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1.
J Clin Orthop Trauma ; 41: 102176, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-37483914

RESUMEN

Background: and methodology: The presented retrospective study is a report of 17 children (18 limbs) with post infective physeal bars around the knee. Minimum 2 years follow up post sepsis follow up was available. Observations: The mean follow up post infection was 6.9 years. The bar formation manifested mean 22.6 months post sepsis. The angular deformity progressed at the mean monthly rate of 0.84, 0.1, 0.26° for peripheral, central and extensive bars respectively. Peripheral bars underwent early intervention. Balancing of physeal growth using contralateral '8' plate was useful for partial bars. For extensive bars and older patients, complete epiphyseodesis and limb length equalization was used. Articular abnormalities (cupping, flattening, small epiphysis) were associated in 80% bars. Neonatal infections were often multifocal and had articular abnormalities. Conclusions: The 3 bar types presented with different characteristics. Peripheral bars produced most angular deformities and required early intervention. Articular abnormalities were associated with physeal bars in large number of patients especially those with neonatal infections. Overall unhealthy physis beside bar, delayed manifestations, and limb length discrepancy should be accounted for while planning treatment.

2.
J Bodyw Mov Ther ; 30: 221-225, 2022 04.
Artículo en Inglés | MEDLINE | ID: mdl-35500974

RESUMEN

INTRODUCTION: Superior cluneal nerve (SCN) entrapment giving rise to low back pain (LBP) remains undiagnosed many times; in this clinical study authors have evaluated therapeutic role of lidocaine injection of SCN for low back pain relief in patients with SCN entrapment. METHODS: The present study was a prospective, observational study; 25 patients with unilateral LBP over the iliac crest and buttock for more than six months not responding to conservative measures were included in this clinical trial. SCN lidocaine injection was done under fluoroscopy guidance; patients having more than 50% reduction in numeric rating scale (NRS) score, for at least 2 h following SCN injection, were enrolled in the study and followed for 6 months. The primary outcome measure was severity of LBP, measured by NRS score. Secondary outcome measures were percentage pain relief; Oswestry Disability Index (ODI) score, reduction of analgesic usage, DSM-IV score for psychological assessment. All these assessments were done prior to the procedure and at 2 weeks, 1, 3 and 6 months after the procedure. RESULTS: A significant reduction in the NRS scores was observed at 2 weeks, 1, 3 and 6 months after SCN lidocaine injection as compared to the baseline (P value < 0.05); authors also observed a significant pain relief and significantly reduced ODI scores, analgesic consumption and DSM scores compared to the baseline values (P value < 0.05). CONCLUSION: A single SCN lidocaine injection provided significant pain relief in LBP patients with SCN entrapment for a period of 6 months.


Asunto(s)
Dolor de la Región Lumbar , Bloqueo Nervioso , Síndromes de Compresión Nerviosa , Analgésicos , Humanos , Lidocaína/uso terapéutico , Dolor de la Región Lumbar/complicaciones , Dolor de la Región Lumbar/tratamiento farmacológico , Bloqueo Nervioso/métodos , Síndromes de Compresión Nerviosa/complicaciones , Síndromes de Compresión Nerviosa/diagnóstico , Síndromes de Compresión Nerviosa/cirugía , Estudios Prospectivos
3.
Kidney Int Suppl (2011) ; 11(1): 46-58, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33777495

RESUMEN

Anemia is common in patients with chronic kidney disease (CKD) and results from the dysregulation of iron metabolism and erythropoiesis. Hepcidin is a key regulator of iron availability and leads to iron sequestration during the state of iron repletion. Decreases in the level of hepcidin in the presence of hypoxia and/or iron limitation allow for greater iron availability for erythropoiesis. However, kidney excretion of hepcidin decreases as the severity of CKD increases, whereas production of hepcidin is increased under inflammatory conditions often present in patients with CKD, both of which contribute to anemia. Assessment of iron status is, therefore, essential in the treatment of anemia. However, current laboratory tests for the determination of the adequate supply of iron have many limitations, including diurnal variation in the levels of biomarkers, lack of standardized reference methods across laboratories, and confounding by the presence of inflammation. In addition, the current treatment paradigm for anemia of CKD can further disrupt iron homeostasis; for example, treatment with erythropoiesis-stimulating agents in the absence of supplemental iron can induce functional iron deficiency. Moreover, supplemental iron can further increase levels of hepcidin. Several novel therapies, including hypoxia-inducible factor prolyl hydroxylase inhibitors and hepcidin inhibitors/antagonists, have shown promise in attenuating the levels and/or activity of hepcidin in anemia of CKD, thus ensuring the availability of iron for erythropoiesis.

4.
J Clin Orthop Trauma ; 8(1): 31-33, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28360493

RESUMEN

OBJECTIVES: It is still unknown whether altered vitamin D levels observed with osteoarticular tuberculosis change during treatment in a child or modify the disease course. To find a possible answer to the above query, we investigated serial serum 25 hydroxy vitamin D concentrations in children suffering from osteoarticular tuberculosis treated with multidrug antitubercular drugs. METHODS: The prospective study enrolled 19 untreated immunocompetent children with an established diagnosis of osteoarticular tuberculosis. None of the patients were offered any therapeutic vitamin D supplementation at initiation or during the treatment. The patients were followed for response to multidrug antitubercular therapy (DOTS) at 2 months interval. Mean values of vitamin D were calculated at 0, 2, and 6 months and statistically compared. The following laboratory references for defining the vitamin D status were used: <30 nmol/L = deficiency; 30-75 nmol/L = insufficiency; >75 nmol/L = sufficiency. RESULTS: All the patients responded to antitubercular therapy. Out of the enrolled children, 73.67% had low vitamin D levels at initial presentation. There was no statistically significant difference in vitamin D levels in affected children at either 0-2 (p = 0.452), 2-6 (p = 0.240), or 0-6 months (p = 0.854) following antitubercular treatment. Although the mean vitamin D levels were higher in male patients when compared to female patients at all times, there was no statistically significant difference in vitamin D levels during treatment stages in either sex. CONCLUSIONS: Vitamin D levels were low at initiation of treatment and did not significantly improve during multidrug antitubercular treatment. Further, tuberculosis healed well with antitubercular therapy despite persistence of low serum levels of vitamin D.

5.
J Bodyw Mov Ther ; 21(1): 194-196, 2017 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-28167178

RESUMEN

Chronic widespread musculoskeletal pain is a cardinal symptom in hypermobility type of Ehler Danlos Syndrome (EDS type III). The management of pain in EDS, however, has not been studied in depth. A 30 year old female, known case of EDS, presented to the pain clinic with complaints of severe upper back pain for 6 months. Physical examination of the back revealed two myofascial trigger points over the left rhomboids and the left erector spinae. Local anaesthetic trigger point injections were given at these points, followed by stretching exercises under analgesic cover for the first week. After 1 week the patient reported 60-80% pain relief. This case highlights that we must keep a high index of suspicion for the more treatable causes of pain like myofascial pain syndrome in patients suffering from EDS, and should address it promptly and appropriately in order to maximise patient comfort.


Asunto(s)
Dolor Crónico/etiología , Dolor Crónico/terapia , Síndrome de Ehlers-Danlos/complicaciones , Síndromes del Dolor Miofascial/etiología , Síndromes del Dolor Miofascial/terapia , Puntos Disparadores , Adulto , Anestésicos Locales/uso terapéutico , Femenino , Humanos , Inyecciones Intramusculares , Ejercicios de Estiramiento Muscular/métodos , Manejo del Dolor/métodos
6.
Korean J Pain ; 29(4): 262-265, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27738505

RESUMEN

Wolff Parkinson White (WPW) syndrome is a condition in which there is an aberrant conduction pathway between the atria and ventricles, resulting in tachycardia. A 42-year-old patient, who was treated for WPW syndrome previously, presented with chronic somatic pain. With her cardiac condition in mind, she was thoroughly worked up for a recurrence of disease. As part of routine screening of all patients at our pain clinic, she was found to have severe depression as per the Patient Health Questionnaire-9 (PHQ-9) criteria. After ruling out sinister causes, she was treated for depression using oral Duloxetine and counselling. This led to resolution of symptoms, and improved her mood and functional capability. This case highlights the use of psychological screening tools and diligent examination in scenarios as confusing as the one presented here. Addressing the psychological aspects of pain and adopting a holistic approach are as important as treatment of the primary pathology.

8.
Int J Behav Med ; 23(1): 63-70, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26025629

RESUMEN

BACKGROUND: One of the biggest challenges in the spirituality, religiosity, and health field is to understand how patients and physicians from different cultures deal with spiritual and religious issues in clinical practice. PURPOSE: The present study aims to compare physicians' perspectives on the influence of spirituality and religion (S/R) on health between Brazil, India, and Indonesia. METHOD: This is a cross-sectional, cross-cultural, multi-center study carried out from 2010 to 2012, examining physicians' attitudes from two continents. Participants completed a self-rated questionnaire that collected information on sociodemographic characteristics, S/R involvement, and perspectives concerning religion, spirituality, and health. Differences between physicians' responses in each country were examined using chi-squared, ANOVA, and MANCOVA. RESULTS: A total of 611 physicians (194 from Brazil, 295 from India, and 122 from Indonesia) completed the survey. Indonesian physicians were more religious and more likely to address S/R when caring for patients. Brazilian physicians were more likely to believe that S/R influenced patients' health. Brazilian and Indonesians were as likely as to believe that it is appropriate to talk and discuss S/R with patients, and more likely than Indians. No differences were found concerning attitudes toward spiritual issues. CONCLUSION: Physicians from these different three countries had very different attitudes on spirituality, religiosity, and health. Ethnicity and culture can have an important influence on how spirituality is approached in medical practice. S/R curricula that train physicians how to address spirituality in clinical practice must take these differences into account.


Asunto(s)
Médicos , Religión y Medicina , Espiritualidad , Adulto , Actitud del Personal de Salud/etnología , Brasil , Comparación Transcultural , Estudios Transversales , Femenino , Humanos , India , Indonesia , Masculino , Médicos/psicología , Médicos/estadística & datos numéricos , Encuestas y Cuestionarios
9.
J Orthop Surg (Hong Kong) ; 22(3): 368-73, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25550021

RESUMEN

PURPOSE: To review radiographic changes in the proximal femurs of children of different ages during the course of treatment for nutritional rickets. METHODS: Pelvic radiographs of 161 children aged ≤ 13 years with nutritional rickets were retrospectively reviewed. Patients were treated with dietary counselling and vitamin D and calcium supplementation. Patients were followed up at week 3 and thereafter at a 2-month interval until ulnar convexity was achieved. Sequential radiographs of the hips in children of different ages were reviewed for each growth plate in terms of (1) the direction of growth, (2) active areas, (3) contribution of growth, and (4) the structure of the epiphysis. Radiographs were superimposed for comparison by matching the triradiate cartilage and the ischial portion of the obturator foramen. RESULTS: The direction of growth of the growth plates was from the physeal plate that is the longitudinal growth plate of the neck (LGP), the femoral neck isthmus (FNI), and the trochanteric growth plate (TGP) to the diaphyseal region, and from the perichondrium to the ossification centre in the proximal femoral epiphysis. Before the age of one year, the growth zone of the proximal femur was homogenous, with no differentiation between the LGP, FNI, and TGP. By the age of 2 years, the differentiation was more clearly established; the FNI was usually smaller than the TGP and LGP. By the age of 3 years, the FNI became prominent and the TGP remained small. By the age of 4 years, the ossification centre of the greater trochanter appeared, and the LGP extended medially as a medial overhang (MOH). During the children's growth, the LGP, FNI, or TGP remained active to a variable extent and were distinct until the age of 6 years. Gradually, the periphery of the LGP became less active than the centre of the LGP and gave rise to the 'eye sign'. The MOH generally ceased to be active beyond the age 9 years. By the age of 12 years, the TGP and FNI were minimally active and only the centre of the LGP remained active. CONCLUSION: The mineralisation process of healing rickets provides a useful biological marker for patterns of growth. Knowledge of the quantitative contribution of various growth plates of the proximal femur in childhood may increase the understanding of the pathomechanism of hip deformations.


Asunto(s)
Fémur/diagnóstico por imagen , Placa de Crecimiento/diagnóstico por imagen , Raquitismo/diagnóstico por imagen , Raquitismo/dietoterapia , Adolescente , Compuestos de Calcio/uso terapéutico , Niño , Preescolar , Consejo , Suplementos Dietéticos , Fémur/fisiopatología , Placa de Crecimiento/fisiopatología , Humanos , Lactante , Radiografía , Estudios Retrospectivos , Raquitismo/fisiopatología , Vitamina D/uso terapéutico
10.
Clin J Am Soc Nephrol ; 5(11): 2130-6, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20930089

RESUMEN

The foundation of endovascular procedures by nephrologists was laid in the private practice arena. Because of political issues such as training, credentialing, space and equipment expenses, and co-management concerns surrounding the performance of dialysis-access procedures, the majority of these programs provided care in an outpatient vascular access center. On the basis of the improvement of patient care demonstrated by these centers, several nephrology programs at academic medical centers have also embraced this approach. In addition to providing interventional care on an outpatient basis, academic medical centers have taken a step further to expand collaboration with other specialties with similar expertise (such as with interventional radiologists and cardiologists) to enhance patient care and research. The enthusiastic initiative, cooperative, and mutually collaborative efforts used by academic medical centers have resulted in the successful establishment of interventional nephrology programs. This article describes various models of interventional nephrology programs at academic medical centers across the United States.


Asunto(s)
Centros Médicos Académicos , Atención Ambulatoria/organización & administración , Procedimientos Endovasculares , Nefrología , Radiología Intervencionista , Centros Médicos Académicos/organización & administración , Cateterismo Cardíaco , Competencia Clínica , Curriculum , Prestación Integrada de Atención de Salud , Educación de Postgrado en Medicina , Procedimientos Endovasculares/educación , Becas , Humanos , Comunicación Interdisciplinaria , Nefrología/educación , Nefrología/organización & administración , Objetivos Organizacionales , Grupo de Atención al Paciente , Desarrollo de Programa , Radiología Intervencionista/educación , Radiología Intervencionista/organización & administración , Estados Unidos
11.
J Orthop Surg (Hong Kong) ; 17(3): 340-5, 2009 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20065377

RESUMEN

PURPOSE: To evaluate early adolescents with nutritional rickets and their responses to treatment. METHODS: 203 adolescents (aged 10 to 13 years) presenting with clinical features of lower-limb deformity, carpopedal spasm, joint swelling, a significant limp, or non-traumatic joint pain were screened for nutritional rickets. Multi-specialty examinations were performed. Family size, number of earning members, number and gender of children, preference for vegetarian food, composition of the meals, and the amount of milk consumed in a day were recorded. Radiographs of wrists, knees, ankles, and pelvis, as well as serum calcium, phosphate, and alkaline phosphatase levels were evaluated. The diagnosis of nutritional rickets was made based on a combination of clinical, radiological, and biochemical criteria, and confirmed by the responses to treatment. Children with nutritional rickets were treated by a single large intramuscular dose of vitamin D (600,000 IU) along with oral calcium and supplementary vitamin D as well as advice on diet and sunlight exposure. RESULTS: 40 females and 11 males were diagnosed as having nutritional rickets. 65% presented with bilateral knee pain with aggravation at night, 37% presented with lower-limb deformity, 24% had joint swelling especially at the wrist and ankle, 6% had a significant limp and walked with an antalgic gait secondary to pathological fractures. No patient reported carpopedal spasm. All patients had rachitic changes on radiographs in some but not all bones (100% in the ulna, 45% in the radius, 37% in the upper tibia, 37% in the lower fibula and 22% in the lower tibia). Three patients had pathological fractures. 55% had hypocalcaemia, 41% had hypophosphataemia and 100% had raised serum alkaline phosphatase levels. The mean time for biochemical resolution was 12 (range, 3-24) weeks. For radiological resolution it was 5 (range, 2-6) months, with the lower end of ulna being last to resolve. CONCLUSIONS: Radiographs of the lower end of ulna and serum alkaline phosphatase levels can be used as a screening and monitoring tool for nutritional rickets in early adolescents. There may be a high prevalence of subclinical vitamin-D deficiency in our adolescent population.


Asunto(s)
Raquitismo/diagnóstico , Raquitismo/terapia , Adolescente , Fosfatasa Alcalina/sangre , Biomarcadores/sangre , Calcio/sangre , Calcio/uso terapéutico , Terapia Combinada , Diagnóstico Diferencial , Dieta , Femenino , Humanos , India/epidemiología , Masculino , Prevalencia , Raquitismo/epidemiología , Factores de Riesgo , Luz Solar , Resultado del Tratamiento , Vitamina D/sangre , Vitamina D/uso terapéutico
12.
Clin Orthop Relat Res ; 466(10): 2350-9, 2008 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-18683015

RESUMEN

In India, health policies, services, health indices, and medical education are improving despite the country's enormous population and limited resources. Orthopaedic training in India should be geared to serve the predominantly rural population (72% of total population) living in some 550,000 villages, but unless the basic amenities improve in villages and towns, orthopaedists will remain averse to serving in these areas. Traditional practitioners play an important role in musculoskeletal trauma care in villages and even some town and city areas, and hence cannot be ignored. We suggest a stratified system of orthopaedic training for medical graduates, postgraduates, and paramedics with a well-defined need-based curriculum, and a clear cut division of labor, terms, and conditions to suit the stratified social and demographic structure of India. This stratified system is intended to provide appropriate musculoskeletal trauma care services to the rural population, reduce neglected and mismanaged trauma, consequently avoiding subsequent orthopaedic disability, and reduce the financial burden of managing these cases. This system also intends to prevent overloading of teaching hospitals and apex institutes and ensure availability of subspecialized orthopaedic services in the country at designated centers. Traditional practitioners shall be periodically educated regarding safe orthopaedic practices, which are anticipated to yield improved trauma care services.


Asunto(s)
Atención a la Salud , Países en Desarrollo , Educación Médica , Servicios Médicos de Urgencia , Sistema Musculoesquelético/lesiones , Procedimientos Ortopédicos/educación , Heridas y Lesiones/terapia , Actitud del Personal de Salud , Costo de Enfermedad , Atención a la Salud/economía , Atención a la Salud/organización & administración , Atención a la Salud/estadística & datos numéricos , Países en Desarrollo/economía , Países en Desarrollo/estadística & datos numéricos , Educación Médica/economía , Servicios Médicos de Urgencia/economía , Servicios Médicos de Urgencia/organización & administración , Servicios Médicos de Urgencia/estadística & datos numéricos , Costos de la Atención en Salud , Asignación de Recursos para la Atención de Salud , Conocimientos, Actitudes y Práctica en Salud , Accesibilidad a los Servicios de Salud , Investigación sobre Servicios de Salud , Disparidades en Atención de Salud , Humanos , India , Medicina Tradicional , Programas Nacionales de Salud , Procedimientos Ortopédicos/economía , Procedimientos Ortopédicos/estadística & datos numéricos , Desarrollo de Programa , Servicios de Salud Rural , Heridas y Lesiones/economía , Heridas y Lesiones/mortalidad
13.
Anesth Analg ; 106(3): 814-6, table of contents, 2008 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-18292424

RESUMEN

BACKGROUND: Venous cannulation is often performed without any analgesia, even though pain experienced during this procedure is at times very distressing. Various pharmacological and nonpharmacological measures have been tried with variable results to minimize venous cannulation pain. We designed the present study to evaluate the efficacy of a flash of light on attenuating venous cannulation pain. METHODS: Ninety adults (15-60 yr), ASA physical status I and II, of either sex, undergoing elective laparoscopic cholecystectomy, were included in this prospective and randomized study. Patients were divided into three groups of 30 each. Group I (control); Group II (distraction): photographed without a flash of light; and Group III (flash): photographed with a flash of light just before venous cannulation of a vein on the dorsum of the nondominant hand. Immediately after the photograph, venous cannulation was performed using an 18-gauge cannula. RESULTS: Two patients from each group could not be cannulated on their first attempt and were therefore dropped from subsequent analysis. The incidence of venous cannulation pain in the flash group was lower, i.e., 50% (14 of 28) when compared to 100% (28 of 28) observed in the other two study groups (P < 0.01). Severity of venous cannulation pain as assessed by the Visual Analog Scale scores (between 0 and 100; where 0 = no pain and 100 = worst imaginable pain) presented as median (interquartile range) were reduced in the flash [10(20)] and distraction [20(10)] groups compared with the control group [40(20)] (P < 0.01). The severity of venous cannulation pain was also reduced in the flash group compared with the distraction group (P < 0.01). CONCLUSION: We conclude that a flash of light before venous cannulation is a safe, effective, and easy-to-use method for minimizing venous cannulation pain.


Asunto(s)
Cateterismo Periférico/efectos adversos , Dolor/prevención & control , Fotograbar , Fototerapia , Adolescente , Adulto , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Dolor/epidemiología , Dolor/etiología , Dimensión del Dolor , Estudios Prospectivos , Índice de Severidad de la Enfermedad
14.
Can J Anaesth ; 54(3): 196-200, 2007 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-17331931

RESUMEN

PURPOSE: To compare the efficacy and side effects of transdermal diclofenac patch with eutectic mixture of local anesthetic (EMLA) cream in attenuating venous cannulation pain. METHODS: Adult ASA I or II patients undergoing elective surgery were randomly divided into three groups of 150 each. Group 1 (Control) patients received a placebo patch; Group 2 (EMLA) patients received EMLA cream; Group 3 (Diclofenac) patients received a transdermal diclofenac patch. The patches were applied at the proposed venous cannulation site 60 min prior to cannulation and pain resulting from an 18G cannula was assessed on an ten-point visual analogue scale (VAS). The cannulation site was observed for blanching, erythema, induration and edema for up to 24 hr. RESULTS: The incidence of venous cannulation pain was 100% in the control group, as compared to 37% and 48% of patients who experienced pain in the EMLA (P = 0.001) and diclofenac (P = 0.001) groups, respectively. The severity of venous cannulation pain [median (VAS) with interquartile ranges] was also higher in the control group: 6 (3) as compared to VAS sores of 0 (1) and 0 (2) in the EMLA (P = 0.001) and diclofenac (P = 0.001) groups. Blanching occurred with greater frequency in the EMLA group compared with the diclofenac (P = 0.001 at six hours) and placebo groups (P = 0.001 at six hours). Erythema, induration and edema were reduced in the diclofenac group compared with the EMLA (P = 0.001 for all comparisons) and placebo groups (P = 0.04 for edema at six hours and P = 0.001 for other comparisons). CONCLUSION: Transdermal diclofenac patch and EMLA are equally effective in reducing venous cannulation pain, but signs of erythema, induration and edema are less frequently observed with the transdermal diclofenac patch.


Asunto(s)
Anestesia Local , Anestésicos Locales , Cateterismo Periférico/efectos adversos , Diclofenaco , Lidocaína , Prilocaína , Adulto , Anestésicos Locales/administración & dosificación , Anestésicos Locales/efectos adversos , Diclofenaco/administración & dosificación , Diclofenaco/efectos adversos , Método Doble Ciego , Femenino , Humanos , Incidencia , Lidocaína/administración & dosificación , Lidocaína/efectos adversos , Combinación Lidocaína y Prilocaína , Masculino , Persona de Mediana Edad , Dolor/etiología , Dolor/prevención & control , Dimensión del Dolor/métodos , Prilocaína/administración & dosificación , Prilocaína/efectos adversos , Venas
17.
Can J Anaesth ; 49(6): 554-60, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-12067865

RESUMEN

PURPOSE: To compare the efficacy of acupressure wrist bands and ondansetron for the prevention of postoperative nausea and vomiting (PONV). METHODS: One hundred and fifty ASA I-II, patients undergoing elective laparoscopic cholecystectomy were included in a randomized, prospective, double-blind and placebo-controlled study. Patients were divided into three groups of 50. Group I was the control; Group II received ondansetron 4 mg iv just prior to induction of anesthesia; in Group III acupressure wristbands were applied at the P6 points. Acupressure wrist bands were placed inappropriately in Groups I and II. The acupressure wrist bands were applied 30 min prior to induction of anesthesia and removed six hours following surgery. Anesthesia was standardized. PONV were evaluated separately as none, mild, moderate or severe within six hours of patients' arrival in the postanesthesia care unit and then at 24 hr after surgery by a blinded observer. If patients vomited more than once, they were given 4 mg ondansetron iv as the rescue antiemetic. Results were analyzed by Z test. A P value of < 0.05 was taken as significant. RESULTS: The incidence of PONV and the requirement of rescue medication were significantly lower in both the acupressure and ondansetron groups during the first six hours. CONCLUSION: Acupressure at P6 causes a significant reduction in the incidence of PONV and the requirement for rescue medication in the first six hours following laparoscopic cholecystectomy, similar to that of ondansetron 4 mg iv.


Asunto(s)
Acupresión , Antieméticos/uso terapéutico , Colecistectomía Laparoscópica , Ondansetrón/uso terapéutico , Náusea y Vómito Posoperatorios/prevención & control , Adolescente , Adulto , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad
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