Acar H Volkan, Yilmaz Ahmet, Demir Gamze, Eruyar Solmaz Günal, Dikmen Bayazit
Department of Anesthesiology and Intensive Care, Ankara Training and Research Hospital of Ministry of Health, Ankara, Turkey.
Paediatr Anaesth. 2012 Nov;22(11):1105-9. doi: 10.1111/j.1460-9592.2012.03876.x.
To detect the effect of capsicum plasters on bilateral HT 7 acupoints for decreasing Emergence agitation (EA) in pediatric patients undergoing tonsillectomy and/or adenoidectomy.
Emergence agitation with its incidence of 10% to 80% may have deleterious effects in postoperative period. Children may harm themselves and/or care providers who require extra nursing care and additional sedatives and/or analgesics that may cause a delay in discharge from hospital. The studies dealt with the potential benefits of the use of adjuvant drugs have yielded controversial results. Some may have side effects as well as the absence of a positive effect on EA.
METHODS/MATERIALS: Fifty patients undergoing elective adenoidectomy and/or tonsillectomy who aged between 2 and 10 were included to the study. Patients were divided into two groups, and capsicum plasters (acupuncture) or inactive plasters (sham) were applied on bilateral HT 7 points preoperatively. Pain, emergence agitation, and side effects were evaluated for 15 min postoperatively.
Incidence of EA (PAED scale) (28.0% vs 60.0) and postoperative side effects was lower in acupuncture group than in sham group while there was no significant difference in the severity of EA between groups. Duration of recovery was shorter in acupuncture group. Pain scores (CHEOPS scale) were comparable between groups. EA patients were noted to have greater age and more retching than non-EA patients. Postoperative side effects such as retching, laryngospasm, and vomiting were seen more frequently in the patients with EA.
Application of capsicum plasters on acupoints offers a valuable choice in the prevention of EA in children.
检测辣椒膏贴于双侧HT 7穴位对减少扁桃体切除术和/或腺样体切除术患儿苏醒期躁动(EA)的效果。
苏醒期躁动发生率为10%至80%,可能对术后产生有害影响。儿童可能会伤害自己和/或护理人员,这需要额外的护理以及额外的镇静剂和/或镇痛药,而这可能会导致出院延迟。关于使用辅助药物潜在益处的研究结果存在争议。有些药物可能有副作用,而且对EA没有积极作用。
方法/材料:纳入50例年龄在2至10岁之间接受择期腺样体切除术和/或扁桃体切除术的患者进行研究。患者分为两组,术前在双侧HT 7穴位贴上辣椒膏(针刺)或无活性膏贴(假对照)。术后15分钟评估疼痛、苏醒期躁动和副作用。
针刺组的EA发生率(PAED量表)(28.0%对60.0%)和术后副作用低于假对照组,而两组间EA严重程度无显著差异。针刺组恢复时间更短。两组间疼痛评分(CHEOPS量表)相当。与无EA的患者相比,EA患者年龄更大,干呕更多。干呕、喉痉挛和呕吐等术后副作用在EA患者中更常见。
穴位贴敷辣椒膏为预防儿童EA提供了一种有价值的选择。