Magnetic acupressure for management of postoperative nausea and vomiting: a preliminary study.

BACKGROUND: To assess the efficacy of magnetic acupressure in the prevention of postoperative nausea and vomiting (PONV). METHODS: Fifty-eight patients were included in this randomized, double blind, preliminary prospective study. Thirty-three underwent ear, nose, and throat (ENT) procedures and twenty-five underwent gynaecological procedures. A magnet patch (M) or a placebo patch (P) was applied to patients in each group randomly. The patch was applied 15 min before surgery to P6 a point situated above the wrist, on the medial aspect of the arm between the palmaris longus and flexor carpi radicis (REF point). Anaesthesia was standardized for all patients. Primary study endpoints included PONV scores and number of rescue antiemetic administrations. Secondary endpoints included pain scores, percentage of patients who required rescue analgesics and satisfaction scores. Study variables were measured on arrival in the PACU and 8, 16 and 24 h after surgery. RESULTS: The global incidence of PONV was 50%. We found no significant difference in the incidence of PONV between ENT patients (46%) and gynaecology patients (56%), and no difference between patients who received magnet treatment (47%) and those that did not (54%). Patients receiving the magnet had a similar satisfaction level (75% satisfied) to those receiving placebo (73% satisfied). In addition, magnet-treated patients had similar pain and PONV scores, and a similar percentage of patients in each groups received postoperative rescue analgesics. Finally, there was no difference in the number of rescue antiemetic administrations between the two groups. CONCLUSION: The use of magnetic acupressure as a prophylactic antiemetic treatment prior to ENT or gynaecology surgeries produced no benefit when compared to placebo.

Medical students' knowledge of and exposure to cleft palate.

To compare the knowledge and experience of medical students in 1989 with that of those surveyed in 1973, a questionnaire about the various aspects of cleft palate was completed by 209 medical students from West Virginia University and the Louisiana State University Medical Center at Shreveport and New Orleans. Results revealed that 1989 students were more familiar with the embryology of cleft palate, racial and gender differences, and intellectual and psychologic issues (p less than .05). In contrast, the 1973 students were more able to define cleft palate, submucous cleft palate, and pharyngeal flap. There was no difference between the two groups of students in the amount of clinical exposure to cleft palate. These findings support the need for greater emphasis on cleft palate at the pre- and postdoctoral levels, as well as within continuing education programs. As part of current programs, the standard of practice of multidisciplinary team management for an individual with cleft palate should be underscored.

Standardization for the reporting of nasopharyngoscopy and multiview videofluoroscopy: a report from an International Working Group.

A multidisciplinary International Working Group of scientists was assembled to address the question of standardizing reporting techniques for multiview videofluoroscopy and nasopharyngoscopy, the generally accepted standards for direct observation of the velopharyngeal valve. This report is a first attempt to propose standards while seeking feedback from the readership in order to further develop a common methodology.

Facial reconstruction in Down syndrome: perceptions of the results by parents and normal adolescents.

Randomized videotaped samples of conversational speech recorded preoperatively and 6 months postoperatively in 15 patients with Down syndrome who had undergone facial reconstruction were studied. The videotapes were rated by 34 normal adolescent students for appearance, friendliness, intelligence, and speech. In addition, the opinions of the patients' parents regarding their child's appearance and speech were surveyed. Results indicated that, although most parents reported improvements in their child's speech and appearance, independent raters could not readily discern improvement in any of the four areas studied. The use of videotape recordings to assess improvements in these traits after surgery in children with Down syndrome has not been previously reported.

Changes in aesthetic appearance and intelligibility of speech after partial glossectomy in patients with Down syndrome.

Eight patients with Down syndrome, aged 9 years and 10 months to 25 years and 4 months, underwent partial glossectomy. Preoperative and postoperative videotaped samples of spoken words and connected speech were randomized and rated by two groups of listeners, only one of which knew of the surgery. Aesthetic appearance of speech or visual acceptability of the patient while speaking was judged from visual information only. Judgments of speech intelligibility were made from the auditory portion of the videotapes. Acceptability and intelligibility also were judged together during audiovisual presentation. Statistical analysis revealed that speech was significantly more acceptable aesthetically after surgery. No significant difference was found in speech intelligibility preoperatively and postoperatively. Ratings did not differ significantly depending on whether the rater knew of the surgery. Analysis of results obtained in various presentation modes revealed that the aesthetics of speech did not significantly affect judgment of intelligibility. Conversely, speech acceptability was greater in the presence of higher levels of intelligibility.