European journal of anaesthesiology
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Randomized Controlled Trial
Acupressure at acupoint P6 for prevention of postoperative nausea and vomiting: a randomised clinical trial.
Postoperative nausea and vomiting causes discomfort in many patients despite both antiemetic prophylactics and improved anaesthetic techniques. Stimulation of acupoint P6 is described as an alternative method for prophylaxis of postoperative nausea and vomiting.In a randomised, double-blinded study, we aimed to investigate the effect of P6 acupoint stimulation on the incidence of postoperative nausea and vomiting within 24 h postoperatively with an acupressure wristband: Vital-Band. ⋯ We did not find the Vital-Band effective in preventing either nausea or vomiting after operation in women undergoing breast surgery.
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Randomized Controlled Trial
Transcutaneous electrical nerve stimulation on ST36 and SP6 acupoints prevents hyperglycaemic response during anaesthesia: a randomised controlled trial.
Hyperglycaemia is a common result of stress signals caused by pain and surgical procedure. Volatile anaesthetics also directly manipulate glucose homeostasis by affecting pancreatic insulin release and induce hyperglycaemia without surgical stress. We determined the preoperative application of transcutaneous electrical nerve stimulation (TENS) to the Chinese acupoints ST36 (Zusanli) and SP6 (Sanyinjiao) as a complementary therapy for controlling plasma glucose and improving insulin resistance during anaesthesia. ⋯ We found TENS at bilateral ST36 and SP6 acupoints to be an alternative means of managing the plasma glucose level and improving insulin resistance perioperatively.
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The pneumatic tourniquet is frequently used for upper and lower limb surgery to reduce bleeding, improve visualisation of important structures and expedite surgical procedures. Despite advances in technology, localised tissue damage secondary to cuff compression, ischaemia-reperfusion injuries and systemic complications still occur. ⋯ Use of the correct pneumatic tourniquet cuff size and a patient-specific cuff pressure with careful control of the duration of inflation may help reduce the incidence of these injuries. The efficacy of ischaemic preconditioning or postconditioning, and experimental treatments such as free radical scavenging, and use of nitric oxide synthetase inhibitors on endothelial dysfunction, systemic neutrophil activation and coagulation reactions needs to be established.
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We investigated patients' self-reported experience following awake flexible fibreoptic tracheal intubation and compared this to the experience of matched patients who had undergone conventional tracheal intubation under general anaesthesia for the same type of surgical procedure. ⋯ Temporary discomfort is encountered more frequently following awake orotracheal intubation than after conventional intubation, but we did not find a difference in long-term problems such as sleeping disorders or nightmares.