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Meta-Analysis
. 2013 Dec 13;8(12):e82474.
doi: 10.1371/journal.pone.0082474. eCollection 2013.

The effectiveness of acupuncture in prevention and treatment of postoperative nausea and vomiting--a systematic review and meta-analysis

Kah Bik Cheong  1 , Ji-ping Zhang  1 , Yong Huang  1 , Zhang-jin Zhang  2
Affiliations
Meta-Analysis

The effectiveness of acupuncture in prevention and treatment of postoperative nausea and vomiting--a systematic review and meta-analysis

Kah Bik Cheong et al. PLoS One. .

Abstract

Background: Acupuncture therapy for preventive and treatment of postoperative nausea and vomiting(PONV), a condition which commonly present after anaesthesia and surgery is a subject of growing interest.

Objective: This paper included a systematic review and meta-analysis on the effect of different type of acupuncture and acupoint selection in PONV prevention and treatment.

Methods: Randomised controlled trials(RCTs) comparing acupuncture with non-acupuncture treatment were identified from databases PubMed, Cochrane, EBSCO, Ovid, CNKI and Wanfangdata. Meta-analysis on eligible studies was performed using fixed-effects model with RevMan 5.2. Results were expressed as RR for dichotomous data, with 95%CI.

Results: Thirty RCTs, 1276 patients (intervention) and 1258 patients (control) were identified. Meta-analysis showed that PC6 acupuncture significantly reduced the number of cases of early vomiting (postoperative 0-6h) (RR=0.36, 95%CI 0.19,0.71; P=0.003) and nausea (postoperative 0-24h) (RR=0.25, 95%CI 0.10,0.61; P=0.002), but not early nausea (postoperative 0-6h) (RR=0.64, 95%CI 0.34,1.19; P=0.150) and vomiting (postoperative 0-24h) (RR=0.82, 95%CI 0.48,1.38; P=0.450). PC6 acupressure significantly reduced the number of cases of nausea (RR=0.71, 95%CI 0.57,0.87; P=0.001) and vomiting (RR=0.62, 95%CI 0.49,0.80; P=0.000) at postoperative 0-24h. PC6 electro-acupoint stimulation significantly reduced the number of cases of nausea (RR=0.49, 95%CI 0.38,0.63; P<0.000) and vomiting (RR=0.50, 95%CI 0.36,0.70; P<0.000) at postoperative 0-24h. Stimulation of PC6 with other acupoint(s) significantly reduced the number of cases of nausea and vomiting (RR=0.29, 95%CI 0.17,0.49; P<0.000) at postoperative 0-24h. Stimulation of other acupoint(s)(non PC6) also significantly reduced the number of cases of nausea and vomiting (RR=0.63, 95%CI 0.49,0.81; P=0.000) at postoperative 0-24h. However, the quality of study was generally low in studies of PC6 combined with other acupoint(s) and other acupoint(s). Details of blinding were not reported in most reports.

Conclusions: Besides PC6, PC6 combined with other acupoint(s) and other alternative acupoint(s) might be beneficial in prevention and treatment of PONV, the evidence justifies future high-quality studies.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA 2009 Flow Diagram for data collection and analysis.
Figure 2
Figure 2. PC6 acupuncture vs.
no acupuncture (postoperative nausea). (A) Postoperative nausea (postoperative 0-6h). (B) Postoperative nausea (postoperative 0-24h).
Figure 3
Figure 3. PC6 acupuncture vs. no acupuncture (postoperative vomiting).
(A) Postoperative vomiting (postoperative 0-6h). (B) Postoperative vomiting (postoperative 0-24h).
Figure 4
Figure 4. PC6 acupressure vs. sham (postoperative 0-24h).
(A) Postoperative nausea. (B) Postoperative vomiting.
Figure 5
Figure 5. PC6 electro-acupoint stimulation vs. sham (postoperative 0-24h).
(A) Postoperative nausea. (B) Postoperative vomiting.
Figure 6
Figure 6. Funnel plot for PC6 acupoint vs. control (postoperative 0-24h).
(A) Postoperative nausea. (B) Postoperative vomiting.
Figure 7
Figure 7. PC6 combined with other acupoint(s) vs.
control for PONV (postoperative 0-24h).
Figure 8
Figure 8. Funnel plot for PC6 combined with other acupoint(s) vs. control for PONV (postoperative 0-24h).
Figure 9
Figure 9. Other acupoint(s) (including auricular acupoints) vs. control (postoperative 0-24h).
(A) Postoperative nausea. (B) Postoperative vomiting. (C) Postoperative nausea and vomiting.
Figure 10
Figure 10. Funnel plot for other acupoint(s) vs. control for PONV (postoperative 0-24h).
Figure 11
Figure 11. Quality assessment graph evaluated with CONSORT and STRICTA for TCM.
(A) Percentage of important items reported (evaluated with CONSORT). (B) Percentage of important items reported (evaluated with STRICTA).
See this image and copyright information in PMC

References

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