OBJECTIVETo assess the impacts on postoperative nausea and vomiting of the patients with laparoscopic surgery undergoing the general anesthesia by electroacupuncture (EA) at different frequencies at bilateral Neiguan (PC 6).

METHODSOne hundred and twenty female patients with laparoscopic surgery undergoing the general anesthesia were randomized into 4 groups: 2 Hz EA treatment group (group A), 2 Hz/100 Hz EA treatment group (group B), 100 Hz EA treatment group (group C) and a control group (group D), 30 cases in each one. The same anesthetic program was adopted in each group. For the patients in A, B and C groups, in the first half a hour undergoing the conventional drug anesthesia, acupuncture was applied to bilateral Neiguan (PC 6). After arrival of qi, HANS-200A electroacupuncture apparatus was connected, at the frequency as 2 Hz, 2 Hz/100 Hz and 100 Hz separately. The electric stimulation was discontinued at the end of surgery. The life physical signs after surgery, the occurrence of postoperative nausea and vomiting and the severity grades of postoperative nausea and vomiting were observed and recorded for the patients in each group.

RESULTSThe differences in the postoperative 1 h heart rate, mean arterial pressure (MAP), finger pulse oxygen saturation and respiratory frequency were not significant statistically in comparison of the patients among groups (all P > 0.05). The incidence of postoperative nausea and vomiting of the patients in group B was lower apparently than that in A, C and D groups [10.0% (3/30) vs 30.0% (9/30), 36.7% (11/30), 53.3% (16/30), all P < 0.01]. The severity of postoperative nausea and vomiting of the patients in group B was lower apparently than that in the rest three groups (all P < 0.01).

CONCLUSIONThe electroacupuncture at 2 Hz/100 Hz reduces effectively the incidence and the severity of postopera tive nausea and vomiting of the patients with laparoscopic surgery undergoing the general anesthesia.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Electroacupuncture ; Female ; Humans ; Laparoscopy ; adverse effects ; Male ; Middle Aged ; Postoperative Complications ; etiology ; therapy ; Postoperative Nausea and Vomiting ; therapy ; Vomiting ; etiology ; therapy ; Young Adult

OBJECTIVETo observe the effect of transcutaneous acupoint electric stimulation on the postoperative nausea and vomiting (PONV) and explore its mechanism.

METHODSNinety cases of elective cesarean section of I to II grade in American Society of Anesthesiologists (ASA) were collected and randomized into a transcutaneous acupoint electric stimulation group (group A), a sham-acupoint group (group B) and a blank control group (group C), 30 cases in each one. In the group A, 30 min before operation, the transcutaneous electric stimulation was applied to bilateral Neiguan (PC 6) and Zusanli (ST 36). The stimulation lasted during operation and 1 h after operation. In the group B, the same electric stimulation was given at the sites 3 cm lateral to the medial sides of Neiguan (PC 6) and Zusanli (ST 36). In the group C, the electric plaster was attached to bilateral Neiguan (PC 6) and Zusanli (ST 36), without any electric stimulation. The lumbar epidural combined anesthesia and the postoperative analgesia were same in each group. The mean arterial pressure (MAP), heart rate (HR) , oxygen saturation of blood (SpO2) and the VAS (visual analogue scale) score of nausea and vomiting were recorded before acupoint stimulation (T0), at skin incision (T1), fetal delivery (T2), abdominal exploration (T3) and 1 h after operation (T4) as well as bleeding and application of oxytocin, ephedrine and atropine during operation separately. The changes of plasma 5-hydroxytryptamine (5-HT) concentration were observed at T0 and 30 min after electric stimulation.

RESULTSThe differences were not significant in MAP, HP and SpO2 at each time point of the three groups (all P> 0.05). The differences were not significant in bleeding and application of oxytocin, ephedrine and atropine during operation (all P > 0.05). The scores of nausea and vomiting in the group A during T1 to T4 were lower than those in the group B and group C (all P < 0.05). In the group A, 30 min after transcutaneous acupoint electric stimulation, plasma 5-HT concentration was lower than those in the group B and group C (both P < 0.01).

CONCLUSIONThe transcutaneous acupoint electric stimulation apparently relieves nausea and vomiting during and after cesarean section and the mechanism is relevant with the decrease of plasma 5-HT concentration.

Acupuncture Points ; Adult ; Cesarean Section ; adverse effects ; Electric Stimulation ; Female ; Humans ; Postoperative Nausea and Vomiting ; blood ; etiology ; therapy ; Pregnancy ; Serotonin ; blood ; Young Adult

OBJECTIVETo investigate the treatment time dependence of electroacupuncture (EA) on Neiguan (PC6) for preventing postoperative nausea and vomiting (PONV).

METHODSOne hundred and seventy-eight patients, who had received intravenous patient-controlled analgesia (PCA) with Fentanyl, were assigned randomly to three groups using random numbers: a pre-operative EA group (PrEA), a post-operative EA group (PoEA), and a non-acupuncture control group (NC). An anesthetist evaluated the incidence and severity of nausea and vomiting for 48 h after surgery blindly. The main outcomes were severity and freguency of PONV, which were measured with a self-reported questionnaire and a confirmation from the anesthetist. The data were analyzed with ANOVA and Z-test.

RESULTSThe incidence of nausea and vomiting was significantly lower in the PrEA group than the NC group during 48 h after surgery (P<0.01, P<0.05). The incidence of vomiting was also significantly lower in the PrEA group than the PoEA group (P<0.05). The PoEA subjects evidenced no significant differences compared with the NC subjects in terms of the incidence of nausea and vomiting (P<0.05). The severity of nausea was significantly lower in the PrEA group than in the NC and PoEA groups (P<0.05).

CONCLUSIONSEA on PC6 is effective in the prevention of PONV, and pre-operative acupuncture is more effective than post-operative acupuncture.

Acupuncture Points ; Adult ; Analgesics, Opioid ; adverse effects ; Electroacupuncture ; Female ; Humans ; Incidence ; Laparoscopy ; adverse effects ; Male ; Middle Aged ; Postoperative Nausea and Vomiting ; epidemiology ; etiology ; prevention & control

OBJECTIVETo explore the best freezing time and the optimum analgesia modality.

METHODSIn dogs, intercostal nerves were froze at -70 degrees C at different time including 30, 60, 90, 120, 180 s. Samples were got at the operative day, in 10 days and 60 days respectively, then carried on the pathology exam. In clinical study, 150 patients undergoing thoracotomy were randomly designated into 5 groups, all patients were recorded the heart rate, blood pressure, SO2, VAS, the dosage of dolantin, and observed the complications and side effects.

RESULTSAt operative day, the freezing nerves appeared brown print macroscopically, and presented degeneration, necrosis of the nerve fiber microscopically with more than 90 s. After 10 days, nerves with more than 90 s became thinner than normal. After 60 days, all nerves had no obvious differentiation than normal. In clinical study, both 90 s group and 90 s with PCIA group were significantly better than 60 s group or PCIA group; The VAS of 90 s with PCIA group was significantly lower than 90 s group but had more side effects such as vomiting, nausea.

CONCLUSIONSAt -70 degrees C, the freezing time should be no less than 90 s. The freezing intercostal nerves can safely and effectively relieve postoperative chest pain. The effect of analgesia of 90 s with PCIA group is the best, but has many side effects.

Adult ; Aged ; Animals ; Chest Pain ; etiology ; therapy ; Cryoanesthesia ; adverse effects ; methods ; Disease Models, Animal ; Dogs ; Female ; Humans ; Intercostal Nerves ; Male ; Middle Aged ; Nausea ; etiology ; Pain, Postoperative ; etiology ; therapy ; Random Allocation ; Thoracotomy ; adverse effects ; Time Factors ; Vomiting ; etiology

INTRODUCTIONKnowing how patients value the quality of anaesthesia helps anaesthesiologists to customise their service. However, generalising findings from Western population-based willingness-to-pay studies across different cultures and societies might result in the oversight of some contextualised perspectives of the anaesthesia experience. This study aimed to capture the Singapore perspective of undesired post-anaesthesia outcomes.

METHODS132 patients recruited in a pre-anaesthetic evaluation clinic were given questionnaires describing ten possible post-anaesthetic outcomes. Outcomes were ranked for undesirability and assigned relative value through the hypothetical proportioning of SGD 100 to avoid their occurrence. Data was analysed with reference to patients' background and anaesthetic history.

RESULTSA response rate of 69.1% (n = 132/191) was achieved. Outcomes from the most to least undesirable were pain; vomiting; nausea; shivering; orodental trauma; sore throat; abrasions; somnolence; and thirst. Relative values allocated, in descending order, were pain; vomiting; nausea; orodental trauma; abrasions; sore throat; shivering; somnolence; and thirst.

CONCLUSIONSimilar to previous studies in Western populations, pain, vomiting and nausea were the top three adverse outcomes that Singapore patients wished to avoid. However, discrepancies with Western patients were seen in spending attitudes, possibly accounted for by differences in healthcare socioeconomics. This study provided a better understanding of Singapore patients' perspectives on post-anaesthesia adverse outcomes and could help to improve treatment strategy and resource management.

Adult ; Aged ; Aged, 80 and over ; Anesthesia ; adverse effects ; Anesthesiology ; methods ; Anesthetics ; Attitude to Health ; Female ; Health Care Costs ; Humans ; Language ; Male ; Middle Aged ; Pain ; etiology ; Postoperative Nausea and Vomiting ; Postoperative Period ; Singapore ; Surveys and Questionnaires ; Treatment Outcome ; Young Adult

OBJECTIVETo compare the efficacy of different 5-hydroxytryptamine 3 receptor antagonists in the prevention of postoperative nausea and vomiting (PONV) in patients undergoing general anesthesia.

METHODSTotally 360 patients, American Society of Anesthesiologists (ASA) grade I - II, aged 18-75 years, and having received elective operation with endotracheal intubation general anesthesia, were randomly divided into three double-blind groups: ondansetron group, tropisetron group, and granisetron group, with 120 patients in each group. Before anesthesia induction, patients were intravenously given ondansetron (4 mg), tropisetron (5 mg), or granisetron (3 mg), respectively. The episodes of nausea and vomiting were recorded for 24 hours after operation.

RESULTSNo significant differences were observed in the terms of complete inhibition rate of PONV among ondansetron group (70.0%), tropisetron group (68.6%), and granisetron group (72.9%) within 24 hours postoperatively (P >0.05), and so did postoperative nausea incidences (22.5%, 25.4%, and 20.3%, respectively), and postoperative vomiting incidences (10.0%, 13.6%, and 8.5%, respectively) (P > 0.05). No remarked antiemetic-related adverse effects were observed within 24 hours postoperatively.

CONCLUSIONIntravenous ondansetron (4 mg), tropisetron (5 mg), or granisetron (3 mg) before anesthesia induction can prevent PONV with similar efficacy and safety.

Adolescent ; Adult ; Aged ; Anesthesia, General ; adverse effects ; Antiemetics ; therapeutic use ; Double-Blind Method ; Female ; Granisetron ; therapeutic use ; Humans ; Indoles ; therapeutic use ; Male ; Middle Aged ; Ondansetron ; therapeutic use ; Postoperative Nausea and Vomiting ; etiology ; prevention & control ; Young Adult

PURPOSE: This study was done to evaluate the combination effects of capsicum plaster at the Korean hand acupuncture points K-D2 with prophylactic antiemetic on Postoperative Nausea and Vomiting (PONV). METHODS: An experimental research design (a randomized, a double-blinded, and a placebo-control procedure) was used. The participants were female patients undergoing gynecologic laparoscopy; the control group (n=34) received intravenous prophylactic ramosetron 0.3mg, while the experimental group (n=34) had Korean Hand Therapy additionally. In the experimental group, capsicum plaster was applied at K-D2 of both 2nd and 4th fingers by means of Korean Hand Therapy for a period of 30 minutes before the induction of anesthesia and removed 8 hours after the laparoscopy. RESULTS: The occurrence of nausea, nausea intensity and need for rescue with antiemetic in the experimental group was significantly less than in the control group 2 hours after surgery. CONCLUSION: Results of the study show capsicum plaster at K-D2 is an effective method for reducing PONV in spite of the low occurrence of PONV because of the prophylactic antiemetic medication.
Acupuncture Points ; Adult ; Anesthesia ; Antiemetics/*therapeutic use ; Asian Continental Ancestry Group ; Capsaicin/therapeutic use ; Capsicum/*chemistry ; Double-Blind Method ; Female ; Fingers ; Genital Diseases, Female/*surgery ; Humans ; Laparoscopy/adverse effects ; Middle Aged ; Postoperative Nausea and Vomiting/*drug therapy/etiology ; Republic of Korea ; Time Factors ; Vomiting/*drug therapy/etiology

Association between postoperative nausea and vomiting (PONV) and micro-opioid receptor A118G single nucleotide polymorphism (SNP) is undefined and might underlie inconsistent results of studies on PONV occurrence in patients undergoing general anesthesia with the opioid, remifentanil. Four hundred and sixteen Korean women undergoing breast surgery with general anesthesia were randomized to receive remifentanil 10 ng/mL (plasma-site, Minto model) using a target-controlled infusion device and either propofol for total intravenous anesthesia (T group) or sevoflurane for inhalation anesthesia (I group) with bispectral index values maintained between 40 and 60. Blood specimens were collected after anesthesia induction for A118G SNP analysis. PONV and postoperative pain were evaluated. A118G SNP type distribution among Korean female adults studied was AG (n=195)>AA (n=158)>GG (n=63). Regardless of anesthetic technique, patients with GG types had lower PONV scale on arrival at postoperative care unit (PACU) (P=0.002), while T group showed lower PONV scale than I group up to 6 hr after PACU discharge in AA and AG types. No differences were apparent for postoperative pain among opioid receptor polymorphism. PONV occurrence differs according to opioid receptor polymorphism and anesthetic technique in patients undergoing general anesthesia with remifentanil.
Adult ; Analgesics, Opioid/*adverse effects ; Anesthesia, General/*adverse effects ; Breast Diseases/surgery ; Demography ; Double-Blind Method ; Female ; Humans ; Methyl Ethers/adverse effects/therapeutic use ; Pain, Postoperative/drug therapy ; Piperidines/*adverse effects/therapeutic use ; *Polymorphism, Single Nucleotide ; Postoperative Nausea and Vomiting/*etiology ; Receptors, Opioid, mu/*genetics