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合谷穴贴敷辣椒膏可减少正颌手术后的术后镇痛需求。

Capsicum plaster at the Hegu point reduces postoperative analgesic requirement after orthognathic surgery.

作者信息

Kim Kyo S, Kim Kyu N, Hwang Kyung G, Park Chang J

机构信息

Department of Anesthesiology, Hanyang University Hospital, #17 Haengdang dong, Sungdong gu, Seoul 133-792, Korea.

出版信息

Anesth Analg. 2009 Mar;108(3):992-6. doi: 10.1213/ane.0b013e318195b78f.

Abstract

BACKGROUND

Capsicum plaster at classical Chinese acupoints is an alternative to acupuncture, which has been used as an effective method for preventing postoperative nausea and vomiting, sore throat, and pain. In this study, we investigated the postoperative analgesic efficacy of capsicum plaster at Hegu (LI 4) acupoints in patients after bilateral sagittal split ramus osteotomy.

METHODS

A double-blind, sham-controlled study was conducted with 84 patients undergoing orthognathic surgery, and who were randomly assigned to three treatment regimens (n = 28 each): Hegu group = capsicum plaster at Hegu acupoints and placebo tape on the shoulders as a nonacupoint; sham group = capsicum plaster on the shoulders and placebo tape at Hegu acupoints; and control group = placebo tape at Hegu acupoints and on the shoulders. The capsicum plaster was applied before induction of anesthesia and maintained for 8 h per day for 3 postoperative days.

RESULTS

The total amount of patient-controlled analgesia, containing 6.5 microg/mL fentanyl and 1.2 mg/mL ketorolac, administered in the first 24 h after the operation was decreased in the Hegu group (26.8 +/- 3.4 mL) compared with the control (44.2 +/- 7.3 mL) and sham (42.1 +/- 6.9 mL) groups (P < 0.01). The incidence of postoperative nausea and vomiting and the need for rescue medication were reduced, and the overall satisfaction score was greater in the Hegu group compared with other groups (P < 0.01).

CONCLUSION

The capsicum plaster at the Hegu acupoints decreased the postoperative opioid requirements and opioid-related side effects in patients after orthognathic surgery.

摘要

背景

中药穴位贴敷是针刺的一种替代疗法,已被用作预防术后恶心呕吐、咽喉痛和疼痛的有效方法。在本研究中,我们调查了双侧下颌支矢状劈开截骨术后患者合谷穴(LI 4)贴敷辣椒膏的术后镇痛效果。

方法

对84例接受正颌手术的患者进行了一项双盲、假对照研究,这些患者被随机分为三种治疗方案(每组n = 28):合谷组 = 合谷穴贴敷辣椒膏,肩部贴敷安慰剂胶带作为非穴位对照;假手术组 = 肩部贴敷辣椒膏,合谷穴贴敷安慰剂胶带;对照组 = 合谷穴和肩部均贴敷安慰剂胶带。辣椒膏在麻醉诱导前应用,术后3天每天维持8小时。

结果

与对照组(44.2 ± 7.3 mL)和假手术组(42.1 ± 6.9 mL)相比,合谷组术后24小时内患者自控镇痛(含6.5 μg/mL芬太尼和1.2 mg/mL酮咯酸)的总量减少(26.8 ± 3.4 mL)(P < 0.01)。与其他组相比,合谷组术后恶心呕吐的发生率和抢救药物的需求降低,总体满意度评分更高(P < 0.01)。

结论

正颌手术后患者合谷穴贴敷辣椒膏可降低术后阿片类药物的需求量及阿片类药物相关的副作用。

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