Abstract
BACKGROUND: Postoperative cough after bronchoalveolar lavage (BAL) is common and can delay recovery. We evaluated whether acupressure at Tiantu (CV22), Chize (LU5), and Taiyuan (LU9), quantified by a flexible pressure sensor, improves anesthesia recovery. METHODS: This single-center randomized controlled trial enrolled adults undergoing BAL under general anesthesia with a laryngeal mask airway. Patients were randomized 1:1 to receive acupressure (Group A) or routine PACU care without acupressure (Group C). In Group A, each acupoint was pressed sequentially for 3 min (CV22 → LU5 → LU9) with pressure recorded by a flexible sensor. Primary outcomes were cough severity and frequency; secondary outcomes included PACU time, heart rate, and complications such as tachycardia, hypertension, and stress urinary incontinence. RESULTS: A total of 120 patients were analyzed (60 in each group). Peak acupressure pressures were 30.2 N for CV22, 35.1 N for LU5, and 25.3 N for LU9, each peaking at 2.0 s. Compared with controls, patients receiving acupressure had a significantly shorter PACU stay (mean difference - 16.0 min, 95% CI - 18.9 to - 13.2), lower cough frequency (- 1.06 times/min, 95% CI - 1.83 to - 0.30), and reduced heart rate (- 9.5 beats/min, 95% CI - 13.7 to - 5.4). The incidence of moderate cough (10.0% vs. 48.3%, RR 0.21, 95% CI 0.09-0.46), severe cough (35.0% vs. 60.0%, RR 0.58, 95% CI 0.39-0.87), tachycardia (8.3% vs. 26.7%, RR 0.31, 95% CI 0.12-0.80), and stress urinary incontinence (6.7% vs. 23.3%, RR 0.29, 95% CI 0.10-0.82) was also significantly lower in the acupressure group. The frequency of sore throat and hemoptysis at six hours did not differ between groups. No adverse events related to acupressure were observed. CONCLUSIONS: Acupressure at CV22, LU5, and LU9, applied with quantified pressure, significantly reduced postoperative cough and related complications and shortened PACU recovery time after BAL. TRIAL REGISTRATION: ISRCTN18030444. Registered on October 25, 2024; retrospectively registered.