The efficacy of transcutaneous electrical acupoint stimulation on postoperative nausea and vomiting after laparoscopic surgery: a meta-analysis of randomized controlled trials.

BACKGROUND

Postoperative nausea and vomiting (PONV) is a common complication after laparoscopic surgery, which may cause fluid and electrolyte imbalance and delay postoperative recovery. Pharmacological interventions are only partially effective and have adverse effects. This study aimed to systematically evaluate the efficacy of transcutaneous electrical acupoint stimulation (TEAS) in managing PONV after laparoscopic surgery.

METHODS

We systematically review Cochrane Library, PubMed, Embase and Web of Science for randomized controlled trials (RCTs). Two investigators independently conducted study selection, data extraction, and bias assessment using the Cochrane Risk of Bias Tool. Meta-analyses were performed in RevMan 5.4 and heterogeneity was assessed using I 2. Outcomes included PONV, postoperative nausea (PON), postoperative vomiting (POV), time to first flatus, and antiemetic rescue requirements.

RESULTS

Nine RCTs involving 2,550 participants (1,272 in the TEAS group and 1,278 in the control group) were analyzed. TEAS significantly reduced PONV incidence [RR = 0.78, 95% CI (0.70, 0.87); P < 0.001], PON incidence [RR = 0.69, 95% CI (0.67, 0.82); P < 0.001] and POV incidence [RR = 0.57, 95% CI (0.43-0.78); P < 0.001]. The intervention shortened the time to first flatus after surgery [MD = -3.36 h, 95% CI (-6.65, -0.21); P = 0.04] and decreased the use for antiemetic rescue medication [RR = 0.67, 95% CI (0.52, 0.87); P = 0.002].

CONCLUSIONS

Our findings suggest that TEAS may be an effective adjunctive non-pharmacological treatment for PONV in patients undergoing laparoscopic surgery. When used in combination with standard antiemetic prophylaxis, TEAS can further reduce the incidence of nausea and vomiting, decrease the need for rescue antiemetics, and shorten the time to first flatus, thereby demonstrating significant added value in facilitating postoperative recovery.

SYSTEMATIC REVIEW REGISTRATION: identifier [CRD42024560238].