Acupoint Stimulation After Anesthesia Induction Does Not Decrease Nausea and Vomiting After Hepatectomy: A Multi-Center Double-Blinded Clinical Trial

Clinical Snapshot

Key Findings

• P Value: Not significant (p-value not provided)

• Effect Size: Odds ratio 0.86

• Primary Outcome: PONV incidence within 24 hours: 23.8% (TEAS) vs 26.6% (control)

• Nnt Or Sensitivity: Number needed to treat cannot be calculated due to non-significant result

• Confidence Interval: 95% CI: 0.42-1.76

Clinical Application

TEAS is non-invasive and could be easily implemented in Australian operating theatres, though cost-effectiveness unclear Would require TGA approval for medical devices. Not currently included in ANZCA guidelines for PONV prevention. Cost-effectiveness analysis needed for PBS consideration Adult patients undergoing major hepatobiliary surgery in tertiary care settings

Abstract

INTRODUCTION: This study evaluated whether adding transcutaneous electrical acupoint stimulation (TEAS) to a double-antiemetic regimen during hepatectomy reduces the incidence of postoperative nausea and vomiting (PONV). METHODS: In this multicenter double-blinded randomized controlled trial conducted across three tertiary hospitals in China, patients scheduled for elective hepatectomy were randomized to either the TEAS group (stimulation at PC6 during surgery) or the control group (no stimulation). The primary outcome was the incidence of PONV within 24 h postoperatively. Key secondary outcomes included the severity of PONV and pain after surgery. RESULTS: Among 161 randomized patients, 159 completed the study. No significant difference was observed in the incidence of PONV within 24 h postoperatively between the TEAS and control groups (23.8% vs. 26.6%; OR, 95% CI: 0.86, 0.42-1.76). However, the TEAS group exhibited less patient controlled analgesia (PCA) attempts (2.7 vs 3.5) or deliveries (2.6 vs 3.5) by 24 h postoperatively. Recovery outcomes, including time to ambulation and to gastrointestinal function recovery, did not differ between groups. CONCLUSION: Intraoperative TEAS did not significantly reduce PONV incidence in hepatectomy patients receiving antiemetic therapy. Nonetheless, its potential to decrease the need for analgesics warrants further investigation to refine its role in perioperative care. CLINICAL TRIAL REGISTRATION: ClinicalTrial.gov (NCT05396716), https://clinicaltrials.gov.

References

1. 1.He, S., Lv, Z., Wang, H., Yu, N., Tuo, X., Wang, Y., Dong, H., Cao, J., Wang, Y., & Lu, Z. (2026). Acupoint stimulation after anesthesia induction does not decrease nausea and vomiting after hepatectomy: A multi-center double-blinded clinical trial. Journal of Investigative Surgery, Article 2653912. https://doi.org/10.1080/08941939.2026.2653912