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Sisodia M, Kaur H, Garg N, Choudhary R, Yeluri R. The Effect of Three-point Acupressure Therapy on Anxiety Levels in Children Undergoing Dental Procedures. Int J Clin Pediatr Dent 2024; 17:136-142. [PMID: 39184886 PMCID: PMC11339470 DOI: 10.5005/jp-journals-10005-2738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2024] Open
Abstract
Background and aim To evaluate the efficacy of three-point acupressure therapy in decreasing the dental anxiety in children undergoing dental procedures and to introduce acupressure as a simple, noninvasive, and cost-effective technique of reducing dental anxiety in children. Materials and methods One hundred and sixty-eight, 8-12 years participants who met the inclusion criteria were randomly allotted to either group I (three-point acupressure) (n = 84) or group II (control) (n = 84). All children were subjected to a self-report measure of anxiety [Modified Child Dental Anxiety Scale (MCDAS)] 30 minutes before starting and after completing the dental treatment. For group I children, acupressure beads were applied on selected three acupoints for approximately 10 minutes and were left adhered in place. After 20 minutes, anxiety scores were recorded for all the children and allotted treatment procedure was initiated. For group II children, the same methodology was followed except for the application of acupressure beads. Frankl behavior (FB) rating scale, pulse rate (PR), and systemic saturation levels of oxygen were also recorded as secondary outcome measures. The data obtained was analyzed statistically using Chi-squared analysis, t-test, repeated measures analysis of variance (ANOVA) along with post hoc Bonferroni test. Significance level was predetermined at p ≤ 0.05. Results At time frame (TF)-2, significant decrease in anxiety scores was observed in acupressure group irrespective of the treatment procedure, whereas in control group, it increased significantly. PR was also increased in acupressure group and FB scale was improved. In control group, PR increased and behavior was not improved. Between TF-2 and 3, no reduction in anxiety score was observed. Conclusion The three-point acupressure therapy reduces anxiety in children undergoing dental procedures when compared to nonacupressure group and the difference was statistically significant. Acupressure is a noninvasive stimulation technique applied to acupoints and can be easily administered by a trained pediatric dentist. How to cite this article Sisodia M, Kaur H, Garg N, et al. The Effect of Three-point Acupressure Therapy on Anxiety Levels in Children Undergoing Dental Procedures. Int J Clin Pediatr Dent 2024;17(2):136-142.
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Affiliation(s)
- Manishi Sisodia
- Department of Paedodontics and Preventive Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Harsimran Kaur
- Department of Paedodontics and Preventive Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Nishita Garg
- Department of Paedodontics & Preventive Dentistry, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Rishika Choudhary
- Department of Paedodontics and Preventive Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Ramakrishna Yeluri
- Department of Pediatric and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India
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Azad SS, Cobey FC, Price LL, Schumann R, Shapeton AD. Supraglottic Airway Use for Transfemoral-Transcatheter Aortic Valve Replacement. J Cardiothorac Vasc Anesth 2020; 34:3243-3249. [PMID: 32507460 DOI: 10.1053/j.jvca.2020.04.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 04/26/2020] [Accepted: 04/29/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Examine outcome differences in patients managed either with a supraglottic airway or an endotracheal tube for general anesthesia during transcatheter aortic valve replacement. The authors hypothesized that patients managed with a supraglottic airway would have shorter post-anesthesia care unit and hospital stays and receive fewer opioids, norepinephrine equivalents, and neuromuscular blocking agents, without an increase in 30-day major adverse cardiovascular events. DESIGN Retrospective chart review with 1:2 supraglottic airway-to-endotracheal tube patient propensity score matching. SETTING Single, urban, tertiary care, academic medical center. PARTICIPANTS Patients undergoing transfemoral- transcatheter aortic valve replacement between 2017 and 2019. INTERVENTIONS Supraglottic or endotracheal tube airway management during general anesthesia. MEASUREMENTS AND MAIN RESULTS Thirty-one supraglottic airway patients were propensity score matched with 62 endotracheal tube patients. There was no significant difference for postanesthesia care unit (p = 0.58) or hospital (p = 0.16) lengths of stay. Supraglottic airway patients received significantly fewer neuromuscular blockers (p < 0.0001) and trended toward fewer opioids (p = 0.05), but received a similar number of norepinephrine equivalents (p = 0.76). The major adverse cardiovascular event odds ratio between groups was 1.39 (p = 0.51). The time under general anesthesia (p = 0.02) and total time in the operating room (p = 0.04) were significantly shorter for supraglottic airway patients. CONCLUSIONS Supraglottic airway management in transcatheter aortic valve replacement was feasible without an increase in major adverse cardiovascular outcomes compared with endotracheal tube management during general anesthesia. Supraglottic airway patients trended toward receiving fewer opioids and received significantly fewer neuromuscular blockers while also having significantly shorter time under general anesthesia and total time in the operating room.
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Affiliation(s)
- Shara S Azad
- Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA
| | - Frederick C Cobey
- Department of Anesthesiology and Perioperative Medicine, Tufts Medical Center, Boston, MA
| | - Lori Lyn Price
- Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA; Institute of Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA
| | - Roman Schumann
- Tufts University School of Medicine, Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine, Boston Veterans Affairs Health Care System, West Roxbury, MA
| | - Alexander D Shapeton
- Tufts University School of Medicine, Boston, MA; Department of Anesthesia, Critical Care and Pain Medicine, Boston Veterans Affairs Health Care System, West Roxbury, MA.
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Locihová H, Axmann K, Padyšáková H, Pončíková V. PERCEPTION OF INTENSIVE CARE STRESSORS BY PATIENTS, NURSES AND FAMILY. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2018. [DOI: 10.15452/cejnm.2018.09.0002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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White PF, Elvir Lazo OL, Galeas L, Cao X. Use of electroanalgesia and laser therapies as alternatives to opioids for acute and chronic pain management. F1000Res 2017; 6:2161. [PMID: 29333260 PMCID: PMC5749131 DOI: 10.12688/f1000research.12324.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/11/2017] [Indexed: 12/28/2022] Open
Abstract
The use of opioid analgesics for postoperative pain management has contributed to the global opioid epidemic. It was recently reported that prescription opioid analgesic use often continued after major joint replacement surgery even though patients were no longer experiencing joint pain. The use of epidural local analgesia for perioperative pain management was not found to be protective against persistent opioid use in a large cohort of opioid-naïve patients undergoing abdominal surgery. In a retrospective study involving over 390,000 outpatients more than 66 years of age who underwent minor ambulatory surgery procedures, patients receiving a prescription opioid analgesic within 7 days of discharge were 44% more likely to continue using opioids 1 year after surgery. In a review of 11 million patients undergoing elective surgery from 2002 to 2011, both opioid overdoses and opioid dependence were found to be increasing over time. Opioid-dependent surgical patients were more likely to experience postoperative pulmonary complications, require longer hospital stays, and increase costs to the health-care system. The Centers for Disease Control and Prevention emphasized the importance of finding alternatives to opioid medication for treating pain. In the new clinical practice guidelines for back pain, the authors endorsed the use of non-pharmacologic therapies. However, one of the more widely used non-pharmacologic treatments for chronic pain (namely radiofrequency ablation therapy) was recently reported to have no clinical benefit. Therefore, this clinical commentary will review evidence in the peer-reviewed literature supporting the use of electroanalgesia and laser therapies for treating acute pain, cervical (neck) pain, low back pain, persistent post-surgical pain after spine surgery (“failed back syndrome”), major joint replacements, and abdominal surgery as well as other common chronic pain syndromes (for example, myofascial pain, peripheral neuropathic pain, fibromyalgia, degenerative joint disease/osteoarthritis, and migraine headaches).
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Affiliation(s)
- Paul F White
- P.O. Box 548, Gualala, CA 95445, USA.,The White Mountain Institute, The Sea Ranch, CA, USA.,Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 95445, USA
| | - Ofelia Loani Elvir Lazo
- Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 95445, USA
| | | | - Xuezhao Cao
- Department of Anesthesiology, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 95445, USA.,First Hospital of China Medical University, Shenyang, China
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Weeks EM, Trinca J, Zheng Z. Knowledge of and Willingness to Try Acupuncture for Postoperative Nausea and Vomiting: An Australian Survey of Surgical Patients. Acupunct Med 2017; 35:345-351. [DOI: 10.1136/acupmed-2016-011191] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2017] [Indexed: 12/18/2022]
Abstract
Introduction Level 1 evidence supports the use of acupuncture as a safe and effective treatment for postoperative nausea and vomiting (PONV). However, to date, very few hospitals in Western countries have incorporated this technique into their management strategies. Objective To conduct a survey to establish patients’ knowledge and opinions of acupuncture as a treatment option for the management of PONV in a large Western teaching hospital that did not offer acupuncture. Methods Over a 4-week period, a self-completed, anonymous questionnaire survey was distributed to 171 consecutive patients attending the preadmission clinic pending surgery. Results Overall, 161 participants met the selection criteria and completed the survey (100%). The majority of them had a European background (88.8%) and were over 40 years old (87.6%). Seventy-eight participants (48%) had a history of nausea and vomiting and 39 (24%) had suffered from PONV. One hundred and four (65%) and 110 (68%) patients, respectively, stated that they would be willing to try acupuncture in hospital or at home following surgery to prevent or reduce PONV. Only 25 (15.5%) participants knew that acupuncture could be used to treat nausea and vomiting; however, 140 (87%) indicated that they would be willing to try the therapy after being informed of the potential benefit of acupuncture for PONV prevention/reduction. Those with previous experience of acupuncture were ~3.9 times more likely to be willing to use acupuncture for PONV than those without. Conclusion Patients attending an Australian tertiary hospital showed an overwhelming interest in acupuncture to manage PONV. This provides strong support for the potential implementation of acupuncture in an acute hospital setting.
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Affiliation(s)
- Evan M Weeks
- Pain Clinic, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust (CUHFT), Cambridge, UK
| | - Jane Trinca
- Barbara Walker Pain Management Centre, St Vincent Hospital, Victoria, Australia
| | - Zhen Zheng
- School of Health and Biomedical Sciences, RMIT University, Victoria, Australia
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White PF. What are the advantages of non-opioid analgesic techniques in the management of acute and chronic pain? Expert Opin Pharmacother 2017; 18:329-333. [DOI: 10.1080/14656566.2017.1289176] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Paul F. White
- White Mountain Institute, The Sea Ranch, CA, USA
- Department of Anesthesiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Han JS. Acupuncture analgesia: areas of consensus and controversy. Pain 2011; 152:S41-S48. [PMID: 21078546 DOI: 10.1016/j.pain.2010.10.012] [Citation(s) in RCA: 206] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Revised: 10/08/2010] [Accepted: 10/12/2010] [Indexed: 11/25/2022]
Affiliation(s)
- Ji-Sheng Han
- Neuroscience Research Institute and Department of Neurobiology, Peking University Health Science Center, Key Laboratory of Neuroscience, The Ministry of Education and Ministry of Public Health, Beijing 100191, China
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Arai YCP, Ushida T, Osuga T, Matsubara T, Oshima K, Kawaguchi K, Kuwabara C, Nakao S, Hara A, Furuta C, Aida E, Ra S, Takagi Y, Watakabe K. The effect of acupressure at the extra 1 point on subjective and autonomic responses to needle insertion. Anesth Analg 2008; 107:661-4. [PMID: 18633049 DOI: 10.1213/ane.0b013e31817b8495] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Premedication with sedatives can decrease the discomfort associated with invasive anesthetic procedures. Some researchers have shown that acupressure on the acupuncture extra 1 point is effective for sedation. We investigated whether acupressure on the extra 1 point could alleviate the pain of needle insertion. METHODS We investigated the effect of acupressure at the extra 1 point or a sham point on needle insertion using verbal rating scale (VRS) pain scores and heart rate variability (HRV). Twenty-two healthy female volunteers were randomly allocated to two groups: the extra 1 group received acupressure at the extra 1 point, and the sham group received acupressure at a sham point. After starting the electrocardiogram record, a 27-gauge needle was inserted into the skin of a forearm. Thereafter, another needle was inserted into the skin of the other forearm during acupressure. RESULTS Acupressure at the extra 1 point significantly reduced the VRS, but acupressure at the sham increased the VRS. Acupressure at the extra 1 significantly reduced the low frequency/high frequency ratio of HRV responding to needle insertion. CONCLUSIONS Acupressure at the extra 1 point significantly reduced needle insertion pain compared with acupressure at the sham point. Also, acupressure at the extra 1 point significantly reduced the low frequency/high frequency ratio of HRV responding to needle insertion, which implies a reduction in sympathetic nervous system activity.
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Affiliation(s)
- Young-Chang P Arai
- Multidisciplinary Pain Center, Aichi Medical University, 21 Karimata, Nagakutecho, Aichigun, Aichi 480-1195, Japan.
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White PF. Red-hot chili peppers: a spicy new approach to preventing postoperative pain. Anesth Analg 2008; 107:6-8. [PMID: 18635459 DOI: 10.1213/ane.0b013e3181753276] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
PURPOSE OF REVIEW Improving perioperative efficiency and throughput has become increasingly important in facilitating the fast-track recovery process following ambulatory surgery. This review focuses on the important role played by the anesthesiologist as a perioperative physician in fast-track ambulatory surgery. RECENT FINDINGS A literature review of more than 200 peer-reviewed publications was used to develop evidence-based recommendations for optimizing recovery following ambulatory anesthesia. The choice of anesthetic technique should be tailored to the needs of the patient as well as the type of surgical procedure being performed in the ambulatory setting. The anesthetic decisions made by the anesthesiologist, as a key perioperative physician, are of critical importance in developing a successful fast-track ambulatory surgery program. SUMMARY The pivotal role played by the anesthesiologist as the key perioperative physician in facilitating the recovery process has assumed increased importance in the current outpatient fast-track recovery environment. The choice of premedication, anesthetic, analgesic and antiemetic drugs, as well as cardiovascular, hormonal and fluid therapies, can all influence the ability to fast-track outpatients after ambulatory surgery.
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Wang SM, Kain ZN, White PF. Acupuncture analgesia: II. Clinical considerations. Anesth Analg 2008; 106:611-21, table of contents. [PMID: 18227323 DOI: 10.1213/ane.0b013e318160644d] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Acupuncture and related percutaneous neuromodulation therapies can be used to treat patients with both acute and chronic pain. In this review, we critically examined peer-reviewed clinical studies evaluating the analgesic properties of acupuncture modalities. METHODS Using Ovid and published medical databases, we examined prospective, randomized, sham-controlled clinical investigations involving the use of acupuncture and related forms of acustimulation for the management of pain. Case reports, case series, and cohort studies were not included in this analysis. RESULTS Peer-reviewed literature suggests that acupuncture and other forms of acustimulation are effective in the short-term management of low back pain, neck pain, and osteoarthritis involving the knee. However, the literature also suggests that short-term treatment with acupuncture does not result in long-term benefits. Data regarding the efficacy of acupuncture for dental pain, colonoscopy pain, and intraoperative analgesia are inconclusive. Studies describing the use of acupuncture during labor suggest that it may be useful during the early stages, but not throughout the entire course of labor. Finally, the effects of acupuncture on postoperative pain are inconclusive and are dependent on the timing of the intervention and the patient's level of consciousness. CONCLUSIONS Current data regarding the clinical efficacy of acupuncture and related techniques suggest that the benefits are short-lasting. There remains a need for well designed, sham-controlled clinical trials to evaluate the effect of these modalities on clinically relevant outcome measures such as resumption of daily normal activities when used in the management of acute and chronic pain syndromes.
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Affiliation(s)
- Shu-Ming Wang
- Center for Advancement of Perioperative Health, Department of Anesthesiology, Yale School of Medicine, 333 Cedar St., New Haven, CT 06510, USA.
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White PF, Kehlet H, Neal JM, Schricker T, Carr DB, Carli F. The Role of the Anesthesiologist in Fast-Track Surgery: From Multimodal Analgesia to Perioperative Medical Care. Anesth Analg 2007; 104:1380-96, table of contents. [PMID: 17513630 DOI: 10.1213/01.ane.0000263034.96885.e1] [Citation(s) in RCA: 247] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Improving perioperative efficiency and throughput has become increasingly important in the modern practice of anesthesiology. Fast-track surgery represents a multidisciplinary approach to improving perioperative efficiency by facilitating recovery after both minor (i.e., outpatient) and major (inpatient) surgery procedures. In this article we focus on the expanding role of the anesthesiologist in fast-track surgery. METHODS A multidisciplinary group of clinical investigators met at McGill University in the Fall of 2005 to discuss current anesthetic and surgical practices directed at improving the postoperative recovery process. A subgroup of the attendees at this conference was assigned the task of reviewing the peer-reviewed literature on this topic as it related to the role of the anesthesiologist as a perioperative physician. RESULTS Anesthesiologists as perioperative physicians play a key role in fast-track surgery through their choice of preoperative medication, anesthetics and techniques, use of prophylactic drugs to minimize side effects (e.g., pain, nausea and vomiting, dizziness), as well as the administration of adjunctive drugs to maintain major organ system function during and after surgery. CONCLUSION The decisions of the anesthesiologist as a key perioperative physician are of critical importance to the surgical care team in developing a successful fast-track surgery program.
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Affiliation(s)
- Paul F White
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, Texas, USA.
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