Re: Comparison of different hypotensive anaesthesia techniques in orthognathic surgery with regard to intraoperative blood loss, quality of the surgical field, and postoperative nausea and vomiting

Background This study was designed to evaluate transcutaneous electrical acupoint stimulation (acustimulation) using the ReliefBand compared with ondansetron for the treatment of established postoperative nausea and vomiting (PONV) after outpatient laparoscopic surgery. Methods After the authors obtained institutional review board approval and written informed consent, 268 outpatients were enrolled in this randomized, double-blind, placebo- and sham-controlled study. All patients received antiemetic prophylaxis with metoclopramide, 10 mg intravenously, or droperidol, 0.625 mg intravenously, after induction of anesthesia. A total of 90 patients developed PONV in the recovery units and were randomized to one of three treatment groups: (1) the ondansetron group received 4 mg intravenous ondansetron and a sham ReliefBand; (2) the acustimulation group received 2 ml intravenous saline and a ReliefBand; and (3) the combination group received 4 mg intravenous ondansetron and a ReliefBand. A rescue antiemetic (10 mg intravenous metoclopramide) was administered only if the PONV symptoms persisted for 15 min or longer after initiating the treatment. A blinded observer recorded the recovery times, emetic symptoms, rescue antiemetics, maximum nausea scores, complete response to study treatment, and time to achieve discharge criteria. Postdischarge side effects, as well as patient satisfaction and quality of recovery scores, were assessed at 24 and 72 h after surgery. Results The combination group had a significantly higher complete response rate than the acustimulation group (73% vs.40%, P <0.01). In addition, fewer patients (8 vs. 18) in the combination (vs. acustimulation) group experienced subsequent emetic events (P < 0.03). However, there were no significant differences between the three groups with respect to patient satisfaction and quality of recovery scores. Conclusions Acustimulation with the ReliefBand can be used as an alternative to ondansetron for the treatment of established PONV. However, the use of ondansetron (4 mg intravenously) in combination with the ReliefBand device improved the complete response rate to the acustimulation therapy.

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Effect of desmopressin administration on intraoperative blood loss and quality of the surgical field during functional endoscopic sinus surgery: a randomized, clinical trial

BMC Anesthesiology ◽

10.1186/s12871-015-0034-8 ◽

2015 ◽

Vol 15 (1) ◽

Cited By ~ 5

Author(s):

Hua Shao ◽

Li-Ting Kuang ◽

Wei-Jian Hou ◽

Tao Zhang

Keyword(s):

Clinical Trial ◽

Blood Loss ◽

Randomized Clinical Trial ◽

Endoscopic Sinus Surgery ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Intraoperative Blood Loss ◽

Surgical Field

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The Effect of Deliberate Hypercapnia and Hypocapnia on Intraoperative Blood Loss and Quality of Surgical Field During Functional Endoscopic Sinus Surgery

Anesthesia & Analgesia ◽

10.1213/01.ane.0000282781.56025.52 ◽

2007 ◽

Vol 105 (5) ◽

pp. 1404-1409 ◽

Cited By ~ 22

Author(s):

Vladimir Nekhendzy ◽

Hendrikus J. M. Lemmens ◽

Winston C. Vaughan ◽

Edward J. Hepworth ◽

Alexander G. Chiu ◽

...

Keyword(s):

Blood Loss ◽

Endoscopic Sinus Surgery ◽

Functional Endoscopic Sinus Surgery ◽

Sinus Surgery ◽

Intraoperative Blood Loss ◽

Surgical Field

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Guided Imagery for Postoperative Pain, Energy Healing for Quality of Life, Probiotics for Acute Diarrhea in Children, Acupuncture for Postoperative Nausea and Vomiting, and Animal-Assisted Therapy for Mental Disorders

EXPLORE ◽

10.1016/j.explore.2014.06.012 ◽

2014 ◽

Vol 10 (5) ◽

pp. 326-329 ◽

Cited By ~ 6

Author(s):

Richard Glickman-Simon ◽

Joshua Tessier

Keyword(s):

Quality Of Life ◽

Postoperative Pain ◽

Mental Disorders ◽

Acute Diarrhea ◽

Postoperative Nausea ◽

Guided Imagery ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Animal Assisted Therapy

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Improving the quality of post-anesthesia care: An evidence based initiative to decrease the incidence of postoperative nausea and vomiting in the post-anesthesia care unit

Perioperative Care and Operating Room Management ◽

10.1016/j.pcorm.2016.08.003 ◽

2016 ◽

Vol 4 ◽

pp. 12-16 ◽

Cited By ~ 2

Author(s):

Christopher A. Smith ◽

Richard E. Haas ◽

John C. Zepp ◽

Michael Klein

Keyword(s):

Postoperative Nausea ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Evidence Based ◽

Anesthesia Care ◽

Post Anesthesia Care Unit

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Comparative Efficacy of Acustimulation (ReliefBand®) versus Ondansetron (Zofran®) in Combination with Droperidol for Preventing Nausea and Vomiting

Anesthesiology ◽

10.1097/00000542-200211000-00008 ◽

2002 ◽

Vol 97 (5) ◽

pp. 1075-1081 ◽

Cited By ~ 76

Author(s):

Paul F. White ◽

Tijani Issioui ◽

Jie Hu ◽

Stephanie B. Jones ◽

Jayne E. Coleman ◽

...

Keyword(s):

Patient Satisfaction ◽

Plastic Surgery ◽

Postoperative Nausea ◽

Postoperative Nausea And Vomiting ◽

Normal Diet ◽

Nausea And Vomiting ◽

Controlled Study ◽

Combination Group ◽

Quality Of Recovery

Background Antiemetic drugs are costly, are associated with variable efficacy, and can produce unwanted side effects when used for prophylaxis against postoperative nausea and vomiting. This clinical study was designed to compare the efficacy of transcutaneous electrical acupoint stimulation using a ReliefBand to ondansetron (Zofran) when utilized alone or in combination for preventing postoperative nausea and vomiting after plastic surgery. Methods A single-center, randomized, double-blind, placebo- and sham-controlled study design was conducted to compare three prophylactic antiemetic treatment regimens in 120 outpatients undergoing plastic surgery procedures with routine low-dose droperidol prophylaxis: (1) ondansetron (n = 40), 4 mg intravenous ondansetron and a sham ReliefBand; (2) acustimulation (n = 40), 2 ml intravenous saline and an active ReliefBand; and (3) combination (n = 40), 4 mg intravenous ondansetron and an active ReliefBand. The incidences of postoperative nausea and vomiting, as well as the need for "rescue" antiemetics, were determined at specific time intervals for up to 72 h after surgery. The outcome variables assessed included recovery times, quality of recovery score, time to resumption of normal diet, and patient satisfaction with the prophylactic antiemetic therapy. Results Use of the ReliefBand in combination with ondansetron significantly reduced nausea (20 vs. 50%), vomiting (0 vs. 20%), and the need for rescue antiemetics (10 vs. 37%) compared with ondansetron alone at 24 h after surgery. Furthermore, the ability to resume a normal diet (74 vs. 35%) within 24 h after surgery was significantly improved when the ReliefBand was used to supplement ondansetron (vs. ondansetron alone). Finally, the quality of recovery (90 +/- 10 vs.70 +/- 20) and patient satisfaction (94 +/- 10 vs. 75 +/- 22) scores were significantly higher in the combination group the ondansetron group. There were no significant differences between the ReliefBand and ondansetron when administered as adjuvants to droperidol for antiemetic prophylaxis. Conclusions The ReliefBand compared favorably to ondansetron (4 mg intravenously) when used for prophylaxis against postoperative nausea and vomiting. Furthermore, the acustimulation device enhanced the antiemetic efficacy of ondansetron after plastic surgery.

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