Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Recovery Room”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 991 records · Page 55Linked to original sources
PubMed2003

Perioperative anxiety and postoperative behavioural disturbances in children undergoing intravenous or inhalation induction of anaesthesia.

BACKGROUND: There are few published data comparing the psychological effects of intravenous (i.v.) and inhalation methods of anaesthesia induction in children. In the present study, we compared perioperative anxiety and postoperative behavioural changes in children undergoing standardized i.v. induction with thiopental and inhalation induction with sevoflurane for routine ear, nose and throat surgery. METHODS: Children were randomly assigned to receive inhalation induction with sevoflurane or i.v. induction with thiopental. Anxiety was assessed on arrival, at induction and 30 min after transfer to the recovery room using a four-point scale. The incidence of postoperative behavioural disturbances was determined using a postoperative questionnaire. RESULTS: Significantly more children were anxious during induction in the i.v. group than in the inhalation group [23 of 50 (46%) versus 5 of 50 (10%); P = 0.0001]. Mean induction time was shorter (5.6 versus 7.0 min; P = 0.0001) and recovery time longer (30.5 versus 10.4 min; P = 0.0001) in the i.v. group compared with the inhalation group. Problematic behavioural changes were reported in the first 2 weeks after surgery in nine of 32 children (28%) in the i.v. group and 16 of 34 (48%) children in the inhalation group (P = 0.13). CONCLUSIONS: Although children were more anxious during i.v. induction than inhalation induction, there was no difference in the incidence of behavioural disturbances in the first 2 weeks postoperatively.

Adolescent↗
PubMed1999

Patients view of the anaesthetist in a developing country.

OBJECTIVE: The objective of this study was to assess patients regarding their knowledge and perception of the anaesthetists' role in patient care in a developing country. SETTING: The audit was conducted at the Aga Khan University Hospital, Karachi. METHODS: Two hundred surgical and 102 medical out-patients were included in the audit prospectively who filled a detailed questionnaire. RESULTS: Fifty-six percent of the patients knew that anaesthetists were medically qualified but only 20% and 27% had an idea about their role in the intraoperative and immediate postoperative period. 14.6% were aware of the anaesthetists role outside the operating room. No difference was observed between the two groups of patients except that a higher percentage of surgical patients were interested in having more information regarding anaesthesia and wanted to choose their anaesthetist if the need arose. Gender difference was observed in answer to two questions only. A higher percentage of males know the role of anaesthetist in the recovery room whereas a greater number of females who had surgery before remembered their anaesthetist postoperatively. CONCLUSION: The results of this audit show a poor perception of the anaesthetists role both inside and outside the operating room. Although public knowledge surveys have been carried out in developed countries there is a pressing need to repeat these in developing countries since the image as perceived by public may have a direct bearing on the recruitment of young doctors into an already shortage specialty in these less affluent countries.

Anesthesia↗
PubMed1992

[Effect of hygrophobic filter or heated humidifier on peroperative hypothermia].

A study was carried out to find out whether the use of a hygrophobic filter (Pall, Ultipor) or of a heated humidifier (Dräger, Aquapor) during surgery had any effect on a patient's intraoperative core temperature and thermal balance. Seventy-five ASA I or II patients scheduled for gynaecological surgery were randomly assigned to three groups: group A (n = 25), where no warming device was used; and two groups (n = 25 for each) where inhaled gases were humidified and heated with either a hygrophobic filter set up between the endotracheal tube and the Y-piece (group B) or a heated humidifier set to 100% saturation at a temperature of 41.5 degrees C (group C). The patients were all anaesthetised with the same technique (thiopentone 5 mg.kg-1, dextromoramide 0.03 mg.kg-1 and 0.1 mg.kg-1 of either pancuronium or vecuronium, followed by enflurane with nitrous oxide in oxygen); the perfused fluids were not heated. Room, tympanic, rectal, oesophageal and four skin (thorax, arm, leg, thigh) temperatures were measured with calibrated Exacon thermistances, on arrival in the operating theatre, during induction, every ten minutes for two hours, and then every twenty minutes for two hours more. Ramanathan's and Burton's formulae were used to calculate mean skin temperature and heat loss respectively. In the recovery room, patients were warmed up with an electric blanket. Shivering was ranked from "0" to "+ +". There were no differences between groups as far as age, drug doses, perfusion volumes and room temperature were concerned.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Inhalation↗
PubMed1998

Paediatric day case anaesthesia: estimate of its quality at home.

The aim of this clinical audit was to evaluate the home recovery and complications of 104 daycase anaesthetized children, as well as parent satisfaction. A questionnaire, explained at the time of preoperative visit, was given to parents at hospital discharge and returned by mail. Opioids were administered in 19% of the children whereas regional anaesthesia was performed in 28% of cases. In the recovery room, 8% of them suffered pain. At home, pain was the main problem (25%) and vomiting and agitation were found in 9% and 6% of the cases respectively. Parents reported anxiety in 45% of cases, and 14% called their general practitioner. Nevertheless, 94% were satisfied with the anaesthetic. A clinical audit is useful in detecting management deficiencies. Quality of home recovery may be improved by: wider use of perioperative analgesia, systematic prescription of take-home analgesia, designation of a hospital practitioner for advice, and closer collaboration with general practitioners.

Adult↗
PubMed1999

Patient-controlled antiemesis: a randomized, double-blind comparison of two doses of propofol versus placebo.

BACKGROUND: The role of propofol for the management of postoperative nausea and vomiting (PONV) is not well established. This study determines the efficacy of small doses of propofol administered by patient-controlled device for the treatment of PONV. METHODS: Patients presenting for ambulatory surgery received a standardized general anesthetic. Those who experienced significant nausea or emesis within 1 h of arrival in the recovery room were randomized to receive repeated doses of propofol 20 mg (P-20), propofol 40 mg (P-40), or intralipid (placebo) on demand. Study medications (in equal volumes) were administered with a patient-controlled delivery device for 2 h. A lockout interval of 5 min between doses was used. The following parameters were assessed: nausea, vomiting, rescue antiemetic use, recovery profile, study drug administration history, and satisfaction with treatment. RESULTS: Sixty-nine patients participated in the study. Patient demographics were similar. The average nausea score for a patient in the P-20 and P-40 groups was 25% and 29% less, respectively, compared with placebo during the study period (P < 0.05). This difference was apparent 15 min after initiation of therapy. More placebo patients vomited (P-20, 12%; P-40, 23%; placebo, 56%; P = 0.003) and needed rescue antiemetics (P-20, 17%; P-40, 23%; placebo, 70%; P = 0.001) compared with treatment groups. Sedation scores were similar between groups. Propofol-treated patients had shorter stays in the post-anesthesia care unit (PACU; P-20, 131+/-35 min [mean +/- SD]; P-40, 141+/-34 min; placebo, 191+/-92 min; P = 0.005) and higher satisfaction with their control of PONV than placebo (P < 0.01). CONCLUSIONS: Propofol is effective in managing PONV with shorter PACU stay and great degree of patient satisfaction. There were two episodes of oversedation in the P-40 group. Hence, propofol at a demand dose of 20 mg seems more appropriate.

Adult↗
PubMed2002

[Sevoflurane anesthesia for magnetic resonance procedures in pediatrics].

OBJECTIVE: To assess the efficacy and safety of sevoflurane anesthesia in children during magnetic resonance imaging procedures. MATERIAL AND METHODS: The patients were 105 ASA-I-II children, mean weight 13 +/- 10 Kg and mean age 2.9 years (range 1 day-10 years), twenty (20%) of whom were under 3 months old. Induction was gradual with 6% sevoflurane in a mixture of nitrous oxide and oxygen, followed by maintenance with 1-2% sevoflurane in the same mixture through a face mask or nasal tubes while the patient breathed spontaneously. All procedures were performed satisfactorily. Ten minutes after anesthesia, 88% of the patients were fully awake. None suffered prolonged sedation and no serious complications occurred during the study period. The most common side effects were transient decreases in oxygen saturation in 15 patients (14%), although none reached the critical level (SpO2 < 90%). Six of those patients were under 3 months old. After recovering from sedation, 13 patients (12%) suffered transient episodes of excessive agitation, usually 5 minutes after awakening. Five patients (4.8%) vomited in the recovery room. CONCLUSIONS: This study indicates that sevoflurane is safe and effective for sedating children, including newborn infants, who must undergo magnetic resonance imaging.

Anesthesia Recovery Period↗
PubMed1994

Propofol modifies recovery from isoflurane-nitrous oxide anesthesia.

A randomized, prospective study was performed to evaluate the hemodynamic changes and recovery characteristics in 60 ASA physical status class I-II unpremedicated patients undergoing gynecological laparotomies with either isoflurane anesthesia only (ISO group) or isoflurane anesthesia followed by propofol infusion (ISO-PRO group). All patients received isoflurane 0.5-1.5% and nitrous oxide (N2O) 66% in oxygen after tracheal intubation. ISO-PRO group (n = 30) received 6 mg kg-1 hr-1 propofol infusion in substitution for isoflurane 25 minutes before the end of surgery. Propofol in ISO-PRO group and isoflurane in ISO group (n = 30) were discontinued 5 minutes before the end of surgery. In both groups, N2O was administered throughout the operation until skin was closed. Hemodynamic measurements were similar between the two groups except at extubation when heart rate and blood pressure were lower in ISO-PRO group. The maximal blood pressure was also lower in ISO-PRO group. In ISO-PRO group, the time required to responsiveness to verbal commands and to orientation were significantly shorter. ISO-PRO group had better Steward's score on arrival at the recovery room and was earlier to get a full score of six. The two groups experienced similar rates of emesis and excitement either two hours or 24 hours postoperatively. We conclude that in relatively long intra-abdominal operations, replacement of isoflurane by propofol infusion 25 minutes before the end of surgery may provide stable maintenance of anesthesia and a faster recovery.

Adult↗
PubMed1986

How to run an endoscopy unit? Experience in the Federal Republic of Germany. Results of a survey of 31 centers.

A survey of 31 German hospitals (14 university hospitals with a special gastrointestinal service, 13 key hospitals with specialized GI units, mainly university teaching hospitals, and 4 smaller hospitals without specialization) showed that a service providing the usual gastrointestinal endoscopic procedures is available in all university and key hospitals. In the university hospitals, an average of 4,765 procedures per year are performed, in the key hospitals with specialized GI units 5,558, and in the smaller hospitals without specialization 2,935. Such special methods as ERCP, PTC and operative endoscopy are usually restricted to special clinics. The number of doctors and nursing staff is adequate at university hospitals and in specialized key hospitals. Smaller hospitals without specialization need more nursing staff. All hospitals need more rooms. The supply of instruments is sufficient at university and key hospitals, but more instruments are needed in general non-specialized hospitals. German endoscopic units are relatively well equipped with X-ray machines, but further X-ray equipment is still needed to achieve less dependence on centralized radiological departments. There is a distinct need for more waiting and recovery rooms. At the present time, there is no optimal endoscopic unit in Germany. Better and appropriate outfitting of the units, and an optimized floor-plan encompassing endoscopy rooms, rooms for preparation and after-care are needed--which is not practical in the case of existing hospitals, but must be considered when planning new hospitals.

Endoscopes↗
PubMed1992

[Droperidol versus metoclopramide. Prevention of emesis following strabismus surgery in children].

Vomiting after strabismus surgery is a major problem that remains as yet unsolved, especially in children. Droperidol and metoclopramide, both known as powerful antiemetic drugs, were compared in this study. METHODS. One hundred ASA class I and II children ranging from 3 to 10 years of age were studied in a double-blind, randomised fashion. They were assigned to three groups: group D (n = 33) received 0.075 mg/kg droperidol, group M (n = 33) 0.15 mg/kg metoclopramide, and group N (n = 34) 0.1 ml/kg NaCl i.v. upon arrival in the post-anaesthesia recovery room (PARR). After oral premedication with 0.4 mg/kg midazolam, anaesthesia was induced via a face mask by inhalation of halothane, nitrous oxide, and oxygen. Barbiturates, atropine, and succinylcholine were not used; 0.05 mg/kg vecuronium was given to facilitate intubation. Gastric contents were aspirated by a gastric tube at the end of the operation. Vomiting and retching were recorded for 24 h; recovery from anaesthesia was assessed by a modified Steward score. RESULTS. The three groups were comparable regarding age, body weight, duration of anaesthesia, number of repaired eye muscles, and occurrence of the oculocardiac reflex (OCR). During the first 24 h postoperatively 21/33 (64%) patients of group D vomited, 24/33 (73%) of group M, and 33/34 (97%) of group N. The differences between groups D and N and between M and N were significant (P less than 0.01); comparison of groups D and M showed no statistical significance. Droperidol was more effective in reducing severe vomiting. Of the group N children, 47% vomited more than 6 times in 24 h compared to 18% of group M and 0% of group D. Age, sex, duration of anaesthesia, number of repaired eye muscles, and occurrence of the OCR had no influence on postoperative vomiting. Despite being administered at the end of the operation, droperidol did not prolong the patients' stay in the PARR. The post-anaesthetic scores for group D children were only slightly lower compared to groups M and N. CONCLUSIONS. Droperidol (0.075 mg/kg) and metoclopramide (0.15 mg/kg) both reduce postoperative vomiting after strabismus surgery. Droperidol seems to be more effective in reducing severe vomiting. Postoperative sedation after droperidol was not a major problem in our experience.

Child↗
PubMed1996

Knee arthroscopy: a cost analysis of general and local anesthesia.

A cost analysis of outpatient knee arthroscopy was performed on 53 patients to determine if cost savings were associated with local versus general anesthesia. Local anesthesia was associated with an average reduction in overall charges of $600 compared with general anesthesia because of the reduction of charges related to the recovery room and anesthesia equipment. This study demonstrates a reduction in the hospital charges associated with outpatient knee arthroscopy when local rather than general anesthetic technique is used.

Adolescent↗
PubMed1983

Fiberoptic fluorometer for skin flap assessment.

The fiberoptic fluorometer permits quantitative measurement of fluorescence after intravenous administration of fluorescein. Accurate assessment of tissue fluorescence can be made at any time after the injection, and both uptake and elimination of fluorescein can be followed. The instrument provides instantaneous digital readout of the fluorescence measured in dye fluorescence (DF) units and an index predictive of viability called the dye fluorescence index (DFI). The unit is portable, can be sterilized for operating room use, and can be operated by paramedical personnel with ease. We have used the instrument extensively in clinical and laboratory investigations, where it has been highly reliable in predicting survival and necrosis of a wide variety of flaps. Little or no operating time is added, and serial, low-dose fluorescein injections may be used to monitor a flap in the recovery room or at the bedside in the early postoperative period.

Fiber Optic Technology↗
PubMed1997

Recovery characteristics of sevoflurane- or propofol-based anaesthesia for day-care surgery.

BACKGROUND: Sevoflurane has a low blood-gas partition coefficient resulting in a rapid recovery. Few studies have examined the maintenance and recovery characteristics of sevoflurane compared with propofol in a standardized outpatient population. METHODS: The study was a multicentre study performed in 10 centres. One hundred and sixty-nine elective outpatients due for knee-arthroscopy received 100 mg diclofenac rectally as pain prophylaxis prior to induction of general anaesthesia with fentanyl 1.0-1.5 micrograms/kg + propofol 2.0-2.5 mg/kg i.v. Anaesthesia was maintained with 60% nitrous oxide in oxygen through a laryngeal mask and continuous administration of either: sevoflurane (group S) or propofol infusion (group P) in order to maintain stable haemodynamics. Data of postoperative function and side-effects were collected in a double-blind design, including a patient interview after 24 h. RESULTS: The sevoflurane patients had a significantly faster emergence from anaesthesia, with response to commands at 6.9 +/- 0.4 min versus 8.2 +/- 0.4 min in the propofol group (P < 0.05, mean +/- SD). At 15 min after surgery, group S had a better score in the digit symbol substitution test and felt less confused in a visual analogue scale test compared with group P (P < 0.05). Peroperative bradycardia, nausea and vomiting and late postoperative dizziness were more common in group S. In the sevoflurane group, 32% had nausea or vomiting in the 24 h observation period compared with 18% for propofol (P < 0.05). There was no difference between group S and group P in postoperative pain, eligibility for recovery room discharge (75 +/- 12 versus 70 +/- 11 min) or home-readiness (155 +/- 12 versus 143 +/- 11 min). CONCLUSION: Maintenance of anaesthesia with sevoflurane results in a more rapid emergence, but a higher incidence of nausea and vomiting compared with propofol. The side-effects were minor in our study, and did not result in any difference in time to discharge from the recovery ward or the hospital.

Adult↗
PubMed1989

Early postoperative arterial oxygen desaturation. Determining factors and response to oxygen therapy.

Oxygen arterial saturation (SaO2) was measured with a pulse oximeter in 209 patients after elective surgery. Measurements were made upon arrival in the recovery room (RR) and 1 hr later. On each occasion, the patients randomly and alternately breathed--for 10 min at a time--room air or 35% O2. Factors that might influence the incidence of postoperative hypoxemia were analyzed. After breathing room air for 10 min after arrival in the RR, the mean SaO2 was 90.7 +/- 3.9% (+/- SD). Twenty min after and 1 hr after arrival in the RR, mean SaO2 increased significantly to 92.4 +/- 3.5% (P less than 0.001) and 93.2 +/- 3.0% (P less than 0.001), respectively. Postoperative hypoxemia (SaO2 less than or equal to 90%) after breathing room air for 10 min at 10 min, 20 min, and 1 hr after arrival in the RR occurred in 43.8%, 26.9%, and 16.9% of the patients, respectively. Breathing 35% O2 for 10 min 10 min after arrival in the RR, as well as 20 min and 1 hr after arrival, significantly increased SaO2 above the SaO2 level after breathing room air by 5.7% (P less than 0.001), 4.3% (P less than 0.001), and 4.0% (P less than 0.001), respectively. A significant multiple correlation was found between low SaO2 levels while breathing room air on arrival in the RR and fentanyl dose, age, and concentration of halothane used intraoperatively (R = 0.46; P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Postoperative neuromuscular block following atracurium or alcuronium in children.

Postoperative neuromuscular block (NMB) was evaluated in 60 children who received randomly either atracurium or alcuronium to induce and maintain an 85-95 per cent NMB during balanced anaesthesia. The EMG-monitor was turned away from the anaesthetist 10-15 min before the end of surgery. The average NMB was comparable between the groups at the time of reversal with neostigmine 50 micrograms.kg-1 (84 +/- 9 per cent, mean +/- SD) as were the NMB and the train-of-four ratio when the tracheas were extubated on a clinical basis (32 +/- 20 per cent and 50 +/- 18 per cent, respectively). Patients who had been paralyzed with atracurium arrived at the recovery room earlier and on arrival had greater train-of-four ratios than the patients paralyzed with alcuronium (P less than 0.01). Time to a train-of-four ratio of greater than 90 per cent was significantly shorter in the atracurium group (10 +/- 5 min vs 26 +/- 15 min, P less than 0.001). Thus, an intermediate-acting muscle relaxant offers a safer recovery profile of the NMB than a long-acting muscle relaxant in paediatric patients.

Adolescent↗
PubMed2003

The effect of an alveolar recruitment strategy on oxygenation during laparascopic cholecystectomy.

This prospective randomized controlled trial examined the effect of an "alveolar recruitment strategy" (ARS) in healthy patients having laparoscopic cholecystectomy. Twenty-four consecutive ASA 1 or 2 patients were randomly allocated to an ARS or control group. All patients were manually ventilated to a maximal airway pressure of 25 to 30 cmH2O or a tidal volume of 10 ml/kg during induction of general anaesthesia. After intubation, the control group was ventilated with standardized mechanical ventilation settings. The ARS group was manually ventilated to an airway pressure of 40 cmH2O for 10 breaths over one minute, followed by mechanical ventilation with similar standardized settings plus 5 cmH2O positive end-expiratory pressure. Blood pressure, heart rate, arterial oxygen and carbon dioxide tension (PaO2 and PaCO2) was measured pre-induction, 20 minutes post induction but before abdominal insufflation, 20 minutes after abdominal insufflation, and 20 minutes after arrival in the recovery room. Demographic and operation data were similar. The ARS group pre-insufflation PaO2 [30.16 (9.43)] was higher than the control group [22.19 (9.08)] (P = 0.047). There was a significant difference in PaO2 between the ARS [23.94 (4.87)] and control [17.26 (3.93)] groups during the post-insufflation period (P = 0.001). There were no significant differences in PaO2 between the groups during baseline and recovery periods. No adverse effects were reported. ARS improved arterial oxygenation intraoperatively in healthy patients having laparoscopic cholecystectomy, without clinical cardiovascular compromise or respiratory complication. We conclude that this alveolar recruitment strategy is a useful method of increasing arterial oxygenation.

Adolescent↗
PubMed1997

[A low dose of nalbuphine reverses respiratory depression but not analgesia induced by intraspinal morphine].

Postoperative pain management after scoliosis surgery is based in our institution on intrathecal morphine administration. This case report describes an immediate and major postoperative respiratory depression that occurred in the recovery room, requiring the maintenance of the endotracheal tube. This respiratory depression was reversed by i.v. administration of a low dose of nalbuphine, which allowed tracheal extubation without suppression of morphine-induced analgesia.

Adolescent↗
PubMed2005

Remifentanil compared with morphine for postoperative patient-controlled analgesia after major abdominal surgery: a randomized controlled trial.

BACKGROUND AND OBJECTIVE: This randomized, double-blinded clinical study was designed to compare the efficacy and safety of remifentanil and morphine administered using intravenous (i.v.) patient-controlled analgesia (PCA) for postoperative analgesia after major abdominal surgery during the first 24 postoperative hours. METHODS: Sixty-nine patients were randomly allocated into two groups, each receiving remifentanil or morphine. The first group received i.v. remifentanil PCA with a loading dose of 45 microg, a maintenance dose of 1 microg min(-1), a bolus dose of 15 microg and a lockout interval of 10 min during the first 24 postoperative hours. The second group received i.v. morphine PCA with a loading dose of 5 mg, a maintenance dose of 0.3 mg h(-1), a bolus dose of 1 mg and a lockout interval of 15 min. Age, weight, sex, history of general anaesthesia, duration of surgery and time spent in the post-anaesthesia care unit were recorded. Preoperative pulse rate, systolic and diastolic blood pressures (BP), respiration rate and arterial blood gases were collected. Pulmonary function was tested before induction of anaesthesia, as well as at 4 and 26 h after operation. Pulse rate, systolic and diastolic BP, respiration rate, arterial blood gases, sedation and visual analogue scores, and presence of side-effects in the recovery room and on the ward for 24 h were recorded at 0, 1, 2, 4, 6, 12, 18 and 24 h after operation. Total drug use, number of boluses delivered, number of boluses demanded and delivery/demand ratio were collected. RESULTS: Sixty patients were evaluated. The groups did not differ in age, weight, sex, history of general anaesthesia, duration of surgery or time spent in the recovery unit. There were also no clinically relevant differences between the groups with regard to haemodynamic and respiratory parameters as well as sedation and visual analogue scores (P > 0.05). More bolus doses were demanded and delivered and the delivery/demand ratio was significantly higher in the remifentanil group (P < 0.05). There was no finding suggesting acute opioid tolerance during remifentanil or morphine PCA. CONCLUSION: The i.v. remifentanil PCA with the chosen dosage regimen after abdominal surgery produces postoperative analgesia and has cardiovascular side-effects similar to those achieved with i.v. morphine. Special attention must be given to respiratory depression during establishment of PCA with remifentanil.

Abdomen↗
PubMed2001

Preoperative intradermal acupuncture reduces postoperative pain, nausea and vomiting, analgesic requirement, and sympathoadrenal responses.

BACKGROUND: In a controlled and double-blind study, the authors tested the hypothesis that preoperative insertion of intradermal needles at acupoints 2.5 cm from the spinal vertebrae (bladder meridian) provide satisfactory postoperative analgesia. METHODS: The authors enrolled patients scheduled for elective upper and lower abdominal surgery. Before anesthesia, patients undergoing each type of surgery were randomly assigned to one of two groups: acupuncture (n = 50 and n = 39 for upper and lower abdominal surgery, respectively) or control (n = 48 and n = 38 for upper and lower abdominal surgery, respectively). In the acupuncture group, intradermal needles were inserted to the left and right of bladder meridian 18-24 and 20-26 in upper and lower abdominal surgery before induction of anesthesia, respectively. Postoperative analgesia was maintained with epidural morphine and bolus doses of intravenous morphine. Consumption of intravenous morphine was recorded. Incisional pain at rest and during coughing and deep visceral pain were recorded during recovery and for 4 days thereafter on a four-point verbal rating scale. We also evaluated time-dependent changes in plasma concentrations of cortisol and catecholamines. RESULTS: Starting from the recovery room, intradermal acupuncture increased the fraction of patients with good pain relief as compared with the control (P < 0.05). Consumption of supplemental intravenous morphine was reduced 50%, and the incidence of postoperative nausea was reduced 20-30% in the acupuncture patients who had undergone either upper or lower abdominal surgery (P < 0.01). Plasma cortisol and epinephrine concentrations were reduced 30-50% in the acupuncture group during recovery and on the first postoperative day (P < 0.01). CONCLUSION: Preoperative insertion of intradermal needles reduces postoperative pain, the analgesic requirement, and opioid-related side effects after both upper and lower abdominal surgery. Acupuncture analgesia also reduces the activation of the sympathoadrenal system that normally accompanies surgery.

Abdomen↗