Abstract
The antiemetic effects and side-effects of P6 acupuncture and droperidol pre-treatment were evaluated in a randomized, patient- and observer-blinded study. Ninety unpremedicated children of ASA physical status I or II undergoing outpatient strabismus repair, and aged over one year, were studied. All patients received intravenous thiopentone 5 mg · kg−1, atropine 0.02 mg · kg−1 and succinylcholine 1.5 mg · kg−1, and the trachea was intubated. Patients then received either intravenous droperidol 0.075 mg · kg−1, droperidol plus five minutes’ P6 acupuncture, or acupuncture alone. Anaesthesia was maintained with nitrous oxide 66% and halothane 1.5–2.0% in oxygen with spontaneous ventilation. There was no difference in the incidence of vomiting in the droperidol group (17% before discharge from hospital and 41% up to 48 hours after discharge), combined treatment group (17% and 34% respectively) and acupuncture group (27% and 45% respectively). Corresponding figures for the incidence of vomiting before discharge were 17%, 17% and 27% respectively; these values were also not different. The incidence of restlessness was significantly greater in children receiving droperidol (63%) or both treatments (67%) than in those receiving acupuncture alone (30%; P = 0.007). P6 acupuncture and droperidol are equally ineffective in preventing vomiting within 48 hours of paediatric strabismus repair. Droperidol is associated with increased incidence of postoperative restlessness.
Résumé
Les effets antiémétiques et les effets secondaires de l’acupuncture P6 et d’un prétraitement au dropéridol ont été évalués lors d’une étude à double insu et au hasard. Quatre-vingt-dix enfants non prémédiqués, classés ASA I ou II, devant subir une chirurgie pour strabisme en cas d’un jour et ågés de plus d’un an, ont été étudiés. Tous les patients ont reçu du thiopental 5 mg · kg−1, de l’atropine 0,02 mg · kg−1 et de la succinylcholine 1,5 mg · kg−1 iv et la trachée a été intubée. Par la suite, les patients ont reçus soit une dose intraveineuse de dropéridol de 0,075 mg · kg−1, soit du dropéridol et 5 minutes d’acupuncture P6, ou seulement de l’acupuncture. L’anesthésie était maintenue à l’aide de protoxyde d’azote 66% et d’halothane 1,5 à 2% avec oxygène, sous ventilation spontanée. Il n’y avait aucune différence dans l’incidence de vomissements chez le groupe dropéridol (17% avant le congé de l’hôpital et 41% jusqu’à 48 heures après le congé), le groupe avec traitement combiné (17% et 34% respectivement) et le groupe acupuncture (27% et 45% respectivement). Les figures correspondantes pour l’incidence de vomissements avant le congé étaient de 17%, 17% et 27% respectivement; ces valeurs n’étaient également pas différentes. L’incidence d’agitation était significativement plus élevée chez les enfants recevant du dropéridol (60%) ou les deux traitements (67%) que chez ceux recevant seulement l’acupuncture (30%; P = 0,007). L’acupuncture P6 et le dropéridol sont tous les deux inefficaces dans la prévention des vomissements, dans les premières 48 heures d’une chirurgie pédiâtrique pour le strabisme. Le dropéridol est associé à une incidence augmentée d’agitation postopératoire.
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Yentis, S.M., Bissonnette, B. Ineffectiveness of acupuncture and droperidol in preventing vomiting following strabismus repair in children. Can J Anaesth 39, 151–154 (1992). https://doi.org/10.1007/BF03008646
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DOI: https://doi.org/10.1007/BF03008646