Electroacupuncture of ST36 and PC6 for postoperative gastrointestinal recovery: A systematic review and meta-analysis

This study was designed to determine the efficacy and safety of electroacupuncture (EA) at acupoints ST36 and/or PC6 for postoperative gastrointestinal (GI) recovery. Studies were retrieved from the PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang, and Airiti library databases from inception to January 23, 2024. Randomized controlled trials (RCTs) that evaluated the effect of EA at ST36 and/or PC6 on postoperative GI recovery were reviewed. Studies that involved acupoints other than the two or treatment modalities other than EA were excluded. Meta-analysis of 17 RCTs revealed that the time to first flatus (Mean difference (MD) = -5.06 h; 95% Confidence interval (CI), -7.12 to -3.01) and time to first defecation (MD = -12.29 h; 95% CI, -20.64 to -5.21) were significantly shorter in the EA group compared with the control group. The incidence of post-operative nausea and vomiting (PONV) was also significantly lower in the EA group than in the control group (Risk ratio (RR) = 0.62; 95% CI, 0.49-0.78). EA application to ST36 or PC6 alone as an adjunctive therapy is effective and safe in promoting postoperative GI recovery and reducing PONV. The benefits are less obvious when ST36 and PC6 are combined. Acupoint selection and EA parameters are important factors that influence therapeutic effects. The establishment of a standardized EA protocol is imperative to minimize bias in research and to maximize applicability in clinical practice.