The Efficacy of Several Neuromuscular Monitoring Modes at the P6 Acupuncture Point in Preventing Postoperative Nausea and Vomiting
The Efficacy of Several Neuromuscular Monitoring Modes at the P6 Acupuncture Point in Preventing Postoperative Nausea and Vomiting
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DOI：
10.1213/ane.0b013e31820f819e
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发表时间：
2011-04-01
影响因子：
5.7
通讯作者：
Yoon, Sung W.
中科院分区：
文献类型：
--
作者：
Kim, Yong H.;Kim, Kyo S.;Yoon, Sung W.
背景技术背景：在这项研究中，我们测试了几种神经肌肉监测模式在P6穴位预防术后恶心和呕吐（PONV）的有效性。方法：在这项前瞻性，双盲，随机，安慰剂对照试验中，264例接受腹腔镜子宫切除术的妇女进行了评估PONV。神经肌肉阻滞监测加速度肌描记术与1-Hz单抽搐（ST）的尺神经（n = 54，对照），ST（n = 52），四串刺激（n = 53），双脉冲刺激（n = 53），或强直（n = 52）在正中神经刺激P6穴位。与对照组相比，治疗组的PONV发生率（P = 0.022）、要求患者自控镇痛的次数（P = 0.009）和强直刺激后6 h的患者自控镇痛总量（P = 0.042）均显著降低。总体而言，破伤风组的患者更满意PONV的管理相比，患者在control group.CONCLUSION：破伤风刺激应用于P6穴位可以减少PONV腹腔镜子宫切除术后相比，ST刺激尺神经，导致更大程度的患者满意度。ST、四串刺激或双脉冲刺激对P6穴位的PONV无显著影响。（Anesth Analg 2011;112：819-23）
BACKGROUND: In this study, we tested the efficacy of several neuromuscular monitoring modes at the P6 acupuncture point for preventing postoperative nausea and vomiting (PONV).METHODS: In this prospective, double-blind, randomized, placebo-controlled trial, 264 women undergoing laparoscopic hysterectomy were evaluated for PONV. Neuromuscular blockade was monitored by acceleromyography with 1-Hz single twitch (ST) over the ulnar nerve (n = 54, control), and ST (n = 52), train-of-four (n = 53), double-burst stimulation (n = 53), or tetanus (n = 52) over the median nerve stimulating at the P6 acupuncture point.RESULTS: The incidence of PONV (P = 0.022), the number of requests for patient-controlled analgesia (P = 0.009), and total patient-controlled analgesia volume (P = 0.042) 6 hours after tetanic stimulation were significantly reduced in the treatment group compared with the control group. Overall, patients in the tetanus group were more satisfied with the management of PONV compared with patients in the control group.CONCLUSION: Tetanic stimulation applied to the P6 acupuncture point can reduce PONV after laparoscopic hysterectomy compared with ST stimulation of the ulnar nerve, resulting in a greater degree of patient satisfaction. None of the stimulations, ST, train-of-four, or double-burst, applied to the P6 acupuncture point significantly affected PONV. (Anesth Analg 2011;112:819-23)