystic and had from recovery to the department, 6 hours after the surgery, and
criteria for entering the research, and selected them after random then 12 hours after the surgery. Finally, we used SPSS software
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allocation, in one of the intervention and control groups. Finally, for analyzing the data by using independent t test, Chi-square,
the patients were randomly divided into two groups of 30 controls repeated measures analysis of variance (ANOVA) at a significant
and intervention. The criteria for entering the study include written level of 0.05% and 95% confidence interval (Flowchart 1).
consent for participation in the study, reading and writing literacy,
diagnosis of cholecystitis by ultrasound, and general surgeon’s
opinion, ages 20–60 years, general anesthesia for operation, history results
of gastrointestinal disorders, lack of experience with reflective This clinical trial study was performed on 60 patients aged 20–60
massage, not having diabetes and diabetic foot, having a healthy years old under laparoscopic cholecystectomy referred to hospitals
limb on foot, having no addiction to any substance or cigarette, in Bojnurd. Patients were randomly divided into two groups of 30
the body mass index was less than 30. Patients with neurological subjects. The mean age of the subjects was 44.96 years. Of the
and postoperative complications, reluctance to continue the studied individuals, 38.3% were women and 61.7% were men.
study, surgery for more than 2 hours, drug injection out of the Demographic characteristics based on the two study groups as
prescribed anesthetic protocol, patients with nasogastric tube shown in Table 1.
(NGT) after surgery and severe pain were excluded from the study. In the present study, as shown in Table 1, there was a significant
Instruments used in this study were a demographic questionnaire difference between age in the two groups (in both intervention and
(age, sex, duration of anesthesia) and a list of the severity of nausea control groups). We used the logistic regression model to eliminate
and vomiting. Visual analog scale (VAS) was used to measure and the age-related confounding effect. However, in the present study,
evaluate it. Through which a ruler, scaled from 0 to 10, was provided the results show that the mean pain of patients in the recovery
to the patient. Zero is equivalent to no nausea and ten equal to the room, was not significantly different in both groups. Also, during
highest severity of nausea (0–3 is mild nausea, 3–7 moderate and the study period (in both the intervention and control groups), the
more than 7 severe nausea). To assess the severity of vomiting, severity of nausea was decreased (p value < 0.001; F = 245.24). The
the following scores were used: 0–3 mild vomiting, 3–7 moderate results indicate the effect of foot reflexology massage on changes
vomiting, more than 7 (severe vomiting). To determine the validity of in nausea in patients after cholecystectomy (p < 0.001; F = 67.62).
the questionnaire, the content validity method was used under the The results of the distribution of changes in severity of nausea
guidance of the supervisors and counselors, and then five experts and vomiting in the intervention and control groups are shown in
in the field of acupuncture and massage therapy. After considering Tables 2 and 3. The results of Table 3 show that during the study period
the suggestions and necessary corrections, the final tool is used. (in both the intervention and control groups), the severity of vomiting
In order to determine the validity of the method of acupressure, was decreased (p < 0.001; F = 245/95). The results indicate that the
the first training course was conducted under the supervision of a effect of massage underwent the foot on changes in vomiting in
traditional Chinese medicine specialist and then the method was patients after cholecystectomy (p < 0.001; F = 94.11).

World Journal of Laparoscopic Surgery, Volume 12 Issue 3 (September–December 2019) 117