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Giriş Son yıllarda yayınlanan makaleler incelendiğinde, anestezistlerin preoperatif muayene sırasında her hastayı obstrüktif uyku apnesi (OUA) olasılığı açısından değerlendirmesinin gerekli olduğu anlaşılmaktadır. Bu gereklilik başlıca iki nedene dayanır; ilki, OUA hastalarının %80-90'ının tanı konmamış durumda olmalarıdır (1). İkinci neden ise, Amerikan Anestezistler Birliği'nin (ASA) 2006'da yayımladığı bir kılavuzla, cerrahi hastalara preoperatif dönemde OUA açısından tarama yapılmasını önermiş olmasıdır (2). Preoperatif dönemde kullanılacak uygun bir tarama ile OUA olasılığı yüksek olan hastalar belirlenip, anestezistlerin peroperatif dönemde karşı karşıya kalabilecekleri riskler en aza indirilebilir.Temel özellikleri uykuda solunumun bozulması, horlama ve gün içinde aşırı uyku hali olan OUA, erişkin popülasyonda kadınlarda %2, erkeklerde %4 oranında görülmektedir (3). OUA'nın cerrahi hastalardaki görülme sıklığına dair rakamlar değişkenlik gösterse de, bariatrik cerrahi gibi bazı özel hasta gruplarında çok yüksek oranlarda (%78) izlendiği bildirilmektedir (4-8). Peroperatif komplikasyonlar ile OUA şiddeti arasında doğrudan bir ilişki olduğu bilindiği için, hangi nedenle cerrahi geçirecek olursa olsun OUA hastalarına önceden tanı konularak gereken önlemlerin alınması büyük önem taşımaktadır (2). Bu hastalarda anestezi indüksiyonu sırasında havayolu sağlanmasında zorlukla karşılaşılabilir (9). Ekstübasyondan hemen sonra solunum yolu obstrüksiyonu görülebileceği gibi, postoperatif dönemde verilen Methods:In 110 adult patients who were admitted to the Sleep Clinic for polysomnography with an initial diagnosis of obstructive sleep apnoea, the STOP-Bang questionnaire was used to calculate the sensitivity, specificity, negative predictive value, positive predictive value and likelihood ratios. Results:In the study, no significant difference was obtained between two sexes for the presence of high risk of obstructive sleep apnoea (p>0.05). When apnoea-hypopnoea index (AHI) ≤5 patients and AHI >5 patients were compared, no significant differences were found in the values of age, sex and body mass index (p>0.05). Mean AHI value was 1.4 in AHI ≤5 patients, while it was 33.8 in AHI >5 patients (p<0.05). Although both STOP and STOP-Bang screening tests have a high sensitivity (>90%) in various severities of OSA (AHI >5, AHI >15 and AHI >30), their specificities were found to be low. As the severity of OSA increases, the positive predictive values of both tests were decreased, while the negative predictive values were increased. Conclusion

Summary Aim:  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. Background:  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. Results:  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. Conclusions:  Application of capsicum plasters on acupoints offers a valuable choice in the prevention of EA in children.

Ear-press needle acupuncture on Yintang point reduces preoperative anxiety in adult surgical patients.

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