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Acupuncture for postoperative nausea and vomiting

Evidence Summaries

Level of Evidence = B

Acupuncture appears to be effective for postoperative and chemotherapy-related nausea and vomiting.

A Cochrane review 1 included 59 studies with a total of 7667 subjects. Compared with sham treatment, PC6 acupoint stimulation significantly reduced the incidence of nausea (RR 0.68, 95% CI 0.60 to 0.77; 40 trials, 4742 participants), vomiting (RR 0.60, 95% CI 0.51 to 0.71; 45 trials, 5147 participants) and the need for rescue antiemetics (RR 0.64, 95% CI 0.55 to 0.73; 39 trials, 4622 participants). PC6 acupoint stimulation was compared with six different types of antiemetic drugs (metoclopramide, cyclizine, prochlorperazine, droperidol. ondansetron and dexamethasone). There was no difference between PC6 acupoint stimulation and antiemetic drugs in the incidence of nausea (RR 0.91, 95% CI 0.75 to 1.10; 14 trials, 1332 participants), vomiting (RR 0.93, 95% CI 0.74 to 1.17; 19 trials, 1708 participants), or the need for rescue antiemetics (RR 0.87, 95% CI 0.65 to 1.16; 9 trials, 895 participants). Compared to antiemetic drugs, the combination of PC6 acupoint stimulation and antiemetic therapy reduced the incidence of vomiting (RR 0.56, 95% CI 0.35 to 0.91; 9 trials, 687 participants) but not nausea (RR 0.79, 95% CI 0.55 to 1.13; 8 trials, 642 participants). The need for rescue antiemetic was lower in the combination PC6 acupoint stimulation and antiemetic group than the antiemetic group (RR 0.61, 95% CI 0.44 to 0.86; 5 trials, 419 participants). The side effects associated with PC6 acupoint stimulation were minor, transient and self-limiting (e.g. skin irritation, blistering, redness and pain) in 14 trials.

Comment: The quality of evidence is downgraded by inconsistency (heterogeneity in interventions and outcomes).

References

1. Lee A, Chan SK, Fan LT. Stimulation of the wrist acupuncture point PC6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev 2015;(11):CD003281.  [PMID:26522652].  [PMID:19370583].


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Citation

"Acupuncture for Postoperative Nausea and Vomiting." Evidence-Based Medicine Guidelines, Duodecim Medical Publications Limited, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/EBMG/456192/all/Acupuncture_for_postoperative_nausea_and_vomiting.
Acupuncture for postoperative nausea and vomiting. Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. https://evidence.unboundmedicine.com/evidence/view/EBMG/456192/all/Acupuncture_for_postoperative_nausea_and_vomiting. Accessed March 24, 2019.
Acupuncture for postoperative nausea and vomiting. (2019). In Evidence-Based Medicine Guidelines. Available from https://evidence.unboundmedicine.com/evidence/view/EBMG/456192/all/Acupuncture_for_postoperative_nausea_and_vomiting
Acupuncture for Postoperative Nausea and Vomiting [Internet]. In: Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. [cited 2019 March 24]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/456192/all/Acupuncture_for_postoperative_nausea_and_vomiting.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Acupuncture for postoperative nausea and vomiting ID - 456192 BT - Evidence-Based Medicine Guidelines UR - https://evidence.unboundmedicine.com/evidence/view/EBMG/456192/all/Acupuncture_for_postoperative_nausea_and_vomiting PB - Duodecim Medical Publications Limited DB - Evidence Central DP - Unbound Medicine ER -