Self-citation of a journal may affect its impact factor. We investigated self-citations in the 1995 and 1996 issues of six anaesthesia journals by calculating the self-citing and self-cited rates for each journal. Self-citing rate relates a journal's self-citations to its total number of references. We defined self-cited rate as the ratio of a journal's self-citations to the number of times it is cited by the six anaesthesia journals. We also correlated self-citing rates with the impact factor of the six journals for 1997. Citations among the six journals differed significantly (P < 0.0001). Anesthesiology had the highest self-citing rate (57%). Anaesthesia, Anesthesia and Analgesia, British Journal of Anaesthesia, Canadian Journal of Anaesthesia and the European Journal of Anaesthesiology had self-citing rates of 28%, 28%, 30%, 11% and 4% respectively. The self-cited rates were 31%, 35%, 34%, 27%, 31% and 17% for Anaesthesia, Anesthesiology, Anesthesia and Analgesia, British Journal of Anaesthesia, Canadian Journal of Anaesthesia and the European Journal of Anaesthesiology, respectively. North America journals cited the North America literature. This also occurred, to a lesser extent, in the European anaesthesia journals. A significant correlation between self-citing rates and impact factors was found (r = 0.899, P = 0.015). A high self-citing rate of a journal may positively affect its impact factor.

Correcting the IF of the 36 journals for self-citation did not significantly change journal rankings. The adjusted IF/fcat to normalize for the scientific field was positively correlated with the conventional IF.

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The possible postoperative antiemetic effect of transcutaneous electrical nerve stimulation (TENS) on the P6 point (on the Pericardium Channel of Hand-Jueyin) was evaluated in 103 women undergoing hysterectomy. TENS on the P6 point was applied 30-45 min before induction of anesthesia in 51 patients and continued for 6 h postoperatively. The control group, 52 patients, was treated exactly in the same way but with the electrical stimulator turned off. Incidence of vomiting was assessed blindly 2 h, 4 h, 6 h, and 8 h postoperatively. The incidence of vomiting postoperatively was significantly less in the TENS-treated group when compared with the control group (between 0 h and 2 h: 23% vs 43%, P < 0.05; between 2 h and 4 h: 27% vs 50%, P < 0.025; and between 4 h and 6 h: 31% vs 67%, P < 0.001, respectively). Six hours postoperatively TENS was discontinued, and 8 h postoperatively the two groups did not differ significantly for incidence of vomiting (between 6 h and 8 h: 51% vs 65%). The authors conclude that TENS reduces the incidence of vomiting after hysterectomy.