Mohadeseh Khakpour - Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
Babak Dabbaghi - Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
Sepideh Noorkhomami - Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Science, Mashhad, Iran.
Asma Javid - Firoozabadi Clinical Research Development Unit (FACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran.

Background: Chemotherapy is the main component of systemic cancer treatment; however, the effective application is restricted due to nausea and vomiting. We aimed to assess the effect of acupressure on nausea and vomiting in children undergoing chemotherapy. Materials and Methods:  An extensive search was done in databases of Medline, Embase, Scopus, Cochrane, and Web of Science until February 2018. Two independent researchers screened articles, in the next step, full texts of probably relevant articles were summarized and categorized based on the evaluated outcomes and overall effect size was presented. Results: Four studies were included in the systematic review (including 223 children and adolescents aged 5 to 19 years). The first study assessed the effect of acupressure wrist bands and placebo bands; the results showed the feasibility of well tolerated acupressure, but not more effective than placebo. In the second study, researchers concluded that the acupressure bands compared to sham bands could not improve nausea and vomiting, neither in the acute nor the delayed phase. In addition, daily vomiting was not improved via acupressure bands in either the acute, or the delayed phases in chemotherapy. In the third study, a significant difference was observed between the two groups auricular acupressure intervention+ standard care (AAP), and auricular acupressure using sham auricular points (SAP) + standard care regarding occurrence, and severity of both nausea and vomiting. The results of fourth study showed that acupressure has a significant role in the reduction of nausea, vomiting and retching associated with chemotherapy among adolescents with cancer. Conclusion: The patients considered the acupressure as a safe, effective and well-received strategy though objective criteria exhibited no statistically significant improvements compared to conventional care.

Acupressure, chemotherapy, Leukemia, Nausea, Pediatric, vomiting