Akupunkturun postoperatif bulantı kusmaya etkisi
Küçük Resim Yok
Tarih
2017
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bulantı ve kusma cerrahi işlem sırasında kullanılan anestezik ajanlar, cerrahi işlemin kendisi gibi birçok neden bağlı görülebilmektedir. Tiroid cerrahisi sonrasında post operatif bulantı ve kusma özellikle cerrahi alanda kanamaya yol açabilir. Anestezistler bulantı ve kusmayı engellemek için bir çok farklı ilaç kullanılmaktadır. Kullanılan bu ilaçların bazı yan etkileri bulunmaktadır. Bu yan etkilerinden dolayı farklı alternetif yöntemler kullanılmaktadır. Akupunktur da bu yöntemlerden birisidir. Sham akupunkturu, akupunkturun plasebo etkisini gösterebilmek için akupunktur noktası olmayan bir yere akupunktur iğnesinin batırılmadan flaster ile tespit edilmesidir. Bu çalışma, DS-6 akupunktur noktası (Neiguan) stimulasyonunun ve Sham akupunkturunun postoperatif bulantı/kusma üzerine etkisini araştırmak amacıyla planlandı. Tiroid cerrahisi geçirecek ASA I-II grubuna dahil, 150 hasta rasgele 3 gruba ayrıldı. 1. gruptaki hastaların bilateral DS-6 noktaları operasyon başlamadan hemen önce 20 dakika süre ile akupunktur iğnesi ile manuel olarak uyarılacak. 2. gruptaki hastalarda aynı işlem DS-6 noktasının 2 cm çevresinde rasgele bir nokta seçilerek aynı şekilde uyarılacak (SHAM Akupunktur tekniği). 3. gruptaki hastalara kontrol grubu olarak hiçbir işlem ve medikasyon uygulanmayacak. Tüm hastalara standart genel anestezi uygulanacak. Ekstübasyon sonrası , ekstübasyondan sonra 5 dakika, 15 dakika, 30 dakika, 6 saat ve 24 saatlik dönemde bulantı, kusma ve ağrı düzeyleri karşılaştırılacak. Ağrı düzeyi VAS skoru kullanılarak yapılacak. Ekstübasyon hemen sonrası , postoperativ 5., 15. dakikalarda bulantı ve kusma; akupunktur grubunda sham grubuna ve kontrol grubuna göre anlamlı derecede düşük bulundu (p<0.05). Ağrı düzeyi akupunktur ve sham grubunda, kontrol grubuna göre anlamlı derecede düşük bulundu. Sonuç olarak; Akupunktur post operatif bulantı, kusma ve ağrıyı anlamlı derecede azaltmaktadır. Sham tekniğinin bulantı ve kusma üzerine etkisi olmayıp, ağrı düzeyini akupuntur tekniği kadar azaltabilmektedir. Biz akupunkturun bulantı, kusma ve ağrıyı engellemek için medikal olarak kullanılan ilaçlara alternetif olarak kullanılabilecek etkili bir yöntem olduğu düşüncesindeyiz.
Nausea and vomiting may be related to many factors such as the surgical procedure and the anesthetic agents used during the surgical procedure. Postoperative nausea and vomiting after thyroid surgery may lead to bleeding, especially in the surgical field. Anesthesiologists use many different medications to prevent nausea and vomiting. These medications have some side effects. Due to these side effects different alternative methods are used. Acupuncture is one of these methods. Sham acupuncture is the acupuncture point where acupuncture needles are spotted without patches to be able to demonstrate the placebo effect of acupuncture. This study was planned to investigate the effect of DS-6 acupuncture point (Neiguan) stimulation and Sham acupuncture on postoperative nausea / vomiting. 150 patients, including ASA I-II group, who underwent thyroid surgery, were randomly divided into 3 groups. Bilateral DS-6 points of patients in group 1 will be stimulated with an acupuncture needle and electrostimulator device for 20 minutes just before the operation begins. For patients in group 2, the same operation will be stimulated in the same way by selecting a random spot around 2 cm from the DS-6 point. (SHAM Acupuncture technique) For patients in group 3, no treatment or medication will be administered as a control group. All patients will receive standard general anesthesia. Nausea, vomiting and pain levels will be compared at after extubation, 5., 15., 30. minutes, 6. and 24. hours after extubation. The pain level will be assessed using the VAS score. Immediately, 5., 15. minutes after extubation; Nausea and vomiting at acupuncture group was significantly lower than sham group and control group (p<0.05). The pain level was significantly lower in the acupuncture and sham group than in the control group. As a result; Acupuncture reduces postoperative nausea, vomiting and pain at a significant rate. Sham technique has no effect on nausea and vomiting, and can reduce the level of pain as much as the technique of acupuncture. We think that acupuncture is an effective method that can be used as an alternative to medically used medicines to prevent nausea, vomiting and pain.
Nausea and vomiting may be related to many factors such as the surgical procedure and the anesthetic agents used during the surgical procedure. Postoperative nausea and vomiting after thyroid surgery may lead to bleeding, especially in the surgical field. Anesthesiologists use many different medications to prevent nausea and vomiting. These medications have some side effects. Due to these side effects different alternative methods are used. Acupuncture is one of these methods. Sham acupuncture is the acupuncture point where acupuncture needles are spotted without patches to be able to demonstrate the placebo effect of acupuncture. This study was planned to investigate the effect of DS-6 acupuncture point (Neiguan) stimulation and Sham acupuncture on postoperative nausea / vomiting. 150 patients, including ASA I-II group, who underwent thyroid surgery, were randomly divided into 3 groups. Bilateral DS-6 points of patients in group 1 will be stimulated with an acupuncture needle and electrostimulator device for 20 minutes just before the operation begins. For patients in group 2, the same operation will be stimulated in the same way by selecting a random spot around 2 cm from the DS-6 point. (SHAM Acupuncture technique) For patients in group 3, no treatment or medication will be administered as a control group. All patients will receive standard general anesthesia. Nausea, vomiting and pain levels will be compared at after extubation, 5., 15., 30. minutes, 6. and 24. hours after extubation. The pain level will be assessed using the VAS score. Immediately, 5., 15. minutes after extubation; Nausea and vomiting at acupuncture group was significantly lower than sham group and control group (p<0.05). The pain level was significantly lower in the acupuncture and sham group than in the control group. As a result; Acupuncture reduces postoperative nausea, vomiting and pain at a significant rate. Sham technique has no effect on nausea and vomiting, and can reduce the level of pain as much as the technique of acupuncture. We think that acupuncture is an effective method that can be used as an alternative to medically used medicines to prevent nausea, vomiting and pain.
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Anestezi ve Reanimasyon, Anesthesiology and Reanimation
