Background: The present study was undertaken to investigate whether the transcutaneous electrical stimulation of the P6 acupoint prevents postoperative nausea and vomiting (PONV) after minor breast surgery.Methods: In this prospective, randomized, double-blind and placebo-controlled study, we investigated ASA I or II female patients who underwent minor breast surgery under general anesthesia using sevoflurane. We used a ReliefBand Ⓡ device (NSTTM 600, Woodside Biomedical Inc, USA) for the transcutaneous electrical stimulation of the P6 acupoint. The patients were randomly divided into two groups; in the P6 group (n = 33) the activated ReliefBand Ⓡ was placed at the P6 acupoint; in the placebo group (n = 33) the inactivated ReliefBand Ⓡ was placed at the P6 acupoint. The ReliefBand Ⓡ was applied 10 min before the end of surgery and it remained in place for 24 h. We evaluated the incidence and severity of PONV, and the need for palliative antiemetics during the first 6 h and 24 h after surgery.Results: The incidence of nausea was significantly lower in the P6 group (33%) than in the placebo group (67%) during the first 24 h after surgery. The severity of nausea was also significantly lower in the P6 group than in the placebo group. However, the incidence of vomiting and the need for palliative antiemetics was not different between the two groups.Conclusions: Transcutaneous electrical stimulation of the P6 acupoint significantly reduced the incidence and severity of nausea, but not the incidence and severity of vomiting, for female patients undergoing minor breast surgery during the first 24 h after surgery.
Background: Thoracic epidural anesthesia (TEA) combined with general anesthesia is commonly used in major upper abdominal surgery. The advantages of this method is the suppression of the perioperative stress response, the improvement in endocardial perfusion, and the reduction of myocardial oxygen consumption, postoperative morbidity and mortality. In particular, this method reduces the level of postoperative ileus and intestinal anastomosis leakage during gastrointestinal surgery. However, there is the possibility of severe cardiovascular depression using this combination method. This study evaluates the cardiovascular effects of extensive TEA combined with sevoflurane general anesthesia.Methods: Fifty patients scheduled subtotal gastrectomy were enrolled in this study. After administering a bolus injection of 20 ml of 0.375% ropivacaine through an epidural catheter during sevoflurane general anesthesia, mean arterial pressure, heart rate, stroke volume, cardiac output, and systemic vascular resistance measured by Hemosonic (HemoSonic TM 100, Arrow, USA) every 5 minutes over a 30-minute period after the injection.Results: All the data showed a significant decrease from 5 minutes after the epidural bolus injection except for the stroke volume, but that was not important clinically.Conclusions: A thoracic epidural injection of 20 ml of 0.375% ropivacaine can be used safely during sevoflurane anesthesia without severe cardiovascular complications during upper abdominal surgery.
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