Abstract

The aim of this study was to evaluate the effects of Electro-Acupuncture (EA) and Transcutaneous Electrical Acupoint Stimulation (TEAS) for narrowing the duration of Postoperative Ileus (POI) and enhancing bowel function after general anesthesia.

Methods: A systematic search of electronic databases included PubMed, EMBASE, Ovid, Web of Science for studies published from 2010 until July 2021 was carried out. Randomized Controlled Trials (RCTs) involving the use of acupuncture for POI and bowel function in patients were identified. Outcomes in every work were collected and combined for determining Standardized Mean Difference (SMD) and Risk Ratio (RR). We also utilized DerSimonian and Laird approach for computing the combined SMD estimates and the respective 95% Confidence Intervals (CIs). Additionally, we conducted subgroup analysis according to intervention timing and intervention frequency.

Results: The present work enrolled 27 RCTs involving 2053 participants. Acupuncture achieved higher efficacy of releasing postoperative ileus, together with shorter time-to-first flatus/bowel sound/ defecation, shorter Length Of Stay (LOS), and greater efficacy of Postoperative Ileus relative to controls (sham acupuncture, non-acupuncture, or additional active treatments). No difference was found between the efficacy of EA and TEAS. Difference in efficacy was not significant between different type of intervention timing and intervention frequency, as revealed by subgroup analysis.

Conclusion:Electro-acupuncture and transcutaneous electrical acupoint stimulation both showed large effect size on improving postoperative gut function. More convincing data are warranted.

Keywords: Electro-acupuncture; Transcutaneous electrical acupoint stimulation; Postoperative ileus; Meta-analysis

Abbreviations: EA: Electro-Acupuncture; TEAS: Transcutaneous Electrical Acupoint Stimulation; POI: Postoperative Ileus; RCTS: Randomized Controlled Trials; SMD: Standard Mean Difference; COX: Cyclooxygenase; CI: Confidence Interval