Effect of Implementing Snap-needle Therapy Combined With Ginger Paste During Anesthesia Recovery on the Recovery of Gastrointestinal Function After Gynecologic Laparoscopy

• Acupuncture therapy (Other), also known as Qin acupuncture therapy, snap-needle therapy: After disinfecting (alcohol or 0.9% Normal saline) the skin at the acupuncture point, use small tweezers to clip the handle of the needle, remove the adhesive tape and stab the acupuncture point at a perpendicular angle, and then press the thumb with moderate pressure on the snap-needle embedded needle site in order for the patient to feel localized soreness and distension as appropriate. The snap-needle was removed after 24 hours, and the pressing time point remained unchanged.
• Ginger Acupuncture Point Patch (Other): Ginger was thinly sliced and then cut into 2-3cm diameter ginger discs according to a circular mold and covered with a sterile circular dressing. The ginger compress was removed within 6 hours.

Primary outcomes

• Postoperative nausea and vomiting [Measured at 0.5 hours postoperatively.]: The Index of Nausea and Vomiting and Retching (INVR) was used in this study. The scale consists of 8 items with 3 dimensions, which can quantify the number of occurrences, duration and severity of symptoms. The scale is scored using the Likert method, with a total of 32 points on a 5-point scale ranging from 0 to 4. The higher the score, the more severe the symptoms of nausea, vomiting, and dry heaving (entries 1, 6, and 7 are reverse scored). According to the score, nausea, vomiting and dry heaving symptoms can be categorized into five grades: 0, I, II, III and IV, and grade ≥I means that the symptom occurs. The severity and incidence of PONV at 0.5 hours postoperatively.
• Postoperative nausea and vomiting [Measured at 1 hours postoperatively.]: The Index of Nausea and Vomiting and Retching (INVR) was used in this study. The scale consists of 8 items with 3 dimensions, which can quantify the number of occurrences, duration and severity of symptoms. The scale is scored using the Likert method, with a total of 32 points on a 5-point scale ranging from 0 to 4. The higher the score, the more severe the symptoms of nausea, vomiting, and dry heaving (entries 1, 6, and 7 are reverse scored). According to the score, nausea, vomiting and dry heaving symptoms can be categorized into five grades: 0, I, II, III and IV, and grade ≥I means that the symptom occurs. The severity and incidence of PONV at 1 hours postoperatively.
• Postoperative nausea and vomiting [Measured at 3 hours postoperatively.]: The Index of Nausea and Vomiting and Retching (INVR) was used in this study. The scale consists of 8 items with 3 dimensions, which can quantify the number of occurrences, duration and severity of symptoms. The scale is scored using the Likert method, with a total of 32 points on a 5-point scale ranging from 0 to 4. The higher the score, the more severe the symptoms of nausea, vomiting, and dry heaving (entries 1, 6, and 7 are reverse scored). According to the score, nausea, vomiting and dry heaving symptoms can be categorized into five grades: 0, I, II, III and IV, and grade ≥I means that the symptom occurs. The severity and incidence of PONV at 3 hours postoperatively.
• Postoperative nausea and vomiting [Measured at 6 hours postoperatively.]: The Index of Nausea and Vomiting and Retching (INVR) was used in this study. The scale consists of 8 items with 3 dimensions, which can quantify the number of occurrences, duration and severity of symptoms. The scale is scored using the Likert method, with a total of 32 points on a 5-point scale ranging from 0 to 4. The higher the score, the more severe the symptoms of nausea, vomiting, and dry heaving (entries 1, 6, and 7 are reverse scored). According to the score, nausea, vomiting and dry heaving symptoms can be categorized into five grades: 0, I, II, III and IV, and grade ≥I means that the symptom occurs. The severity and incidence of PONV at 6 hours postoperatively.
• Postoperative nausea and vomiting [Measured at 12 hours postoperatively.]: The Index of Nausea and Vomiting and Retching (INVR) was used in this study. The scale consists of 8 items with 3 dimensions, which can quantify the number of occurrences, duration and severity of symptoms. The scale is scored using the Likert method, with a total of 32 points on a 5-point scale ranging from 0 to 4. The higher the score, the more severe the symptoms of nausea, vomiting, and dry heaving (entries 1, 6, and 7 are reverse scored). According to the score, nausea, vomiting and dry heaving symptoms can be categorized into five grades: 0, I, II, III and IV, and grade ≥I means that the symptom occurs. The severity and incidence of PONV at 12 hours postoperatively.
• Postoperative nausea and vomiting [Measured at 24 hours postoperatively.]: The Index of Nausea and Vomiting and Retching (INVR) was used in this study. The scale consists of 8 items with 3 dimensions, which can quantify the number of occurrences, duration and severity of symptoms. The scale is scored using the Likert method, with a total of 32 points on a 5-point scale ranging from 0 to 4. The higher the score, the more severe the symptoms of nausea, vomiting, and dry heaving (entries 1, 6, and 7 are reverse scored). According to the score, nausea, vomiting and dry heaving symptoms can be categorized into five grades: 0, I, II, III and IV, and grade ≥I means that the symptom occurs. The severity and incidence of PONV at 24 hours postoperatively.
• Abdominal distention [Measured at 0.5 hours postoperatively.]: The severity and incidence of Abdominal distention at 0.5 hours postoperatively.
• Abdominal distention [Measured at 1 hours postoperatively.]: The severity and incidence of Abdominal distention at 1 hours postoperatively.
• Abdominal distention [Measured at 3 hours postoperatively.]: The severity and incidence of Abdominal distention at 3 hours postoperatively.
• Abdominal distention [Measured at 6 hours postoperatively.]: The severity and incidence of Abdominal distention at 6 hours postoperatively.
• Abdominal distention [Measured at 12 hours postoperatively.]: The severity and incidence of Abdominal distention at 12 hours postoperatively.
• Abdominal distention [Measured at 24 hours postoperatively.]: The severity and incidence of Abdominal distention at 24 hours postoperatively.
• Time to first flatus [Approximately 24 hours after surgery.]: Record the time of the first flatus. The earlier the time of first flatus, the earlier the time of recovery of gastrointestinal function.

Secondary outcomes

• Postoperative pain response [Measured at 0.5 hours postoperatively.]: The Visual Analog Score was used to assess pain response at 0.5 hours postoperatively. The score ranges from 0 (pain free or no pain) to 10 (worst pain).
• Postoperative pain response [Measured at 1 hours postoperatively.]: The Visual Analog Score was used to assess pain response at 1 hours postoperatively. The score ranges from 0 (pain free or no pain) to 10 (worst pain).
• Postoperative pain response [Measured at 3 hours postoperatively.]: The Visual Analog Score was used to assess pain response at 3 hours postoperatively. The score ranges from 0 (pain free or no pain) to 10 (worst pain).
• Postoperative pain response [Measured at 6 hours postoperatively.]: The Visual Analog Score was used to assess pain response at 6 hours postoperatively. The score ranges from 0 (pain free or no pain) to 10 (worst pain).
• Postoperative pain response [Measured at 12 hours postoperatively.]: The Visual Analog Score was used to assess pain response at 12 hours postoperatively. The score ranges from 0 (pain free or no pain) to 10 (worst pain).
• Postoperative pain response [Measured at 24 hours postoperatively.]: The Visual Analog Score was used to assess pain response at 24 hours postoperatively. The score ranges from 0 (pain free or no pain) to 10 (worst pain).
• Consumption of postoperative analgesic [Approximately 24 hours after surgery.]: Record the type and dosage of postoperative analgesic within 24 hours after surgery.
• Consumption of postoperative rescue antiemetic [Approximately 24 hours after surgery]: Record the type and dosage of postoperative rescue antiemetic within 24 hours after surgery.
• Time to first defecation [Approximately 24 hours after surgery.]: Record the time of first defecation.

Sex: Female, ages: 18 Years to 65 Years

Inclusion Criteria:

1. ASA I or II;
2. Performing gynecologic laparoscopic procedures under general anesthesia;

Exclusion Criteria:

1. Age ≤ 18 or ≥65;
2. The patient has a previous history of PONV, digestive disorders, etc;
3. Ulcers, infections, and skin tears at acupressure and acupuncture (snap-needle) treatment sites;
4. Patients allergic to ginger；
5. Inability to follow protocol or refusal to participant

• Lin Cheng, B.S, Principal investigator, Weifang People's Hospital