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- Effect of BL-10 (Tianzhu), BL-11 (Dazhu) and GB-34 (Yanglinquan) Acuplaster for Prevention of Vomiting after Strabismus Surgery in Children
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題名 | Effect of BL-10 (Tianzhu), BL-11 (Dazhu) and GB-34 (Yanglinquan) Acuplaster for Prevention of Vomiting after Strabismus Surgery in Children=於天柱、大抒及陽陵泉施予穴壓對孩童斜視手術後止吐效果之評估 |
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作者 | 朱雅淳; 林素滿; 謝瀛洲; 彭國城; 林易希; 蔡勝國; 李德譽; | 書刊名 | 麻醉學雜誌 |
卷期 | 36:1 1998.03[民87.03] |
頁次 | 頁11-16 |
分類號 | 416.7551 |
關鍵詞 | 眼球運動病症; 斜視; 小兒; 穴壓; 天柱; 大抒; 陽陵泉; Ocular motility disorders; Strabismus pediatrics; Acupressure; Tianzhu (BL-10); Dazhu (BL-11); Yanglinquan (GB-34); |
語文 | 英文(English) |
中文摘要 | 前言:據實驗在內關穴予以針灸或穴壓可以減少婦科手術和癌症化療後所造成 之噁心嘔吐。然而在孩童斜視及扁桃線切除手術中卻無此種效果。本實驗選取三組相關穴位 :天柱、大抒及陽陵泉。目的在評估在此三組穴道予以刺激,對孩童斜視手術後之止吐效果 。 方法:本實驗選擇六十四位三至十四歲之 ASA class I 之孩童,隨機分為對照組( n=30 )及穴壓組( n=34 )。在手術的前一晚,於穴壓組在三組穴道之雙側貼上針灸絆, 於對照組則無此處置。麻醉誘導是以氧氣、笑氣及 halothane。麻醉過程一如往常般。病人 的基本資料記錄及針灸絆的貼置是由一位醫療人員所執行,麻醉過程資料及手術後嘔吐情形 由另位人員記錄。病房之嘔吐情形則由家長觀察記錄。 結果:兩組病人在恢復室的嘔吐發生率並無顯著差異。在病房的嘔吐發生率,於對照組 有十八人( 60% ),於穴壓組有八人( 23.5% ),兩者呈現顯著差異( p<0.05 )。總計 術後二十四小時內之嘔吐發生率,於對照組為 66.7%,於穴壓組為 29.4%,兩者亦呈現顯著 差異( p<0.05 )。 結論:經由刺激天柱、大抒及陽陵泉,進而可能減低眼外肌術後之張力,因此直接或間 接減輕副交感神經之刺激。藉此能有效降低孩童斜視手術後嘔吐的發生率。 |
英文摘要 | Background: Stimulation of P6 (Neiguan) acupoint can prevent nausea and vomiting in adults. However, there is no antiemetic effect in children undergoing strabismus surgery. The effect of P6 may act only on hollow organs; in contrast, BL-10 (Tianzhu), BL-11 (Dazhu) and GB-34 (Yanglinquan) are more related to the meridians of the eye. Therefore these three more relevant acupoints, BL-10, BL-11 and GB-34 were stimulated to evaluate the antiemetic effect on children undergoing strabismus surgery. Methods: Sixty-five children, ASA physical status 1, between 3and 14 years of age, were randomly divided into two groups as follows: placebo group (n=31) and acuplaster group (n=34). Bilateral acupressure using the Vital Point Needleless Acuplaster (Koa, Japan) was applied to BL-11 and GB-34 points the night before surgery. Anesthesia was induced and maintained with halothane and nitrous oxide in oxygen. Postoperative emesis was assessed at early (at PACU) and late (at ward) phases, and was recorded by an investigator blind to the treatment characteristics. Results: In the early emesis phase, the incidence of vomiting was 35.5% for placebo group, compared with 14.7% for acuplaster group. In the late emesis phase, acuplaster patients had a significantly lower incidence of vomiting (23.5% vs-58.1% in placebo patients, p<0.05). The overall postoperative vomiting incidence in the acuplaster patients in a 24 h period which was significantly decreased was 29.4% as opposed 64.5% in the placebo group (p<0.05). Conclusions: The results demonstrated that prophylactic use of bilateral noninvasive acuplaster on the BL-10, BL-11, and GB-34 acupoints significantly reduces vomiting after strabismus correction. The mechanism may be dispersal of these three acupoints, thus diminishing the parasympathetic stimulation resulting from surgical traction of eye muscles. |
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