Effectiveness and safety of electroacupuncture for the treatment of pain after laparoscopic surgery: a systematic review

doi:10.19852/j.cnki.jtcm.2022.04.002

Abstract

Abstract:

OBJECTIVE: To evaluate the clinical effectiveness and safety of electroacupuncture for treating pain after laparoscopic surgery.METHODS: The following databases were searched (since their establishment until November 16, 2021) for randomized controlled trials (RCTs) on electro-acupuncture for pain after laparoscopic surgery: PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure Database, Wanfang Database, China Science and Technology Journal Database, and Chinese Biomedical Literature Database. Data were screened independently and extracted by two reviewers. Two researchers independently extracted and cross-checked data and applied the modified Jadad scale and the Cochrane-recommended assessment method to evaluate the bias risk. The Meta-analysis was conducted using RevMan5.3 software.RESULTS: Twelve RCTs enrolling 788 patients were included. (a) For postoperative 24 h visual analogue scale, five trials were included on electroacupuncture + routine analgesia therapy vs routine analgesia therapy with significance in electroacupuncture conducted after surgery [mean difference (MD) = -0.63, 95% confidence interval (CI) (-0.90, -0.37)], as well as in electroacupuncture conducted before and after surgery [MD = -1.01, 95% CI (-1.62, -0.41)] and in surgery. However, two trials were included in electroacupuncture conducted 24 h before surgery with no significant difference [MD = -0.16, 95% CI (-0.44, 0.12)]. (b) The anesthetics intake of electroacupuncture + routine analgesia therapy vs. routine analgesia therapy was significant [MD = -121.71, 95% CI (-164.92, -78.49)]. (c) The adverse effects of electroacupuncture + routine analgesia therapy vs. routine analgesia therapy were significant both in the incidence of postoperative nausea and vomiting [risk rate (RR) = 0.49, 95% CI (0.39, 0.61)] and postoperative dizziness and headache [RR = 0.14, 95% CI (0.04, 0.47)].CONCLUSION: The evidence showed that electro-acupuncture combined with routine analgesia therapy effectively treated pain after laparoscopic surgery. However, more rigorously designed RCTs are required due to the low quality of the included studies and the incomplete outcome evaluation system.

Key words: electroacupuncture, laparoscopy, pain, treatment outcome, safety, systematic review

HUANG Yusi, YANG Jiju, LI Xinyi, HAO Huifeng, LI Chong, ZHANG Fan, LIN Haiming, XIE Xianfei, HE Ke, TIAN Guihua. Effectiveness and safety of electroacupuncture for the treatment of pain after laparoscopic surgery: a systematic review[J]. Journal of Traditional Chinese Medicine, 2022, 42(4): 505-512.

Figures/Tables 8

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Study	Country	Sample size（T/C）	Age (years)		Operation type	ASA grade	Treatment timing	Intervention		Outcomes
Study	Country	Sample size（T/C）	Treatment	Control	Operation type	ASA grade	Treatment timing	Treatment	Control	Outcomes
Chen et al 2019¹¹	China	45/45	43.80±8.14	42.25±7.92	Gynecological laparoscopic surgery	Ⅰ-Ⅱ	before surgery+after surgery	EA+RA	RA	①③④
Wang et al 2016¹²	China	30/30	53.50±8.30	51.30±8.10	Laparoscopic cholecystectomy	Ⅰ-Ⅱ	after surgery	EA+RA	RA	①③
Wang et al 2018¹³	China	27/28	34.90±5.10	34.80±6.20	Gynecological laparoscopic surgery	Ⅰ-Ⅱ	before surgery	EA+RA	RA	①③
Jiang et al 2018¹⁴	China	40/40	50.3±10.8	50.4±10.9	Laparoscopic cholecystectomy	Ⅰ-Ⅱ	in surgery	EA+RA	RA	①③④
Yu et al 2014¹⁵	China	30/30	47±11	47±11	Laparoscopic cholecystectomy	Ⅰ-Ⅱ	before surgery+after surgery	EA+RA	RA	①③
Sun et al 2019¹⁶	China	34/35	71.5±10.4	73.2±11.9	Laparoscopic intestinal surgery	Ⅰ-Ⅱ	before surgery	EA+RA	Sham EA+RA	②
Zhang et al 2015¹⁷	China	45/45	52.29±6.37	52.37±6.4	Laparoscopic cholecystectomy	Ⅰ-Ⅱ	before surgery	EA+RA	Sham EA+RA	②③④
Wang et al 2015¹⁸	China	30/30	54.88±9.01	56.15±10.6	Laparoscopic cholecystectomy	Ⅰ-Ⅱ	before surgery	EA+RA	RA	②③
Ding et al 2011¹⁹	China	30/30	53.87±11.48	56.3±10.11	Laparoscopic cholecystectomy	Ⅰ-Ⅱ	before surgery	EA+RA	RA	②
Chen et al 2015²⁰	China	30/30	42±10	41±11	Gynecological laparoscopic surgery	Ⅰ-Ⅱ	after surgery	EA+RA	RA	③
Li et al 2017²¹	China	20/20	35.2±6.1	34.4±9.1	Gynecological laparoscopic surgery	Ⅰ-Ⅱ	before surgery	EA+RA	RA	①③
Li 2021²²	China	33/31	36.27±6.09	37.16±6.08	Gynecological laparoscopic surgery	Ⅰ-Ⅱ	before surgery+after surgery	EA+RA	RA	①③

Study	Country	Sample size（T/C）	Age (years)		Operation type	ASA grade	Treatment timing	Intervention		Outcomes
Study	Country	Sample size（T/C）	Treatment	Control	Operation type	ASA grade	Treatment timing	Treatment	Control	Outcomes
Chen et al 2019¹¹	China	45/45	43.80±8.14	42.25±7.92	Gynecological laparoscopic surgery	Ⅰ-Ⅱ	before surgery+after surgery	EA+RA	RA	①③④
Wang et al 2016¹²	China	30/30	53.50±8.30	51.30±8.10	Laparoscopic cholecystectomy	Ⅰ-Ⅱ	after surgery	EA+RA	RA	①③
Wang et al 2018¹³	China	27/28	34.90±5.10	34.80±6.20	Gynecological laparoscopic surgery	Ⅰ-Ⅱ	before surgery	EA+RA	RA	①③
Jiang et al 2018¹⁴	China	40/40	50.3±10.8	50.4±10.9	Laparoscopic cholecystectomy	Ⅰ-Ⅱ	in surgery	EA+RA	RA	①③④
Yu et al 2014¹⁵	China	30/30	47±11	47±11	Laparoscopic cholecystectomy	Ⅰ-Ⅱ	before surgery+after surgery	EA+RA	RA	①③
Sun et al 2019¹⁶	China	34/35	71.5±10.4	73.2±11.9	Laparoscopic intestinal surgery	Ⅰ-Ⅱ	before surgery	EA+RA	Sham EA+RA	②
Zhang et al 2015¹⁷	China	45/45	52.29±6.37	52.37±6.4	Laparoscopic cholecystectomy	Ⅰ-Ⅱ	before surgery	EA+RA	Sham EA+RA	②③④
Wang et al 2015¹⁸	China	30/30	54.88±9.01	56.15±10.6	Laparoscopic cholecystectomy	Ⅰ-Ⅱ	before surgery	EA+RA	RA	②③
Ding et al 2011¹⁹	China	30/30	53.87±11.48	56.3±10.11	Laparoscopic cholecystectomy	Ⅰ-Ⅱ	before surgery	EA+RA	RA	②
Chen et al 2015²⁰	China	30/30	42±10	41±11	Gynecological laparoscopic surgery	Ⅰ-Ⅱ	after surgery	EA+RA	RA	③
Li et al 2017²¹	China	20/20	35.2±6.1	34.4±9.1	Gynecological laparoscopic surgery	Ⅰ-Ⅱ	before surgery	EA+RA	RA	①③
Li 2021²²	China	33/31	36.27±6.09	37.16±6.08	Gynecological laparoscopic surgery	Ⅰ-Ⅱ	before surgery+after surgery	EA+RA	RA	①③

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