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--- acupuncture:evaluation:soins peri-operatoires:07. nausees et vomissements post-operatoires [11 Dec 2020 07:53]
Nguyen Johan Replacement automatique de '===== Recommandation de bonne pratique =====' par '===== Guidelines ====='
+++ acupuncture:evaluation:soins peri-operatoires:07. nausees et vomissements post-operatoires [25 May 2025 11:26] (Version actuelle)
Nguyen Johan
@@ Ligne 1: / Ligne 1: @@
+/*English:Postoperative Nausea and Vomiting*/
+=======  Postoperative Nausea and Vomiting  =======
 ======= Nausées-vomissements post-opératoires : évaluation de l'acupuncture =======
-===== Revues synthétiques et méta-analyses =====
+===== Systematic Reviews and Meta-Analysis=====
-| ☆☆☆ | Evidence for effectiveness and a specific effect of acupuncture |
-| ☆☆ | Evidence for effectiveness of acupuncture |
-| ☆ |Limited evidence for effectiveness of acupuncture |
-| Ø |No evidence or insufficient evidence |
+==== Generic Acupuncture ====
+=== Arslan 2024 ===
-==== Acupuncture générique  ====
+Arslan HN, Çelik SŞ. Nonpharmacological Nursing Interventions in Postoperative Nausea and Vomiting: A Systematic Review. J Perianesth Nurs. 2024 Feb;39(1):142-154.  https://doi.org/10.1016/j.jopan.2023.06.096
+^Purpose| This study aims to assess the impact of nonpharmacological nursing interventions on postoperative nausea and vomiting (PONV).|
+^Design| This is a systematic review.|
+^Methods| MEDLINE, Web of Science, ScienceDirect, Tübitak-ULAKBİM, and TRDizin databases were searched for the following search terms, including "Postoperative Nausea and Vomiting," "Nurse," "Nursing," and "Nonpharmacological Interventions" to identify nonpharmacological nursing interventions for PONV. A systematic review of English and Turkish articles published in the period between January 1, 2012 and June 1, 2023 was conducted. The PICOT-SD method was used to determine the compatibility of the pieces with the eligibility criteria.|
+^Findings| Fifty-eight of 3,874 articles obtained from databases fulfilled the eligibility criteria. This study demonstrated that **acupuncture**, aromatherapy, the oral intake of ginger, listening to music, education, and visits to patients decreased the incidence of nausea and vomiting and increased the quality of life. Additionally, it was found that patients' quality of life tended to improve along with reductions in postoperative complications.|
+^Conclusions| The results of this study support previous findings in the literature and demonstrate that nonpharmacological nursing interventions help reduce and prevent PONV. Based on our results, we suggest that nonpharmacological nursing interventions can be employed for the management of PONV in patients undergoing surgery.|
-==== Lederer 2018 ====
+=== Lederer 2018 ===
 Lederer AK, Schmucker C, Kousoulas L, Fichtner-Feigl S, Huber R. Naturopathic Treatment and Complementary Medicine in Surgical Practice. Dtsch Arztebl Int. 2018;115(49):815-821.   {{:medias securises:acupuncture:evaluation:soins peri-operatoires:lederer-200295.pdf|[200295]}}.
@@ Ligne 71: / Ligne 82: @@
-==== Techniques particulières  ====
+==== Special Acupuncture Techniques  ====
-=== Traitement avant l'intervention  ===
+=== Acupuncture prior to surgery  ===
@@ Ligne 87: / Ligne 98: @@
 ^Relevance To Clinical Practice| The overall results of this review conclude that **all kinds of AP stimulation, both non-invasive and invasive, seem to prevent PONV with minimal side effects**. The findings from this study can be used to inform future research to evaluate the effects of preoperative treatment with acupuncture vs. sham procedure before surgery to avoid PONV. |
-=== Neiguan (¤6MC) ===
+=== Neiguan Acupoint (PC6) ===
+== Zhang 2020 (Children) ==
+Zhang Y, Zhang C, Yan M, Wang N, Liu J, Wu A. The effectiveness of PC6 acupuncture in the prevention of postoperative nausea and vomiting in children: A systematic review and meta-analysis. Paediatr Anaesth. 2020;30(5):552-63.   {{:medias securises:acupuncture:evaluation:soins peri-operatoires:zhang-168211.pdf|[168211]}}.  [[https://doi.org/10.1111/pan.13860|doi]]
+^Background|A growing number of studies have demonstrated the effectiveness of acupuncture in preventing and treating postoperative nausea and vomiting. Here, we used meta-analysis to confirm these benefits in children and to determine the optimal time to perform this treatment. |
+^Methods| Four databases (MEDLINE, EMBASE, CENTRAL, and Chinese Database of Biology and Medicine) were searched from inception until January 16, 2019. We included randomized controlled trials for evaluating the effectiveness of acupuncture in the prevention and treatment of postoperative nausea and vomiting during the early stage (0-4 hours) and within 24 hours postoperatively in pediatrics. Control groups received standardized care control or standardized care combined with sham control. |
+^Results| **Sixteen literatures and 1773 patients** undergoing general anesthesia were included in the study. The results indicated that acupuncture was effective in reducing postoperative vomiting, both during the first 4 hours (RR = 0.47, 95% CI 0.26, 0.84; low quality) and within 24 hours postoperatively (RR = 0.74, 95% CI 0.60, 0.91; low quality). Stratifying by the timing of acupuncture, acupuncture was effective in reducing the first 4 hours (RR = 0.34, 95% CI 0.18, 0.64; moderate quality), and 0-24 hours postoperative vomiting (RR = 0.81, 95% CI 0.70, 0.93; moderate quality) when performed before and during anesthesia, respectively. Further, the RR value was more robust when acupuncture was performed before anesthesia. Acupuncture was also effective in treating 0-24 hours postoperative nausea (RR = 0.73, 95% CI 0.60, 0.88; moderate quality) and in reducing the utilization of remedies during the first 4 hours (RR = 0.64, 95% CI 0.45, 0.89; moderate quality). |
+^Conclusion|Acupuncture reduces the incidence of postoperative nausea and vomiting as well as the utilization of antiemetic remedies, particularly during the first 4 hours following the operation. Acupuncture performed before anesthesia was demonstrated to be the most ideal intervention time for children. |
@@ Ligne 158: / Ligne 181: @@
 === Electro-acupuncture ===
+== Ge 2023 (gynecologic surgery )==
+Ge Y, Zheng J. The efficacy of transcutaneous electronic acupoint stimulation for improving postoperative recovery after gynecologic surgery: A systematic review and meta-analysis. Medicine (Baltimore). 2023 Sep 1;102(35):e34834.  https://doi.org/10.1097/MD.0000000000034834. https://pubmed.ncbi.nlm.nih.gov/37657060; PMCID: PMC10476788.
+^Background| This systematic review and meta-analysis aimed to evaluate the efficacy of transcutaneous electronic acupoint stimulation (TEAS) for improving postoperative recovery after gynecologic surgery.|
+^Methods| We performed a thorough search of 6 databases until March 2023, identifying 12 randomized controlled trials that met our predefined inclusion criteria and encompassed a total of 1510 patients. For continuous outcomes, we calculated the weighted mean difference (WMD), and for binomial outcomes, we used the risk ratio (RR). We evaluated heterogeneity among the included studies using Cochran I2 and Q statistics, utilizing a random-effects model when the I2 value exceeded 50%. To assess publication bias, we employed Egger test.|
+^Results| Our analysis found that **TEAS significantly reduced the risk of postoperative nausea (RR: 0.60, 95% CI: 0.43-0.83, P = .002) and postoperative vomiting (RR: 0.54, 95% CI: 0.43-0.67, P < .001)**, visual analogue scale (WMD: -0.47, 95% CI: -0.76 to -0.17, P = .002), as well as shortened the time to first bowel movement (WMD: -18.43, 95% CI: -20.87 to -15.99, P < .001) and time to first flatus (WMD: -8.98, 95% CI: -12.46 to -5.51, P < .001) compared to the conventional group.|
+^Conclusions| Our findings suggested that TEAS may improve postoperative recovery following gynecologic surgery. However, to confirm these results, larger randomized controlled trials encompassing a more diverse range of patient populations are urgently required.|
+== Han 2023 ==
+Han Z, Zhang X, Yang H, Yuan P, Wang H, Du G. Suggested Electroacupuncture for Postoperative Nausea and Vomiting: A Comprehensive Meta-Analysis and Systematic Review of Randomized Controlled Trials. Med Sci Monit. 2023 Oct 18;29:e941262.  https://doi.org/10.12659/MSM.941262
+^Backgound| The purpose of this meta-analysis was to evaluate the effectiveness of electroacupuncture in preventing and treating postoperative nausea and vomiting (PONV) after general anesthesia. |
+^Material and methods| We searched for papers on randomized controlled trials on electroacupuncture for PONV prevention after general anesthesia published in PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) since October 1, 2016. Primary outcome was incidence of PONV; secondary outcomes were incidence of postoperative nausea (PON) at 6 h, postoperative vomiting (POV) at 6 h, and postoperative antiemetic requirement. Data were combined and analyzed using RevMan 5.4.1 software. |
+^Results| **Eight randomized controlled trials, with 899 total participants**, were included. Findings showed (1) there was no significant difference in occurrence rate of PONV between electroacupuncture and control groups (OR=0.31, 95% CI [0.06, 1.49], P=0.14, I²=82%); (2) electroacupuncture reduced incidence of PON at 6 h postoperatively, compared with controls (OR=0.43, 95% CI [0.27, 0.67], P=0.0002, I²=0%); (3) compared with control group, electroacupuncture reduced POV incidence 0-6 h postoperatively (OR=0.38, 95% CI [0.23, 0.63], P=0.0001, I²=0%); (4) electroacupuncture group demonstrated a significant reduction in postoperative requirement for antiemetic medications (OR=0.44, 95% CI [0.25, 0.78], P=0.005, I²=61%); (5) one study reported adverse reactions during observation, with 3 patients experiencing pain and itching at acupuncture site and 2 patients refusing a second acupuncture treatment; all symptoms lasted less than 2 h. |
+^Conclusions| Based on current evidence, electroacupuncture significantly reduces the occurrence rate of PON and POV at 6 h after surgery and the use of antiemetic medication postoperatively. However, more high-quality, large-sample randomized controlled trials are needed to further validate its efficacy.|
+== Lu 2023 ==
+Lu L, Xie C, Li X, Zhou Y, Yin Z, Wei P, Gao H, Wang J, Yong Y, Song J. Efficacy and safety of electrical acupoint stimulation for postoperative nausea and vomiting: A systematic review and meta-analysis. PLoS One. 2023 May 31;18(5):e0285943.  https://doi.org/10.1371/journal.pone.0285943
+^Background| Postoperative nausea and vomiting are typical postsurgical complications. Drug therapy is only partially effective. The goal of our meta-analysis is to systematically evaluate the efficacy and safety of electrical acupoint stimulation for postoperative nausea and vomiting and to score the quality of evidence supporting this concept.|
+^Methods| PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov were searched from inception to March 19, 2020.|
+^Results| **Twenty-six studies (2064 patients)** were included. Compared with control treatment, electrical acupoint stimulation reduced the incidence of postoperative nausea and vomiting (RR 0.49, 95% CI 0.41 to 0.57, P < 0.001), postoperative nausea (RR 0.55, 95% CI 0.47 to 0.64, P < 0.001) and postoperative vomiting (RR 0.56, 95% CI 0.45 to 0.70, P < 0.001). Electrical acupoint stimulation also reduced the number of patients requiring antiemetic rescue (RR 0.60, 95% CI 0.43 to 0.85, P = 0.004). No differences in adverse events were observed. Subgroup analysis showed that both electroacupuncture (RR 0.58, 95% CI 0.46 to 0.74, P < 0.001) and transcutaneous electrical acupoint stimulation (RR 0.44, 95% CI 0.34 to 0.58, P < 0.001) had significant effects. Electrical acupoint stimulation was effective whether administered preoperatively (RR 0.40, 95% CI 0.27 to 0.60, P < 0.001), postoperatively (RR 0.59, 95% CI 0.46 to 0.76, P < 0.001), or perioperatively (RR 0.50, 95% CI 0.37 to 0.67, P < 0.001). The quality of evidence was moderate to low.|
+^Conclusions| Electrical acupoint stimulation probably reduce the incidence of postoperative nausea and vomiting, postoperative nausea, postoperative vomiting, and reduce the number of patients requiring antiemetic rescue, with few adverse events. |
 == Chen 2020 ==
@@ Ligne 169: / Ligne 220: @@
 ^Conclusions|TEAS is a reasonable modality to incorporate into a multimodal management approach for the prevention of PONV, PON, POV and associated with lower numbers needing antiemetic rescue, lower incidence of adverse effects after general anesthesia. |
+=== Comparison of Acupuncture techniques ===
+== Zhou 2025 ==
+Zhou T, Hou H, Cairen Z, Wang Y, Wang P, Ge L, Wa M, Xu Z, Tang F, Wang C, Liu R, Li D, Xue J, Zhang S. Comparative effectiveness of acupoint stimulation for preventing postoperative nausea and vomiting after general anesthesia: a network meta-analysis of randomized trials. Int J Surg. 2025 Jan 1;111(1):1330-1347.  https://doi.org/10.1097/JS9.0000000000001976
+^Objective| The objective was to systematically evaluate the effectiveness of different acupoint stimulation techniques in preventing postoperative nausea and vomiting (PONV) after general anesthesia.|
+^Methods| The authors searched PubMed, Cochrane Library, Web of Science, and Embase for relevant papers, about the effect of acupoint stimulation for preventing PONV from their inception to 31 July 2023. Two reviewers performed study screening, data extraction, and risk of bias assessment. The authors focused on patient important outcomes, including the incidence of PONV, postoperative nausea (PON), or postoperative vomiting (POV), and the number of patients requiring antiemetic rescue. The authors conducted network meta-analyses to estimate the relative effectiveness between different acupoint stimulation using Stata 17.0 and Revman 5.3 software.|
+^Results| The authors included **50 randomized trials** involving **7372 participants **(median age: 43.5 years, female: 73.3%). The network meta-analysis revealed that compared with the control (sham acupoint stimulation or blank control), antiemetic alone could significantly reduce the incidence of POV (RR 0.49, 95% CI: 0.36-0.69), but could not significantly reduce the incidence of PONV and PON (RR 0.49, 95% CI: 0.36-0.69; RR 0.81, 95% CI: 0.59-1.10; respectively); both TEAS and electroacupuncture alone significantly reduced the incidence of PONV, PON, and POV, and combined with antiemetic was usually more effective than single acupoint stimulation.|
+^Conclusions| Both TEAS and electroacupuncture, with or without antiemetic, could significantly reduce the incidences of postoperative nausea and vomiting after general anesthesia.|
+==== Specific Clinical Forms  ====
+=== Children ===
-==== Applications particulières  ====
+== Zhang 2020 (Neiguan Acupoint (PC6)) ==
-=== Zhang 2020 (6MC chez l'enfant) ===
@@ Ligne 183: / Ligne 245: @@
 ^Conclusion|Acupuncture reduces the incidence of postoperative nausea and vomiting as well as the utilization of antiemetic remedies, particularly during the first 4 hours following the operation. Acupuncture performed before anesthesia was demonstrated to be the most ideal intervention time for children. |
+== Shin 2016 (Tonsillectomy)☆☆ ==
+Shin HC, Kim JS, Lee SK, Kwon SH, Kim MS, Lee EJ, Yoon YJ. The effect of acupuncture on postoperative nausea and vomiting after pediatric tonsillectomy: A meta-analysis and systematic review. Laryngoscope. 2016;126(8):1761-7.   [179462].
+^ Objectives/Hypothesis|Tonsillectomy is one of the most frequently performed pediatric surgical procedures worldwide. The complications of this procedure include postoperative nausea and vomiting (PONV) and pain; therefore, both the treatment and prevention of PONV are important. Classical antiemetics include drug therapies such as ondansetron, which are undesirable because they often carry a high cost and several side effects. Therefore, in this study we aimed to evaluate the antiemetic effect of acupuncture after pediatric tonsillectomy.|
+^ Methods|We searched for eligible articles that reported on the antiemetic effects of acupuncture after tonsillectomy using the three databases, MEDLINE, Embase, and Cochrane, through July 2015. We included full-length original articles with adequate data for evaluating the antiemetic effects on pediatric tonsillectomy in the form of a relative ratio. The Newcastle-Ottawa scale was used to assess the quality of case control and cohort studies, and the Cochrane risk of bias tool was employed for randomized controlled trials (RCTs).|
+^Results| The search identified 415 publications. After screening, we selected eight articles for review (**4 RCTs**, 3 prospective cohorts, and 1 pilot study). A meta-analysis of acupuncture in pediatric tonsillectomy revealed that the number of patients with PONV was significantly reduced with acupuncture compared to the control group, with a risk ratio of 0.77 (95% confidence interval: 0.63-0.94, P < 0.05). |
+^Conclusion|**When acupuncture at PC6 (neiguan) was used to prevent PONV after pediatric tonsillectomy, the risk ratio was significantly lower compared to that of conventional drug therapy**. Although further randomized controlled trials are needed, acupuncture at PC6 is considered an economic and effective treatment for emesis after pediatric tonsillectomy. |
+== Dune 2006 (Children) ☆☆==
+Dune LS, Shiao SY. Metaanalysis of acustimulation effects on postoperative nausea and vomiting in children. Explore (NY). 2006;2(4):314-20. [143359].
+^Objective| Using metaanalysis, we sought to determine acustimulation (AS) effects on postoperative nausea and vomiting (PONV) in children. |
+^ Methods| Metaanalyses were performed on various acupoint AS effects including acupressure, acupuncture, laser acupuncture, and electrical stimulation (ETS) on PONV in children. On-line databases were searched for randomized controlled trials (RCTs) from 1966 through May 2005. In addition, the reference lists of reviewed papers were scanned for additional trials. The identified RCTs were evaluated for methodological quality using the Quality Reporting of Meta-analyses (QUOROM) guidelines, and results were pooled using the fixed-effects model. |
+^Results| **Twelve RCTs** were pooled for the outcomes of 24-hour PONV including 12 trials for vomiting and two trials for nausea. Compared with the control groups, all AS modalities reduced vomiting (RR = 0.69, 95% CI: 0.59-0.80, P < .0001) and nausea (RR = 0.59, 95% CI: 0.46-0.76, P < .0001). Acupressure (two trials) and acupuncture (six trials) modalities were effective in reducing vomiting (P < .005); however, ETS (two trials) did not show significant effects in reducing the vomiting (P = .118) in children. Compared with the controls, medications (three trials) reduced vomiting (RR = 0.42, 95% CI: 0.22-0.7, P = .0056). There were no differences between the medication and AS treatments (three trials) in reducing vomiting (RR = 1.25, 95% CI: 0.54-2.93, P = .6025). |
+^ Conclusions| **This metaanalysis demonstrated that acupressure and acupuncture are effective treatment modalities to reduce postoperative vomiting in children**. Acupuncture treatment is as effective as medications to reduce vomiting in children. Acupuncture had the greatest impact on reducing vomiting when compared with acupressure and ETS in children. |
+== Bolton 2006 (Tonsillectomy) Ø==
+Bolton CM, Myles PS, Nolan T, Sterne JA. prophylaxis of postoperative vomiting in children undergoing tonsillectomy: a systematic review and meta-analysis. Br J Anaesth. 2006;97(5):593-604. {{:medias securises:acupuncture:evaluation:soins peri-operatoires:bolton-141426.pdf|[141426].}}
+^Background| Postoperative vomiting (POV) remains one of the commonest causes of significant morbidity after tonsillectomy in children. A variety of prophylactic anti-emetic interventions have been reported, but there has only been a limited systematic review in this patient group. |
+^Objectives & methods| A systematic search was performed by using Cochrane Controlled Trials Register, MEDLINE and EMBASE to identify double-blind, randomized, placebo-controlled trials of prophylactic anti-emetic interventions in children undergoing tonsillectomy, with or without adenoidectomy. The outcome of interest was POV in the first 24 h. Summary estimates of the effect of each prophylactic anti-emetic strategy were derived using fixed effect meta-analysis. Where appropriate, dose-response effects were estimated using logistic regression and 22 articles were identified. |
+^Results| Good evidence was found for the prophylactic anti-emetic effect of dexamethasone [odds ratio (OR) 0.23, 95% CI 0.16-0.33], and the serotinergic antagonists ondansetron (OR 0.36, 95% CI 0.29-0.46), granisetron (OR 0.11, 95% CI 0.06-0.19), tropisetron (OR 0.15, 95% CI 0.06-0.35) and dolasetron (OR 0.25, 95% CI 0.1-0.59). Metoclopramide was also found to be efficacious (OR 0.51, 95% CI 0.34-0.77). **There is not sufficient evidence** to suggest that dimenhydrinate, perphenazine or droperidol, in the doses studied, are efficacious, nor were gastric aspiration or **acupuncture**. In conclusion, dexamethasone and the anti-serotinergic agents appear to be the most effective agents for the prophylaxis for POV in children undergoing tonsillectomy. |
+=== Abdominal Surgery ===
-=== Fu 2020 (chirurgie abdominale) ===
+== Fu 2020  ==
 Fu C, Wu T, Shu Q, Song A, Jiao Y. Acupuncture therapy on postoperative nausea and vomiting in abdominal operation: A Bayesian network meta analysis. Medicine (Baltimore). 2020;99(23). {{:medias securises:acupuncture:evaluation:soins peri-operatoires:fu-210027.pdf|[210027]}}. [[https://doi.org/10.1097/MD.0000000000020301|doi]]
@@ Ligne 199: / Ligne 283: @@
+=== Laparoscopic surgery ===
+== Tang 2025 ==
+Tang X, Qu S. The Impact of Acupuncture on Pain Intensity, Nausea, and Vomiting for Laparoscopic Cholecystectomy: A Meta-analysis Study. Surg Laparosc Endosc Percutan Tech. 2025 Feb 1;35(1):e1349.  https://doi.org/10.1097/SLE.0000000000001349
+^Backgound| Acupuncture may have some potential in pain relief after laparoscopic cholecystectomy, and this meta-analysis aims to explore the impact of acupuncture on pain intensity, nausea and vomiting for patients undergoing laparoscopic cholecystectomy.|
+^Methods| PubMed, EMbase, Web of science, EBSCO, Cochrane library databases, CNKI, VIP, and Wangfang were systematically searched, and we included randomized controlled trials (RCTs) assessing the effect of acupuncture on pain control for laparoscopic cholecystectomy.|
+^Results| **Five RCTs and 366 patients** were included in the meta-analysis. Overall, compared with control intervention for laparoscopic cholecystectomy, acupuncture was associated with significantly reduced pain scores at 6 hours [mean difference (MD)=-0.86; 95% CI=-1.37 to -0.34; P =0.001, 2 RCTs) and pain scores at 8 to 10 hours (MD=-0.71; 95% CI=-1.13 to -0.28; P =0.001, 2 RCTs), decreased incidence of nausea (odds ratio=0.10; 95% CI=0.03-0.34; P =0.0003, 3 RCTs), and vomiting (odds ratio=0.11; 95% CI=0.01-0.85; P =0.03, 3 RCTs), but demonstrated no obvious impact on pain scores at 12 to 24 hours (MD=-0.38; 95% CI=-1.02 to 0.27; P =0.25, 2 RCTs).|
+^Conclusions| Acupuncture may be effective to reduce pain intensity, nausea, and vomiting for laparoscopic cholecystectomy.|
+== Huang 2023 ==
+Huang WH, Zhang J, Ding SS, Xue JJ. Efficacy of acupuncture for nausea and vomiting after Huang WH, Zhang J, Ding SS, Xue JJ. Efficacy of acupuncture for nausea and vomiting after laparoscopic surgery: A systematic review and meta-analysis. Asian J Surg. 2023 Oct;46(10):4462-4464.  https://doi.org/10.1016/j.asjsur.2023.04.107
+[letter]
+=== Colorectal cancer resection ===
+== Qi 2023 ==
+Qi L, Shi H, Zhang Y, Zhang X, Jia H, Tian H. The effect of acupuncture on recovery after colorectal cancer resection: A systematic review meta-analysis of randomized controlled trials. Medicine (Baltimore). 2023 Sep 1;102(35):e34678.  https://doi.org/10.1097/MD.0000000000034678
+^Background| To evaluate the efficacy and safety of acupuncture by systematically reviewing the literature on colorectal cancer resection. |
+^Methods| Seven electronic databases were searched from inception to February 28, 2023. Randomized controlled trials on acupuncture in patients after CRC resection were included. Two reviewers independently selected relevant trials, extracted data, and assessed the risk of bias. A random-effects meta-analysis model was used to obtain summary effect estimates. The data were pooled and analyzed using RevMan 5.3. The heterogeneity of selected studies was evaluated by evaluating the I-squared (I2) statistics. |
+^Results| **Twenty-two studies with 1878 patients** were included. Results of the meta-analysis showed there was a low level evidence that acupuncture may improve early postoperative symptoms, such as time to first flatus (n = 876, MD -0.77h, 95% CI -1.22 to -0.33 h, I2 = 89%), time to first bowel movement (n = 671, MD -1.41h, 95% CI -2.20 to -0.63 h, I2 = 95%), time to first defecation (n = 556, MD -1.03h, 95% CI -1.88 to -0.18 h, I2 = 95%), and **nausea/vomiting** (n = 1488, RR 0.72, 95% CI 0.59-0.89, I2 = 49%) compared with usual care and sham acupuncture. However, there were no statistically significant differences in postoperative pain (n = 1188, MD-0.21, 95% CI -0.59 to 0.17, I2 = 74%). And there was no sufficient evidence of improving long-term functional outcomes. There was substantial heterogeneity across trials. The adverse events associated with acupuncture stimulation were minor in include studies. |
+^Conclusion subsections| There is currently low-level evidence supporting the use of acupuncture on postoperative symptoms for patients after colorectal cancer resection. More investigations should be established based on the STRICTA statement strictly. |
+=== Breast Surgery ===
-=== Sun 2019 (acupression ou electro-acupuncture de surface dans la chirurgie du sein) ☆☆===
+== Sun 2019  ☆☆==
@@ Ligne 213: / Ligne 329: @@
+=== Tonsillectomy ===
-=== Shin 2016 (amygdalectomie chez l'enfant)☆☆ ===
+== Shin 2016 (Children)☆☆ ==
 Shin HC, Kim JS, Lee SK, Kwon SH, Kim MS, Lee EJ, Yoon YJ. The effect of acupuncture on postoperative nausea and vomiting after pediatric tonsillectomy: A meta-analysis and systematic review. Laryngoscope. 2016;126(8):1761-7.   [179462].
@@ Ligne 223: / Ligne 340: @@
 ^Conclusion|**When acupuncture at PC6 (neiguan) was used to prevent PONV after pediatric tonsillectomy, the risk ratio was significantly lower compared to that of conventional drug therapy**. Although further randomized controlled trials are needed, acupuncture at PC6 is considered an economic and effective treatment for emesis after pediatric tonsillectomy. |
-=== Cho 2016 (amygdalectomie) ☆☆===
+== Cho 2016  ☆☆==
 Cho HK, Park IJ, Jeong YM, Lee YJ, Hwang SH. Can perioperative acupuncture reduce the pain and vomiting experienced after tonsillectomy? A meta-analysis. Laryngoscope. 2016;126(3):608-15. [186329].
@@ Ligne 231: / Ligne 348: @@
 ^Conclusion| perioperative acupuncture may provide pain relief without side effects in patients undergoing tonsillectomy. However, there were high levels of heterogeneity in several of the measured parameters; thus, the efficacy of acupuncture cannot be considered to have been evaluated sufficiently. For this reason, additional large well-designed trials are required to further support the results of this study. |
-=== Dune 2006 (l'enfant) ☆☆===
+== Bolton 2006 (Children) Ø==
-Dune LS, Shiao SY. Metaanalysis of acustimulation effects on postoperative nausea and vomiting in children. Explore (NY). 2006;2(4):314-20. [143359].
+Bolton CM, Myles PS, Nolan T, Sterne JA. prophylaxis of postoperative vomiting in children undergoing tonsillectomy: a systematic review and meta-analysis. Br J Anaesth. 2006;97(5):593-604. {{:medias securises:acupuncture:evaluation:soins peri-operatoires:bolton-141426.pdf|[141426].}}
-^Objective| Using metaanalysis, we sought to determine acustimulation (AS) effects on postoperative nausea and vomiting (PONV) in children. |
+^Background| Postoperative vomiting (POV) remains one of the commonest causes of significant morbidity after tonsillectomy in children. A variety of prophylactic anti-emetic interventions have been reported, but there has only been a limited systematic review in this patient group. |
-^ Methods| Metaanalyses were performed on various acupoint AS effects including acupressure, acupuncture, laser acupuncture, and electrical stimulation (ETS) on PONV in children. On-line databases were searched for randomized controlled trials (RCTs) from 1966 through May 2005. In addition, the reference lists of reviewed papers were scanned for additional trials. The identified RCTs were evaluated for methodological quality using the Quality Reporting of Meta-analyses (QUOROM) guidelines, and results were pooled using the fixed-effects model. |
+^Objectives & methods| A systematic search was performed by using Cochrane Controlled Trials Register, MEDLINE and EMBASE to identify double-blind, randomized, placebo-controlled trials of prophylactic anti-emetic interventions in children undergoing tonsillectomy, with or without adenoidectomy. The outcome of interest was POV in the first 24 h. Summary estimates of the effect of each prophylactic anti-emetic strategy were derived using fixed effect meta-analysis. Where appropriate, dose-response effects were estimated using logistic regression and 22 articles were identified. |
-^Results| **Twelve RCTs** were pooled for the outcomes of 24-hour PONV including 12 trials for vomiting and two trials for nausea. Compared with the control groups, all AS modalities reduced vomiting (RR = 0.69, 95% CI: 0.59-0.80, P < .0001) and nausea (RR = 0.59, 95% CI: 0.46-0.76, P < .0001). Acupressure (two trials) and acupuncture (six trials) modalities were effective in reducing vomiting (P < .005); however, ETS (two trials) did not show significant effects in reducing the vomiting (P = .118) in children. Compared with the controls, medications (three trials) reduced vomiting (RR = 0.42, 95% CI: 0.22-0.7, P = .0056). There were no differences between the medication and AS treatments (three trials) in reducing vomiting (RR = 1.25, 95% CI: 0.54-2.93, P = .6025). |
+^Results| Good evidence was found for the prophylactic anti-emetic effect of dexamethasone [odds ratio (OR) 0.23, 95% CI 0.16-0.33], and the serotinergic antagonists ondansetron (OR 0.36, 95% CI 0.29-0.46), granisetron (OR 0.11, 95% CI 0.06-0.19), tropisetron (OR 0.15, 95% CI 0.06-0.35) and dolasetron (OR 0.25, 95% CI 0.1-0.59). Metoclopramide was also found to be efficacious (OR 0.51, 95% CI 0.34-0.77). **There is not sufficient evidence** to suggest that dimenhydrinate, perphenazine or droperidol, in the doses studied, are efficacious, nor were gastric aspiration or **acupuncture**. In conclusion, dexamethasone and the anti-serotinergic agents appear to be the most effective agents for the prophylaxis for POV in children undergoing tonsillectomy. |
-^ Conclusions| **This metaanalysis demonstrated that acupressure and acupuncture are effective treatment modalities to reduce postoperative vomiting in children**. Acupuncture treatment is as effective as medications to reduce vomiting in children. Acupuncture had the greatest impact on reducing vomiting when compared with acupressure and ETS in children. |
-=== Allen 2008 (Césarienne) Ø===
+=== Cesarean ===
+== Griffiths 2021 ==
+Griffiths JD, Gyte GM, Popham PA, Williams K, Paranjothy S, Broughton HK, Brown HC, Thomas J. Interventions for preventing nausea and vomiting in women undergoing regional anaesthesia for caesarean section. Cochrane Database Syst Rev. 2021;5(5). [220029]. [[https://doi.org/10.1002/14651858.cd007579.pub3|doi]]
+^ Background| Nausea and vomiting are distressing symptoms which are experienced commonly during caesarean section under regional anaesthesia and in the postoperative period. |
+^Objectives|To assess the efficacy of pharmacological and non-pharmacological interventions versus placebo or no intervention given prophylactically to prevent nausea and vomiting in women undergoing regional anaesthesia for caesarean section. |
+^Methods| Search methods: For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) (16 April 2020), and reference lists of retrieved studies. Selection criteria: We included randomised controlled trials (RCTs) of studies and conference abstracts, and excluded quasi-RCTs and cross-over studies. Data collection and analysis: Review authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. Our primary outcomes are intraoperative and postoperative nausea and vomiting. Data entry was checked. Two review authors independently assessed the certainty of the evidence using the GRADE approach. |
+^Main results| Eighty-four studies (involving 10,990 women) met our inclusion criteria. Sixty-nine studies, involving 8928 women, contributed data. Most studies involved women undergoing elective caesarean section. Many studies were small with unclear risk of bias and sometimes few events. The overall certainty of the evidence assessed using GRADE was moderate to very low. 5-HT3 antagonists: We found intraoperative nausea may be reduced by 5-HT3 antagonists (average risk ratio (aRR) 0.55, 95% confidence interval (CI) 0.42 to 0.71, 12 studies, 1419 women, low-certainty evidence). There may be a reduction in intraoperative vomiting but the evidence is very uncertain (aRR 0.46, 95% CI 0.29 to 0.73, 11 studies, 1414 women, very low-certainty evidence). There is probably a reduction in postoperative nausea (aRR 0.40, 95% CI 0.30 to 0.54, 10 studies, 1340 women, moderate-certainty evidence), and these drugs may show a reduction in postoperative vomiting (aRR 0.47, 95% CI 0.31 to 0.69, 10 studies, 1450 women, low-certainty evidence). Dopamine antagonists: We found dopamine antagonists may reduce intraoperative nausea but the evidence is very uncertain (aRR 0.38, 95% CI 0.27 to 0.52, 15 studies, 1180 women, very low-certainty evidence). Dopamine antagonists may reduce intraoperative vomiting (aRR 0.41, 95% CI 0.28 to 0.60, 12 studies, 942 women, low-certainty evidence) and postoperative nausea (aRR 0.61, 95% CI 0.48 to 0.79, 7 studies, 601 women, low-certainty evidence). We are uncertain if dopamine antagonists reduce postoperative vomiting (aRR 0.63, 95% CI 0.44 to 0.92, 9 studies, 860 women, very low-certainty evidence). Corticosteroids (steroids): We are uncertain if intraoperative nausea is reduced by corticosteroids (aRR 0.56, 95% CI 0.37 to 0.83, 6 studies, 609 women, very low-certainty evidence) similarly for intraoperative vomiting (aRR 0.52, 95% CI 0.31 to 0.87, 6 studies, 609 women, very low-certainty evidence). Corticosteroids probably reduce postoperative nausea (aRR 0.59, 95% CI 0.49 to 0.73, 6 studies, 733 women, moderate-certainty evidence), and may reduce postoperative vomiting (aRR 0.68, 95% CI 0.49 to 0.95, 7 studies, 793 women, low-certainty evidence). Antihistamines: Antihistamines may have little to no effect on intraoperative nausea (RR 0.99, 95% CI 0.47 to 2.11, 1 study, 149 women, very low-certainty evidence) or intraoperative vomiting (no events in the one study of 149 women). Antihistamines may reduce postoperative nausea (aRR 0.44, 95% CI 0.30 to 0.64, 4 studies, 514 women, low-certainty evidence), however, we are uncertain whether antihistamines reduce postoperative vomiting (average RR 0.48, 95% CI 0.29 to 0.81, 3 studies, 333 women, very low-certainty evidence). Anticholinergics: Anticholinergics may reduce intraoperative nausea (aRR 0.67, 95% CI 0.51 to 0.87, 4 studies, 453 women, low-certainty evidence) but may have little to no effect on intraoperative vomiting (aRR 0.79, 95% CI 0.40 to 1.54, 4 studies; 453 women, very low-certainty evidence). No studies looked at anticholinergics in postoperative nausea, but they may reduce postoperative vomiting (aRR 0.55, 95% CI 0.41 to 0.74, 1 study, 161 women, low-certainty evidence). Sedatives: We found that sedatives probably reduce intraoperative nausea (aRR 0.65, 95% CI 0.51 to 0.82, 8 studies, 593 women, moderate-certainty evidence) and intraoperative vomiting (aRR 0.35, 95% CI 0.24 to 0.52, 8 studies, 593 women, moderate-certainty evidence). However, we are uncertain whether sedatives reduce postoperative nausea (aRR 0.25, 95% CI 0.09 to 0.71, 2 studies, 145 women, very low-certainty evidence) and they may reduce postoperative vomiting (aRR 0.09, 95% CI 0.03 to 0.28, 2 studies, 145 women, low-certainty evidence). Opioid antagonists: There were no studies assessing intraoperative nausea or vomiting. Opioid antagonists may result in little or no difference to the number of women having postoperative nausea (aRR 0.75, 95% CI 0.39 to 1.45, 1 study, 120 women, low-certainty evidence) or postoperative vomiting (aRR 1.25, 95% CI 0.35 to 4.43, 1 study, 120 women, low-certainty evidence). **Acupressure**: It is uncertain whether acupressure/acupuncture reduces intraoperative nausea (aRR 0.55, 95% CI 0.41 to 0.74, 9 studies, 1221 women, very low-certainty evidence). Acupressure may reduce intraoperative vomiting (aRR 0.52, 95% CI 0.33 to 0.80, 9 studies, 1221 women, low-certainty evidence) but it is uncertain whether it reduces postoperative nausea (aRR 0.46, 95% CI 0.27 to 0.75, 7 studies, 1069 women, very low-certainty evidence) or postoperative vomiting (aRR 0.52, 95% CI 0.34 to 0.79, 7 studies, 1069 women, very low-certainty evidence). Ginger: It is uncertain whether ginger makes any difference to the number of women having intraoperative nausea (aRR 0.66, 95% CI 0.36 to 1.21, 2 studies, 331 women, very low-certainty evidence), intraoperative vomiting (aRR 0.62, 95% CI 0.38 to 1.00, 2 studies, 331 women, very low-certainty evidence), postoperative nausea (aRR 0.63, 95% CI 0.22 to 1.77, 1 study, 92 women, very low-certainty evidence) and postoperative vomiting (aRR 0.20, 95% CI 0.02 to 1.65, 1 study, 92 women, very low-certainty evidence). Few studies assessed our secondary outcomes including adverse effects or women's views. |
+^Authors' conclusions| This review indicates that 5-HT3 antagonists, dopamine antagonists, corticosteroids, sedatives and **acupressure** probably or possibly have efficacy in reducing nausea and vomiting in women undergoing regional anaesthesia for caesarean section. However the certainty of evidence varied widely and was generally low. Future research is needed to assess side effects of treatment, women's views and to compare the efficacy of combinations of different medications. |
+== Allen 2008  Ø==
@@ Ligne 250: / Ligne 380: @@
 ^Conclusions| While some studies showed a benefit of P6 stimulation, **this finding was not consistent**. The presence of heterogeneity and inconsistent results among the included trials prevents any definitive conclusions on the efficacy of P6 stimulation in reducing IONV and PONV associated with cesarean delivery performed under neuraxial anesthesia. |
+=== Total Knee Arthroplasty ===
+== Chen 2021 ==
+Chen Z, Shen Z, Ye X, Xu Y, Liu J, Shi X, Chen G, Wu J, Chen W, Jiang T, Liu W, Xu X. Acupuncture for Rehabilitation After Total Knee Arthroplasty: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Med (Lausanne). 2021.   [216629]. [[https://doi.org/10.3389/fmed.2020.602564|doi]]
+^ Background| There is an increasing interest in acupuncture for promoting post-operative rehabilitation, but the effectiveness of acupuncture for rehabilitation after total knee arthroplasty (TKA) remains controversial. Objective: This study aims to investigate the effect of acupuncture on rehabilitation after TKA. |
+^Methods|Database searches of PubMed, EMBASE, CINAHL, and China National Knowledge Infrastructure (CNKI) were conducted to obtain articles published until August 2020. All identified articles were screened, and data from each included study were extracted independently by two investigators. Meta-analysis was performed to examine the effects of acupuncture on pain, range of knee motion, function, and nausea/vomiting after TKA. |
+^ Results| A total of **nine randomized clinical trials** were included according to the inclusion and exclusion criteria in this review. Compared with routine treatment, acupuncture combined with routine treatment showed a significantly greater pain reduction at 8, 12, 24, and 48 h post-operatively after TKA. Meanwhile, we found that the acupuncture groups showed a significant function improvement and a lower percentage of nausea/vomiting in comparison with the control groups after operation. However, acupuncture groups demonstrated no statistically significant improvement in post-operative pain at 4 h, 7 days, 14 days, and more than 21 days, and no significant difference in range of knee motion was observed between the acupuncture groups and control groups after surgery. |
+^Conclusions|Acupuncture, as a supplementary treatment after TKA, could improve function and reduce nausea/vomiting. However, the effect of acupuncture on pain relief may be mainly achieved within post-operative 48 h, and it had no efficacy in improving range of knee motion. More large-scale and high-quality studies are warranted. |
-=== Bolton 2006 (amygdalectomie chez l'enfant) Ø===
-Bolton CM, Myles PS, Nolan T, Sterne JA. prophylaxis of postoperative vomiting in children undergoing tonsillectomy: a systematic review and meta-analysis. Br J Anaesth. 2006;97(5):593-604. {{:medias securises:acupuncture:evaluation:soins peri-operatoires:bolton-141426.pdf|[141426].}}
-^Background| Postoperative vomiting (POV) remains one of the commonest causes of significant morbidity after tonsillectomy in children. A variety of prophylactic anti-emetic interventions have been reported, but there has only been a limited systematic review in this patient group. |
-^Objectives & methods| A systematic search was performed by using Cochrane Controlled Trials Register, MEDLINE and EMBASE to identify double-blind, randomized, placebo-controlled trials of prophylactic anti-emetic interventions in children undergoing tonsillectomy, with or without adenoidectomy. The outcome of interest was POV in the first 24 h. Summary estimates of the effect of each prophylactic anti-emetic strategy were derived using fixed effect meta-analysis. Where appropriate, dose-response effects were estimated using logistic regression and 22 articles were identified. |
-^Results| Good evidence was found for the prophylactic anti-emetic effect of dexamethasone [odds ratio (OR) 0.23, 95% CI 0.16-0.33], and the serotinergic antagonists ondansetron (OR 0.36, 95% CI 0.29-0.46), granisetron (OR 0.11, 95% CI 0.06-0.19), tropisetron (OR 0.15, 95% CI 0.06-0.35) and dolasetron (OR 0.25, 95% CI 0.1-0.59). Metoclopramide was also found to be efficacious (OR 0.51, 95% CI 0.34-0.77). **There is not sufficient evidence** to suggest that dimenhydrinate, perphenazine or droperidol, in the doses studied, are efficacious, nor were gastric aspiration or **acupuncture**. In conclusion, dexamethasone and the anti-serotinergic agents appear to be the most effective agents for the prophylaxis for POV in children undergoing tonsillectomy. |
-=====  Guidelines =====
+===== Clinical Practice Guidelines =====
 | ⊕ positive recommendation (regardless of the level of evidence reported) \\ Ø negative recommendation (or lack of evidence) |
+==== National Institute for Health and Clinical Excellence (NICE, UK) 2021 ⊕ ====
+National Institute for Health and Clinical Excellence (NICE). Caesarean section. London (UK): National Institute for Health and Clinical Excellence (NICE). 2021; 44p.   [217697].
+|Women having a CS (Caesarean section) should be offered antiemetics (either pharmacological or **acupressure**) to reduce nausea and vomiting during CS. [2004] |
+==== Enhanced Recovery After Surgery Society and the European Society of Thoracic Surgeons (ERASVR, ESTS, Europe)  2019 ⊕ ====
+Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, Brunelli A, Cerfolio RJ, Gonzalez M et al. Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERASVR ) Society and the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg. 2019;55:91-155.   [203434]. [[http://dx.plos.org/10.1371/journal.pone.0214195|doi]]
+| Evidence level: The use of non-pharmacological measures: High. Recommendation level: The use of non-pharmacological measures: Strong. Electrical stimulation of the P6 acupoint has a significant impact on decreasing the rates of PONV. Acupoint stimulation is considered to be just as effective if performed either preoperatively or postoperatively. |
@@ Ligne 292: / Ligne 442: @@
 Martin S, Baines D, Holtby H, Carr AS. Guidelines on the Prevention of Post-operative Vomiting in Children. The Association of Paediatric Anaesthetists of Great Britain and Ireland. 2016:36p.   {{:medias securises:acupuncture:evaluation:soins peri-operatoires:martin-197119.pdf|[197119]}}.
- | Current evidence base supports acustimulation reducing POV compared to the non-active control situation. Acustimulation appears to be equally effective in preventing POV as anti-emetic drugs in children. The use of acustimulation can be considered as an alternative treatment to antiemetic medications for surgery where there is a high-risk POV in children.|
+| Current evidence base supports acustimulation reducing POV compared to the non-active control situation. Acustimulation appears to be equally effective in preventing POV as anti-emetic drugs in children. The use of acustimulation can be considered as an alternative treatment to antiemetic medications for surgery where there is a high-risk POV in children.|
 ==== Australian and New Zealand College of Anaesthetists (ANZCA, Autralia- New Zealand) 2015 ⊕ ====

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