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在小儿扁桃体切除术中,针灸能否成为地塞米松的合适替代方法?

Could acupuncture be an adequate alternative to dexamethasone in pediatric tonsillectomy?

作者信息

Moeen Seham M

机构信息

Anesthesia and Intensive Care Department, Faculty of Medicine, Assiut University, Asyut, Egypt.

出版信息

Paediatr Anaesth. 2016 Aug;26(8):807-14. doi: 10.1111/pan.12933. Epub 2016 Jun 22.

Abstract

BACKGROUND

Usage of nonpharmacological treatment contributes to an overall patient well-being, assisting in physical and emotional healing. Acupuncture has been reported to be useful in reducing early postoperative vomiting (POV) and attenuating postoperative pain.

AIM

The aim of this study was to compare the effect of dexamethasone vs acupuncture at P6 bilaterally and CV13 on the incidence and severity of POV in children undergoing tonsillectomy with or without adenoidectomy.

METHOD

One hundred and twenty children, ASA I-III aged 2-8 years undergoing elective tonsillectomy were included in this prospective randomized double-blind study. Children were randomly divided into two equal groups (60 each). At induction of anesthesia, the dexamethasone group received 0.15 mg·kg(-1) dexamethasone IV plus sham acupuncture, and the acupuncture group received acupuncture at P6 bilaterally and CV13 plus 2 ml of normal saline IV. Vomiting was recorded at 0-6, 6-24, and 0-24 h postoperatively.

RESULTS

There was no difference in the incidence of vomiting between the acupuncture and dexamethasone groups. The mean difference in time to first oral intake (95% CI) was 4.3 (0.5-8.6) min between dexamethasone group and acupuncture group; P = 0.426. The mean difference in time until first vomit (95% CI) was 12 (9.5-13.8) min between both groups. No significant differences between Kaplan-Meier curves for time until first vomit (log-rank test) were obtained (P = 0.697).

CONCLUSION

Acupuncture at P6 bilaterally and CV13 provided similar antiemetic effect to dexamethasone in children undergoing tonsillectomy.

摘要

背景

非药物治疗的应用有助于患者的整体健康,促进身体和情感的康复。据报道,针灸可有效减少术后早期呕吐(POV)并减轻术后疼痛。

目的

本研究旨在比较地塞米松与双侧P6和CV13穴位针刺对行扁桃体切除术(无论是否同时行腺样体切除术)的儿童POV发生率和严重程度的影响。

方法

本前瞻性随机双盲研究纳入了120例年龄在2至8岁、ASA分级为I-III级且接受择期扁桃体切除术的儿童。将儿童随机分为两组,每组60例。麻醉诱导时,地塞米松组静脉注射0.15mg·kg⁻¹地塞米松加假针刺,针刺组双侧P6和CV13穴位针刺加静脉注射2ml生理盐水。术后0至6小时、6至24小时和0至24小时记录呕吐情况。

结果

针刺组和地塞米松组的呕吐发生率无差异。地塞米松组与针刺组首次经口进食时间的平均差值(95%CI)为4.3(0.5-8.6)分钟;P = 0.426。两组首次呕吐时间的平均差值(95%CI)为12(9.5-13.8)分钟。两组首次呕吐时间的Kaplan-Meier曲线(对数秩检验)无显著差异(P = 0.697)。

结论

双侧P6和CV13穴位针刺对行扁桃体切除术的儿童提供了与地塞米松相似的止吐效果。

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