Acupoint injection and electrical stimulation for postoperative nausea and vomiting: A randomized clinical trial

OBJECTIVE: To assess the efficacy and safety of dexamethasone injection into the Neiguan acupoint combined with transcutaneous electrical acupoint stimulation (TEAS) on postoperative nausea and vomiting (PONV) in patients undergoing gynaecological laparoscopic surgery. STUDY DESIGN: This trial included 160 patients aged between 18 and 65 years who underwent gynaecological laparoscopic surgery. Participants were assigned at random to one of four groups - the acupoint injection (AI) + TEAS group, AI group, TEAS group or control group - in a 1:1:1:1 ratio. The primary outcome was the incidence of PONV within 0-24 h of surgery. Secondary outcomes included the incidence of PONV within 0-12 h and 0-48 h of surgery, Myles score within 0-24 h of surgery, number of rescue antiemetic administrations within 0-48 h of surgery, postoperative recovery-related indicators, patient satisfaction and adverse events. RESULTS: Of the 160 patients, 38 (23.8 %) experienced PONV within 24 h of surgery. The use of AI + TEAS (17.5 %) and AI (17.5 %) was associated with lower risk of PONV [odds ratio (OR) 0.354, 95 % confidence interval (CI) 0.125-0.997; p = 0.045] compared with the control group (37.5 %). However, no significant difference was observed between the TEAS group (22.5 %) and the control group (OR 0.484, 95 % CI 0.182-1.289; p = 0.143). The AI + TEAS group had significantly fewer patients with a second dose of antiemetics compared with the control group (relative risk 0.125, 95 % CI 0.016-0.945; p = 0.029). CONCLUSION: Dexamethasone injection into the Neiguan acupoint was effective in reducing the risk of PONV, and reduced the need for rescue antiemetics when combined with TEAS. Both AI and TEAS interventions enhanced patient satisfaction.