Capsicum plasters on acupoints decrease the incidence of emergence agitation in pediatric patients

Abstract

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.

Abundant expression and functional participation of TRPV1 at Zusanli acupoint (ST36) in mice: mechanosensitive TRPV1 as an “acupuncture-responding channel”

“…This is also true in clinical settings, as others reported the acupuncture-like effect of the topical application of capsaicin on acupoints [56,57]. Capsaicin can cause conduction analgesia (or desensitization) [58,59].…”

Electrical stimulation of the heart 7 acupuncture site for preventing emergence agitation in children

“…9,10 The stimulation methods used in the previous studies are difficult to apply in daily clinical practice because they require special techniques or medications. Our method, however, is easy to apply in daily practice because it only requires PNS devices that are regularly used in operating theatres.…”

Is acupuncture “stimulation” a misnomer? A case for using the term “blockade”

“…As noted above, acupuncture treatment is not strictly limited to needle insertion, with many practitioners employing other techniques, including moxibustion [1], low level laser [6], capsaicin plaster [9], and even simple manual acupoint massage (acupressure) [33]. …”

“…Yet, rather than being stimulatory, Chow et al have found that laser actually inhibits peripheral nerves [8]. Similarly, the application of capsaicin to acupuncture points in bother upper [9] and lower [10] limbs results in identical effects to needle acupuncture, yet capsaicin induces neural conduction blockade rather than stimulation [11]. It is, of course, quite possible, that acupuncture employing needle insertion induces its clinical effect through an entirely different mechanism to that of laser acupuncture and capsaicin application to acupuncture points.…”