Impact of Preoperative Acupuncture on Postoperative Nausea and Vomiting in Surgical Patients Under General Anesthesia

Abstract

Objective

This study aimed to evaluate the efficacy of acupuncture at the PC6 (Neiguan) point in reducing the incidence of postoperative nausea and vomiting (PONV) in patients undergoing elective surgical or gynecological laparoscopic surgery under general anesthesia.

Methods

This prospective, single-center, randomized controlled trial involved 225 patients who were divided into three groups: the acupuncture group (n = 75), which received bilateral PC6 acupuncture with needle manipulation; the sham-acupuncture group (n = 75), which received superficial needling at non-acupoints near PC6; and the control group (n = 75), which received routine care only. Interventions were performed 30 min before anesthesia induction. All patients received a standardized general anesthetic protocol, and no prophylactic antiemetics were used. The primary outcome was the incidence of PONV (nausea, retching, or vomiting) during the 0–24 h postoperative period. The secondary outcomes included the time to first request for rescue antiemetic, nausea severity assessed by a visual analog scale (VAS), patient satisfaction, and adverse events.

Results

The overall 24 h PONV incidence was significantly lower in the acupuncture group (25.3%) compared with that in the sham-acupuncture (49.3%) and control groups (64.0%) (P < 0.001). The acupuncture group also demonstrated a significantly longer median time to first rescue antiemetic use (18.5 h) than those in the sham (6.2 h) and control groups (4.1 h) (P < 0.001). Nausea VAS scores were consistently lower in the acupuncture group at all assessed time points (2, 6, and 24 h postoperatively). Patient satisfaction was highest in the acupuncture group. No serious acupuncture-related adverse events were reported.

Conclusion

Preoperative acupuncture at PC6 is an effective and safe non-pharmacological intervention that significantly reduces the incidence and severity of PONV in patients undergoing laparoscopic surgery under general anesthesia, within a standardized anesthetic protocol that omitted prophylactic antiemetics.