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Meta-Analysis
. 2019 Mar;98(10):e14713.
doi: 10.1097/MD.0000000000014713.

Non-needle acupoint stimulation for prevention of nausea and vomiting after breast surgery: A meta-analysis

Ran Sun  1   2 , Wei Dai  1   2 , Yang Liu  3 , Changli Liu  1   2 , Yongning Liu  1   2 , Ying Gong  1   4 , Xiaohong Sun  1   4 , Tieying Shi  1 , Mingzhi Song  4   5
Affiliations
Meta-Analysis

Non-needle acupoint stimulation for prevention of nausea and vomiting after breast surgery: A meta-analysis

Ran Sun et al. Medicine (Baltimore). 2019 Mar.

Abstract

Background: Breast disease has been a global serious health problem, among women. Surgery is the main treatment for the patients suffering from breast disease. Postoperative nausea and vomiting are still disturbing. Acupoint stimulation, an effective treatment of traditional Chinese medicine, has been used to reduce postoperative nausea and vomiting. Recently, non-needle acupoint stimulation becomes a new intervention. Though several clinical trials have been done, there is still no final conclusion on the efficacy. This Meta-Analysis aims at evaluating the efficacy of non-needle acupoint stimulation for prevention of nausea and vomiting after breast surgery.

Methods: Systematic searches were conducted in PubMed, Embase, Cochrane, and Wanfang Med Online databases for studies. The review period covered from the inception of databases to December 31, 2017. The outcome measures of interest were frequency of nausea, frequency of vomiting, frequency of PONV, verbal rating scale of nausea, and use of rescue antiemetic. Data extraction and risks of bias evaluation were accomplished by 2 independent reviewers using the Cochrane Collaboration Review Manager software (RevMan 5.3.5).

Results: Fourteen randomized controlled trials with a total of 1009 female participants in the non-needle acupoint stimulation group and control group met the inclusion criteria. Although the therapeutically effect on vomiting within postoperative 2 hours was not obvious, non-needle acupoint stimulation still had an important role in reducing nausea and vomiting within postoperative 48 hours. According to Jadad scale, there was moderate quality evidence for the pooled analysis results in this study. In addition, stimulating acupoint by wristband acupressure was more likely to cause adverse reactions.

Conclusion: Non-needle acupoint stimulation can be used for female patients undergoing breast surgery to reduce postoperative nausea and vomiting. Into consideration, we recommend transcutaneous acupoint electrical stimulation on PC6 from 30 minutes before induction of anesthesia to the end of surgery for application. This non-pharmaceutical approach may be promising to promote the recovery of patients after breast surgery.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow diagram of the study selection process.
Figure 2
Figure 2
Risk of bias for included trials.
Figure 3
Figure 3
The forest plot indicates the difference of PONV between the non-needle acupoint stimulation group and control group. RevMan 5.3 software (Cochrane Information Management System) was used for this meta-analysis.
Figure 4
Figure 4
The forest plots indicate the differences in nausea within PO6H (A), nausea within PO12H (B), nausea within PO24H (C), nausea within PO48H (D), and nausea in the recovery room (E).
Figure 5
Figure 5
The forest plots indicate the differences in vomiting within PO6H (A), nausea within PO12H (B), vomiting within PO24H (C), vomiting within PO48H (D), VRS of nausea within PO2H (E), and nausea in the recovery room (F).
Figure 6
Figure 6
The forest plot indicates the difference of use of rescue antiemetic between the non-needle acupoint stimulation group and control group.
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