RESUMEN
PURPOSE: Acupuncture ameliorates several pain disorders including postoperative pain. This can help to decrease the need for postoperative analgesics. We aimed to evaluate the effectiveness of acupuncture as an adjuvant scheme reduce both intraoperative and postoperative analgesia needs in children undergoing adenotonsillectomy. METHODS: This was a randomized controlled single-blinded trial that was performed over sixty children scheduled for adenotonsillectomy. They were randomly allocated to either an intervention group that received general anesthesia plus acupuncture or a control group which received general anesthesia alone. The primary outcome was the measurement of postoperative pain scores. Secondary outcomes included measurement of time to the first request of postoperative analgesia, the number of children requesting postoperative analgesics in the first 2 hours, the incidence of postoperative complications including postoperative nausea and/or vomiting (PONV), and emergence agitation (EA). RESULTS: AThe Wong-Baker FACES pain scores at rest and on swallowing were significantly lower in the intervention group than in the control group postoperatively. The time to the first request of postoperative analgesia was delayed in the intervention group versus the control group, with less number of patients who have requested additional analgesia during the first 2 hours postoperatively. Postoperative agitation was lower in the intervention group versus the control group patients. However, the incidence of PONV was not statistically different between study groups. CONCLUSION: Combined acupuncture with general anesthesia in children undergoing adenotonsillectomy provided better postoperative pain control with no adverse effects.
RESUMEN
OBJECTIVE: To compare two different supraglottic airway devices, the laryngeal mask airway (LMA) and the I-gel, regarding easiness of insertion of the device, leak pressure, gastric insufflation, end tidal CO2, oxygen saturation, hemodynamic and postoperative complications in anesthetized, spontaneously ventilated adult patients performing different non-emergency surgical procedures. MATERIALS AND METHODS: The study was carried out as a prospective, randomized, clinical trial among 80 patients who underwent different surgical procedures under general anesthesia with spontaneous ventilation in supine position. They were equally randomized into two groups: I-gel and LMA groups. Both the devices were compared with regard to heart rate, arterial BP, SPO2, end-tidal CO2, number and duration of insertion attempts, incidence of gastric insufflation, leak pressure and airway assessment after removal of the device. RESULTS: No statistically significant difference was reported between both the groups, regarding heart rate, arterial BP, SPO2 and end-tidal CO2. The mean duration of insertion attempts was 15.6 +/- 4.9 seconds in the I-gel group, while it was 26.2 +/- 17.7 seconds in the LMA group. The difference between both the groups regarding duration of insertion attempts was statistically significant (P 0.0023*), while the number of insertion attempts was statistically insignificant between both the study groups (P > 0.05). Leak pressure was(25.6 +/- 4.9 versus 21.2 +/- 7.7 0.016* cmH2O) significantly higher among studied patients of the I-gel group and incidence of gastric insufflation was significantly more with LMA 9 (22.5%) versus 2 (5%) 0.016* in I-gel group. CONCLUSION: Both LMA and I-gel do not cause any significant alteration in the hemodynamic status of the patients, end tidal CO2, and SPO2. The postoperative complications were not significantly different except nusea and vomiting was statistically significant higher in LMAgroup(P 0.032). among both LMA and I-gel patients. Insertion of I-gel was significantly easier and more rapid than insertion of LMA. Leak pressure was significantly higher with I-gel than LMA and thus incidence of gastric insufflation was significantly lower with I-gel.
Asunto(s)
Anestesia General/métodos , Intubación Intratraqueal/instrumentación , Máscaras Laríngeas , Complicaciones Posoperatorias/epidemiología , Adulto , Presión Sanguínea , Dióxido de Carbono/metabolismo , Remoción de Dispositivos , Diseño de Equipo , Femenino , Frecuencia Cardíaca , Humanos , Intubación Intratraqueal/métodos , Máscaras Laríngeas/efectos adversos , Masculino , Persona de Mediana Edad , Oxígeno/metabolismo , Estudios Prospectivos , Posición Supina , Factores de Tiempo , Adulto JovenRESUMEN
OBJECTIVE: To compare two different supraglottic airway devices, the laryngeal mask airway (LMA) and the I-gel, regarding easiness of insertion of the device, leak pressure, gastric insufflation, end tidal CO(2), oxygen saturation, hemodynamic and postoperative complications in anesthetized, spontaneously ventilated adult patients performing different non-emergency surgical procedures. MATERIALS AND METHODS: The study was carried out as a prospective, randomized, clinical trial among 80 patients who underwent different surgical procedures under general anesthesia with spontaneous ventilation in supine position. They were equally randomized into two groups: I-gel and LMA groups. Both the devices were compared with regard to heart rate, arterial BP, SPO(2), end-tidal CO(2), number and duration of insertion attempts, incidence of gastric insufflation, leak pressure and airway assessment after removal of the device. RESULTS: No statistically significant difference was reported between both the groups, regarding heart rate, arterial BP, SPO(2) and end-tidal CO(2). The mean duration of insertion attempts was 15.6±4.9 seconds in the I-gel group, while it was 26.2±17.7 seconds in the LMA group. The difference between both the groups regarding duration of insertion attempts was statistically significant (P=0.0023*), while the number of insertion attempts was statistically insignificant between both the study groups (P>0.05). Leak pressure was (25.6±4.9 vs. 21.2±7.7 cm H(2)O) significantly higher among studied patients of the I-gel group (P=0.016*) and the incidence of gastric insufflation was significantly more with LMA group 9 (22.5%) vs. I-gel group (5%) (P=0.016). CONCLUSION: Both LMA and I-gel do not cause any significant alteration in the hemodynamic status of the patients, end tidal CO(2), and SPO(2). The postoperative complications were not significantly different except nusea and vomiting was statistically significant higher in LMA group (P=0.032). among both LMA and I-gel patients. Insertion of I-gel was significantly easier and more rapid than insertion of LMA. Leak pressure was significantly higher with I-gel than LMA and thus incidence of gastric insufflation was significantly lower with I-gel.