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Summaries of recent papers
  1. Adrian White1,
  2. Michael Meinen2
  1. 1Primary Care Group, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
  2. 2Denton Park Health Centre, Newcastle Upon Tyne, UK
  1. Correspondence to Dr Adrian White, N14 ITTC Building, Plymouth Science Park, Plymouth PL6 8BX, UK; Adrian.white{at}

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Clinical effectiveness

Postoperative emergence agitation

▸ Hijikata T, Mihara T, Nakamura N, et al. Electrical stimulation of the heart 7 acupuncture site for preventing emergence agitation in children: a randomised controlled trial. Eur J Anaesthesiol 2015. Published Online First.

Double-blind RCT (n=120).


One hundred and twenty children aged 18–96 months were undergoing minor elective surgery under general anaesthesia with sevoflurane. They were randomly assigned to either undergo bilateral stimulation of HT7 with two percutaneous nerve stimulation devices (1  Hz, 50  mA) during surgery (group HT7) or a control group that had no intervention.

The primary outcome was the incidence of emergence agitation evaluated in the post-anaesthesia care unit (PACU) using the Paediatric Anaesthesia Emergence Delirium scale. The secondary outcomes were the time from operation completion to tracheal extubation, PACU stay duration, and postoperative pain scores.


The incidence of emergence agitation was significantly lower in the HT7 group compared with the control group (figure 1). The number needed to treat was 4 (95% CI 3 to 13). There were no statistically significant differences between groups in time from operation completion to tracheal extubation, PACU stay duration or postoperative pain.

Figure 1

Postoperative emergence agitation. Based on Eur J Anaesthesiol 2015.


Emergence agitation is common in children recovering from general anaesthesia, and its prevention remains an important challenge in the field of paediatric anaesthesia. EA appears promising, though this review is written from the abstract only so might understate any weaknesses in the study.

Hot flushes

▸ Ee C, Xue C, Chondros P, et al. Acupuncture for menopausal hot flashes: a randomized trial. Ann Intern Med 2016;164:146–54.

Sham-controlled RCT (n=327).


Australian women older than 40 years in the late menopausal transition or post-menopause, with at least seven moderate flushes daily, were recruited. They had to have …

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