Biomedical subjects

Shu-Ming Wang

Publications and source records attributed to Shu-Ming Wang.

22 records · Page 2Linked to original sources

PubMed2002

Attitudes of patients undergoing surgery toward alternative medical treatment.

BACKGROUND/OBJECTIVES: There has been an increased interest in complementary and alternative medical (CAM) therapies in the scientific literature and the popular press for the last decade. We undertook a survey study to assess the prevalence of CAM therapies in a surgical patient population as well as their interests toward CAM therapies during the preoperative period. METHODS: A total of 1000 questionnaires were administrated to the patients in the presurgical holding area of Yale-New Haven Hospital. A total of 857 surveys were returned (85.7%). RESULTS: Two hundred and seventy-five (275) patients undergoing surgery (32%) reported having used CAM therapies. The most common CAM therapies in patients undergoing surgery were reported to be massage therapy (15.2%), followed by herb therapy (9.7%), relaxation (8.3%), and acupuncture (6.6%). A significant proportion of patients (42%) indicated their willingness to use acupuncture as a treatment modality for anxiety during the preoperative period. Those surgical patients who expressed an interest in using acupuncture as a preoperative anxiety treatment modality are younger than those who have no interest (47 +/- 16 vs. 53 +/- 19, p = 0.0001). In addition, those patients who used CAM therapies had a significant interest in using acupuncture as a preoperative anxiety treatment modality as compared to individuals who had no experience in CAM therapies (66.3% vs. 29.9%, p = 0.0001). A logistic regression model that included various demographics as predictors demonstrated that age and education level were significant factors that determined the use of CAM therapies in our surgical patients population. In our survey, however, gender does not play a significant role in the usage of CAM therapies. CONCLUSIONS: Alternative medicine use is reported to be a common phenomenon prior to surgery. A significant number of patients are willing to accept acupuncture as treatment for anxiety during the preoperative period.

Acupuncture Therapy↗

PubMed2002

Music and preoperative anxiety: a randomized, controlled study.

UNLABELLED: Music may decrease the anxiety experienced by patients before surgery. Previous studies of this issue were hindered with multiple methodological problems. In this investigation, we examined this hypothesis while using a rigorous study design and objective outcome measures. Adult patients undergoing anesthesia and surgery were randomly assigned to two study groups. Subjects in Group 1 (n = 48) listened to a 30-min patient-selected music session, and subjects in Group 2 (n = 45) received no intervention. By using self-report validated behavioral (State-Trait Anxiety Inventory) and physiological measures of anxiety (heart rate, blood pressure, and electrodermal activity and serum cortisol, epinephrine, and norepinephrine), patients were evaluated before, during, and after administration of the intervention. We found that after intervention, subjects in the Music group reported significantly lower anxiety levels as compared with the Control group (F(1,91) = 15.4, P = 0.001). That is, the postintervention anxiety level of subjects in the Music group decreased by 16% as compared with the preintervention level, whereas the anxiety level of the Control group did not change significantly. Two-way repeated-measures analysis of variance performed for the electrodermal activity, blood pressure, heart rate, cortisol, and catecholamine data demonstrated no group difference and no time x group interaction (P = not significant). In conclusion, under the conditions of this study, patients who listened to music before surgery reported lower levels of state anxiety. Physiological outcomes did not differ, however, between the two study groups. IMPLICATIONS: Patients who listen to music of their choice during the preoperative period report less anxiety.

Adolescent↗

PubMed2002

P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting in children.

BACKGROUND: P6 acupuncture in adults is reported to be an effective preventive treatment for postoperative nausea and vomiting (PONV). It is not clear, however, whether this technique is effective as a preventive treatment for PONV in children. METHODS: Children undergoing anesthesia and surgery were randomized to four groups: (a) intravenous saline + bilateral P6 acupoint injections (n = 50); (b) intravenous droperidol + bilateral P6 sham acupuncture (n = 49); (c) intravenous saline + bilateral sham point injections (n = 43); (d) intravenous saline +bilateral P6 sham acupuncture (n = 45). The perioperative anesthetic technique was standardized in all subjects. The incidence of postoperative nausea and vomiting (PONV) was evaluated in postanesthesia care unit (PACU) and 24 h after surgery. RESULTS: Incidence of nausea in the PACU was significantly lower in the acupoint group as compared with the sham point group (32% vs. 56%, P = 0.029) and P6 sham group (32% vs. 64%, P = 0.002) but not as compared with the droperidol group (32% vs. 46%, P = ns). Similarly, subjects in the acupoint group had a significantly lower incidence of vomiting in the PACU as compared with the sham point group (12% vs. 33%, P = 0.026) and P6 sham group (12% vs. 31%, P = 0.029) but not as compared with the droperidol group (12% vs. 18%, P = ns). The combined incidence of early PONV was also lower in the acupoint group as compared with the sham point group (P = 0.045) and P6 sham group (P = 0.004) but not as compared with the droperidol group (42% vs. 51%, P = ns). Finally, significantly fewer subjects in the acupoint group required intravenous ondansetron as an initial rescue therapy (P = 0.024). At 24 h after surgery, however, the incidence of late PONV was similar among the four study groups (P = ns). CONCLUSION: In children, P6 acupoint injections are as effective as droperidol in controlling early postoperative nausea and vomiting.

Acupuncture↗

PubMed2002

Sleeping characteristics of children undergoing outpatient elective surgery.

BACKGROUND: A significant number of children undergoing anesthesia and surgery exhibit new-onset sleep-related problems postoperatively. The aim of this longitudinal cohort study was to expand previous research in this area by using a new objective technology. METHODS: This study compared children undergoing general anesthesia and outpatient surgery (n = 92) to a community-based control group of children (n = 77). Data regarding coping, temperament, anxiety, surgical procedures, and postoperative pain were collected. Subjects underwent actigraphy sleep monitoring for at least 3 nights before surgery and 5 postoperative days (POD). Sleep assessment was performed with actigraphy sleep monitoring and the Post Hospitalization Behavioral Questionnaire (PHBQ). RESULTS: Forty-three children (47%) in the surgery group experienced postoperative sleeping disturbances as determined by either the actigraphy or the PHBQ. Only 13 children (14.4%), however, experienced a decrease of at least 1 SD in percentage sleep as assessed by actigraphy. Postoperative pain scores on POD 1 and POD 2 were significantly higher among children who exhibited sleep problems as diagnosed by actigraphy (F = 4.283; P= 0.047). Also, children who exhibited actigraph-based sleep problems scored lower sociability-temperament (14.1 +/- 4.3 vs. 17.5 +/- 3.4; P= 0.04) scores compared with the community group and had a higher rate of change in their perioperative anxiety levels (group x time interaction, F = 5.1; P= 0.03). CONCLUSION: A significant number of children undergoing outpatient surgery experience postoperative sleep-related problems. The clinical significance of this finding, however, is unclear.

Ambulatory Surgical Procedures↗