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. 2025 Jun 18:12:1583898.
doi: 10.3389/fmed.2025.1583898. eCollection 2025.

Acupuncture for post-cesarean pain and gastrointestinal function recovery: a meta-analysis and systematic review

Hejing Liu #  1 , Kehan Xing #  1 , Cai Liao  1 , Jiapei Wang  1 , Chenglin Tang  1 , Siqin Huang  1
Affiliations

Acupuncture for post-cesarean pain and gastrointestinal function recovery: a meta-analysis and systematic review

Hejing Liu et al. Front Med (Lausanne). .

Abstract

Objective: Postoperative pain and gastrointestinal dysfunction are common complications after cesarean section, significantly affecting maternal recovery and quality of life. Acupuncture has recently shown promise in alleviating postoperative pain and promoting the recovery of gastrointestinal function. This study aimed to assess the effectiveness of acupuncture in relieving postoperative pain and improving gastrointestinal function after cesarean section via a meta-analysis.

Materials and methods: A comprehensive search for randomized controlled trials (RCTs) examining acupuncture for post-cesarean pain and gastrointestinal function was conducted across multiple databases, covering literature up to 1 February 2025. Data analysis was conducted using Stata 15.

Result: A total of 26 studies involving 2,641 patients were included. This meta-analysis evaluated the effects of acupuncture on postoperative pain, bowel sound recovery, and time to first flatus. The results demonstrated that acupuncture significantly reduced VAS at 6 h (SMD = -0.36, 95%CI [-0.65, -0.07]), 12 h (SMD = -1.23, 95%CI [-1.81, -0.64]), 24 h (SMD = -1.06, 95%CI [-1.56, -0.56]), and 48 h (SMD = -0.96, 95%CI [-1.76, -0.17]). Additionally, acupuncture significantly shortened bowel sound recovery time (SMD = -2.26, 95% CI [-2.97, -1.54]) and anal exhaust time (SMD = -2.41, 95% CI [-3.21, -1.61]). Subgroup analysis revealed that conventional acupuncture was effective across the majority of outcomes, while electroacupuncture showed comparatively weaker effects at certain time points. However, the presence of substantial heterogeneity (I2 values above 90%), along with variations in study quality and acupuncture protocols, could limit the accuracy and generalizability of the findings.

Conclusion: This meta-analysis suggests that acupuncture may effectively relieve pain and improve gastrointestinal function after cesarean section. The study's results showed significant improvements in pain scores and gastrointestinal recovery indicators, including bowel sound recovery time and anal exhaust time. However, the results should be interpreted with caution due to the high degree of heterogeneity and variability in study quality and acupuncture protocols. Further high-quality, large-scale RCTs are needed to validate these findings.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42025638696.

Keywords: acupuncture; cesarean; gastrointestinal function; meta-analysis; pain.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Literature search flowchart.
Figure 2
Figure 2
A 6-h pain score meta-analysis forest plot. The coordinate value corresponding to the box represents the difference in response rate between the experimental group and the control group for each study. The value range covered by the horizontal line represents the confidence interval for each study. The bottom diamond represents the aggregated effect.
Figure 3
Figure 3
A 12-h pain score meta-analysis forest plot. The coordinate value for the box represents the difference in response rate between the experimental group and the control group for each study, while the range of values covered by the horizontal line represents the confidence interval for each study. The bottom diamond represents the aggregated effect.
Figure 4
Figure 4
A 24-h pain score meta-analysis forest plot. The coordinate value corresponding to the box represents the difference in response rate between the experimental group and the control group for each study, while the range of values covered by the horizontal line represents the confidence interval for each study. The bottom diamond represents the aggregated effect.
Figure 5
Figure 5
A 48-h pain score meta-analysis forest plot. The coordinate value corresponding to the box represents the difference in response rate between the experimental group and the control group for each study. The value range covered by the horizontal line represents the confidence interval for each study. The bottom diamond represents the aggregated effect.
Figure 6
Figure 6
Meta-analysis forest plot of bowel sound recovery time. The coordinate value of the box represents the difference in response rate between the experimental group and the control group for each study. The value range covered by the horizontal line represents the confidence interval for each study. The bottom diamond represents the aggregated effect.
Figure 7
Figure 7
A meta-analysis forest plot of anal exhaust time. The coordinate value corresponding to the box represents the difference in response rate between the experimental group and the control group for each study. The value range covered by the horizontal line represents the confidence interval for each study. The bottom diamond represents the aggregated effect.
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