Comparing the efficacy of prophylactic p6 acupressure, ondansetron, metoclopramide and placebo in the prevention of vomiting and nausea after strabismus surgery.

To compare the efficacy of acupressure wrist bands, ondansetron, metoclopramide and placebo in the prevention of vomiting and nausea after strabismus surgery. Two hundred patients, ASA physical status I or II, aged between 10 and 60 years, undergoing strabismus surgery in Farabi Hospital in 2007-2008 years, were included in this randomized, prospective, double-blind and placebo-controlled study. Group I was the Control, group II received metoclopramide 0.2 mg/kg, group III received ondansetron 0.15 mg/kg iv just before induction, in Group IV acupressure wristbands were applied at the P6 points. Acupressure wrist bands were placed inappropriately in Groups I, II and III. The acupressure wrist bands were applied 30 min prior to the induction of anesthesia and removed six hours after surgery. Postoperative nausea and vomiting (PONV) was evaluated within 0-2 hours and 2-24 hours after surgery by a blinded observer. Results were analyzed by X(2) test. A P value of < 0.05 was taken as significant. The incidence of PONV was not significantly different in acupressure, metoclopramide and ondansetron during the 24 hours. Acupressure at P6 causes a significant reduction in the incidence of PONV 24 hours after strabismus surgery as well as metoclopramide 0.2 mg/kg and ondansetron 0.15 mg/kg iv for patients aged 10 or more.

Effect of cryoanalgesia on post-thoracotomy pain.

We prepared this study to determine the effect of cryoanalgesia on post-thoracotomy pain. In this double-blinded randomized clinical trial, 60 patients who underwent thoracotomy were divided into two groups (control and cryoanalgesia). Visual Analogue Scale (VAS, 0-10) was used for the measurement of severity of post-thoracotomy pain. It was classified into three categories: 0-1 (mild), 2-3 (moderate), and 4-10 (severe). Pethidine (0.5-1 mg/kg) was administered in case of need for both groups. Patients were visited at the hospital a week later, and were contacted by phone at the first, second, and third months post-operatively. Intensity of pain in the control group was higher than the cryoanalgesia group in all visits the follow-up period. On the second day, the frequencies of severe pain (4-10) were 33.3% and 0 in the control and cryoanalgesia groups, respectively. The mild pain on the seventh day was 13.3% and 83.3% in the control and cryoanalgesia groups, respectively (P < 0.01). Pethidine consumption was 151.6 ± 27 mg in the control group and 87.5 ±48 mg in the cryoanalgesia group on the first day post-operation (P < 0.001). Cryoanalgesia is a useful technique with not serious side effects in order to alleviate post-thoracotomy pain and reduce the need for opiate consumption.

Acupressure using ondansetron versus metoclopramide on reduction of postoperative nausea and vomiting after strabismus surgery.

OBJECTIVE: To compare the clinical efficacy of acupressure with treatment induced by ondansetron and metoclopramide on reduction of the severity of postoperative nausea and vomiting (PONV) after strabismus surgery. METHODS: There were 200 patients with ASA classes I-II, ages 10 to 60 years old, who underwent strabismus surgery that were included in this randomized, prospective, double-blind, placebo-controlled trial. Group I was the control, group II received metoclopramide 0.2 mg/kg, and group III received ondansetron 0.15 mg/kg intravenously immediately prior to anesthesia induction. In Group IV, acupressure wristbands were applied at the P6 points. Acupressure wrist bands were not placed appropriately for subjects of groups I-III. The acupressure wrist bands were applied 30 minutes before anesthesia induction and removed six hours after surgery completion. Anesthesia was standardized. PONV was evaluated within 0 - 2 hours and 2 - 24 hours after surgery by a blinded observer. Results were analyzed by the Chi-square or Fisher exact test. A P value of <0.05 was considered significant. RESULTS: The incidence of PONV was not significantly different among acupressure, metoclopramide and ondansetron groups during 24 hours. Also, the severity of PONV was not significantly different between acupressure, metoclopramide, and ondansetron in the recovery and ward. CONCLUSION: Acupressure at the P6 point causes a significant reduction in the incidence and severity of PONV 24 hours after strabismus surgery as well as metoclopramide (0.2 mg/kg) and ondansetron (0.15 mg/kg) intravenous for patients aged 10 or older. (Irct ID: IRCT138807152556N1).