Clinical impact of acupuncture on post-operative nausea and vomiting (PONV) in enhanced recovery after surgery (ERAS) protocols for patients undergoing colorectal surgery: A case control study.

BACKGROUND

Acupuncture therapy is gaining prevalence in the perioperative treatment of postoperative nausea and vomiting (PONV). Furthermore, PONV prophylaxis is recommended by enhanced recovery after surgery (ERAS) guidelines. The study investigated the efficacy of acupuncture in reducing PONV in patients undergoing colorectal surgery with the ERAS program.

METHODS

We conducted a case-control study in patients, who underwent colorectal surgery between January 2022 and March 2024. All of them were enrolled in the ERAS program and they were divided into two study groups: Group 1, was composed of patients who received acupuncture as additional PONV prophylaxis. Group 2, were patients who received only pharmacologic PONV prophylaxis. Patients were matched based on gender, American Society of Anesthesia Physical Status (ASA-PS) score, surgical approach, and age (±5 years).

RESULTS

Forty-four patients in each study group were enrolled. No differences in terms of surgical approach and duration of surgery were observed (respectively, P = 0.53, 0.96). Furthermore, no significant differences between the groups regarding postoperative pain (post-anesthesia care unit admission and at 24 hours after surgery, respectively, P = 0.67, 0,82), opioid consumption as rescue (P = 0.80), and length of stay (P = 0.33) were observed. Group 1 experienced a lower incidence of vomiting (P < 0.03).

DISCUSSION: Current literature reports very low quality and inconclusive results on the efficacy of acupoint stimulation in addition to antiemetic drugs. The study shows that acupuncture as an additional prophylaxis therapy effectively reduces vomiting incidence in patients undergoing colorectal surgery with the ERAS program. This result may implement the use of acupuncture therapy into perioperative care practice.