Electroacupuncture or transcutaneous electroacupuncture for postoperative ileus after abdominal surgery: A systematic...

At present, there is no ideal treatment for postoperative ileus (POI) after abdominal surgery. This meta-analysis aims to evaluate the efficacy of electroacupuncture (EA) and transcutaneous electroacupuncture (TEA) in improving postoperative POI.

We systematically screened randomized controlled trials (RCTs) from multiple databases and included 15 high quality RCTs. Two investigators independently conducted data extraction, risk of bias assessment and statistical analysis. Meta-analysis was performed by a random- (REM) or fixed-effect (FIXED) model.

A total of 15 trials involving 965 participates were included. Meta-analysis results favored EA/TEA treatment for POI by analysis of time to first flatus [mean difference (MD) -11.60 h, I² = 94%, REM)], time to first defecation (MD -12.94 h, I² = 90%, REM), time to bowel sound recovery (MD -7.25 h, I² = 85%, REM), time to first oral feeding (MD -15.76 h, I² = 47%, REM) and length of hospital stay (MD -1.19 d, I² = 44%, REM). Subgroup analysis of laparoscopic surgery patients also favored EA/TEA by analysis of time to first flatus (MD -2.46 h, I² = 0%, FIXED), time to first oral feeding (MD -10.73 h, I² = 0%, FIXED) and length of hospital stay (MD -1.30 d, I² = 32%, REM). ST36 (Zusanli), ST37 (Shangjuxu) and ST39 (Xiajuxu) are preferred EA/TEA acupoints for treating POI. There was no significant difference in postoperative analgesic consumption between EA and control groups (P = 0.39). No severe adverse events associated with EA/TEA were reported.

This meta-analysis suggests that EA/TEA is a safe, effective treatment for POI after abdominal surgeries including laparoscopic surgery, and that EA/TEA does not relieve postoperative pain after abdominal surgery. There is significant heterogeneity of research on this subject, thus, a professional consensus is needed to establish a standard protocol for use of this technique.