Comparison of Adverse Reactions Between Remimazolam and Propofol in Hysteroscopic Surgery in Mainland China: A Meta‐Analysis and Systematic Review

To improve patient tolerability and satisfaction as well as minimize complications, procedural sedation has been widely used. Propofol is the most widely used agent for induction of anesthesia and sedation by anesthesiologists. With a different mechanism compared to propofol, remimazolam is a new short-acting GABA-A receptor agonist. It is an ester-based benzodiazepine. This meta-analysis aims to clarify the efficacy and safety of remimazolam versus propofol for procedure sedation. Electronic databases were searched for randomized controlled trials (RCTs) comparing efficacy or safety of remimazolam versus propofol. Meta-analysis were conducted using RStudio with "metafor" package with random-effects model. A total of twelve RCTs were included in the meta-analysis. The pooled results demonstrated that patients with remimazolam for procedural sedation had lower risk of bradycardia (OR 0.28, 95% CI [0.14-0.57]), hypotension (OR 0.26, 95% CI [0.22-0.32]), and respiratory depression (OR 0.22, 95% CI [0.14-0.36]). There was no difference in the risk of developing postoperative nausea and vomiting (PONV) (OR 0.65, 95% CI [0.15-2.79]) and dizziness (OR 0.93, 95% CI [0.53-1.61]) between the remimazolam and propofol groups. Using remimazolam for procedural sedation is significantly associated with less injection pain compared to propofol (OR 0.06, 95% CI [0.03-0.13]). Regarding the sedation efficacy, there was no difference in sedation success rate or time to loss of consciousness, recover and discharge between the remimazolam and the propofol groups. Based on our meta-analysis, patients receiving procedural sedation with remimazolam had lower risk of bradycardia, hypotension, respiratory depression and injection pain compared with propofol. On the other hand, there was no difference in sedation success rate, risk of PONV, dizziness, time to LOC, recovery and discharge between these two sedatives. CRD42022362950.

Hysteroscopic surgery will stimulate the autonomic nerves innervating the uterus, causing intense discomfort and pain in the examined person, and in severe cases, it will cause blood pressure drop, heart rate slowing, arrhythmia and even cardiac arrest, so most patients need anesthetic intervention. This study to retrospectively compare the anesthetic effect of remimazolam and propofol in minimally invasive painless hysteroscopic surgery and to explore the safety and efficacy of remimazolam. The clinical data of 110 female patients who underwent painless hysteroscopic minimally invasive surgery in our hospital from January 2023 to June 2023 were collected. The patients were divided into the remimazolam group (group R, n = 55) and the propofol group (group P, n = 55) according to the main anesthetic drugs used during the operation. The changes in heart rate (HR), mean arterial pressure (MAP), blood oxygen saturation (SpO2), and respiratory rate (RR) at the time of entry (T0), modified vigilance/sedation score (MOAA/S) 0 (T1), cervical dilation (T2), end of the operation (T3) and anesthesia recovery (T4) were compared between the two groups. Anesthesia induction time, operation time, and anesthesia recovery time were compared between the two groups, and the incidence of intraoperative and postoperative adverse reactions was compared between the two groups. HR, MAP, and SpO2 in group R were significantly higher than those in group P at T1, T2, T3, and T4 (p < 0.05), and there was no significant difference in RR between the two groups (p > 0.05). HR, MAP, and SpO2 at T1 and T2 were significantly lower than those at T0 in group R (p < 0.05), and RR at different time points in the group had no significant difference (p > 0.05). HR, MAP, and SpO2 at T1, T2, T3, and T4 were significantly lower than those at T0 in group P (p < 0.01), and RR at different time points in the same group had no significant difference (p > 0.05). The anesthesia induction time in group R was more prolonged than in group P, and the anesthesia recovery time in group R was shorter than in group P (p < 0.05). The incidences of hypotension, bradycardia, low oxygen saturation, respiratory depression, and injection pain in group R were significantly lower than those in group P (p < 0.05). Intravenous induction of remimazolam at 6 mg·kg-1·h-1 and maintenance of anesthesia at 1-2 mg·kg-1·h-1 have less effect on hemodynamics, faster recovery time and lower incidence of adverse reactions compared with propofol when used in minimally invasive hysteroscopic surgery. Remimazolam can be safely and effectively used in this kind of surgery.

ANESTHESIA has become remarkably safe, and while death and permanent damage have become rare occurrences, other sequelae of anesthesia are gaining more importance. Postoperative nausea and vomiting (PONV) still is the most troublesome adverse event encountered in the recovery room, despite advances in prevention and treatment. The incidence of PONV has remained high and has a major negative impact on patient satisfaction about the overall surgical experience. Furthermore, the ongoing trend toward ambulatory procedures has increased the focus on PONV as its occurrence may delay discharge or cause unanticipated hospital admission. General anesthesia has long been considered as causing a greater frequency and severity of PONV than regional anesthetic techniques. Recent studies investigating this time-honored dictum in a controlled manner mostly, but not unanimously, confirmed it. Accordingly, considerable effort has been invested to examine etiology, define patients at risk, and outline preventive and therapeutic strategies in patients undergoing general anesthesia. Reviews dealing with PONV have discussed almost exclusively general anesthesia and largely ignored regional anesthesia. This contrasts with the increasing popularity of regional anesthesia. A survey in Europe showed that one third of patients are undergoing regional anesthesia for their operative procedure. In France, the proportion of regional anesthesia increased from 15 to 25% of all anesthetics administered from 1980 to 1996. The number of local anesthetic and analgesic agents available for regional anesthesia has increased over the last two decades. Since the introduction of intrathecal and epidural morphine in 1979, a multitude of medications, such as synthetic opioids, 2-agonists, and cholinesterase inhibitors, have been introduced in an attempt to enhance the action of local anesthetics. The decision about their usefulness will not only rely on their effects on nerve blockade and pain relief, but also on their influence on side effects such as PONV. This review focuses on PONV in the setting of perioperative regional anesthesia. General aspects of PONV, such as physiology, patient, and perioperative factors involved are discussed. Few studies regarding these issues have been specifically devoted to regional anesthesia. Therefore, much information must be derived from investigations of general anesthesia. Specific regional anesthetic techniques and the influence of adjunctive medications on PONV are also presented. Combined general–regional anesthesia is purposefully excluded, avoiding the many variables introduced by general anesthesia. A final section is devoted to continuous peripheral nerve blocks and their possible impact on PONV.

Postoperative nausea and vomiting (PONV) remain significant complication after general anesthesia. Inhaled anesthetics are a known risk factor for PONV. Heart rate variability (HRV), an indicator of autonomic nervous system balance, is influenced by anesthetic agents and may be linked to PONV. This study aimed to compare HRV dynamics and their relationship with PONV between sevoflurane and propofol anesthesia. This preliminary randomized double-blind study included 40 adult participants aged 20-60 years, with the American Society of Anesthesiologist Physical Status I or II, scheduled for elective breast surgery; the participants were randomly assigned to sevoflurane or propofol group. HRV was measured preoperatively and postoperatively, in the post-anesthetic care unit. Incidence (defined as the presence or absence of any PONV during the study period), severity (0-3 points), PONV impact scale, and patient satisfaction, were recorded postoperatively at 30 min, 3 h, and 1 and 2 days. There was no significant intergroup difference in demographics, type of surgery, anesthesia duration, and Apfel score. The sevoflurane group had a higher PONV incidence than the propofol group; significant intergroup differences in the PONV profile were mainly observed <30 min postoperatively in PONV frequency and severity and nausea severity. Although there was no significant intergroup difference in preoperative and postoperative frequency-domain parameters, total power (Ln), LF, LF (Ln), and HF (Ln), decreased postoperatively in the sevoflurane group. Sevoflurane use was associated with more frequent, severe PONV <30 min postoperatively than propofol use, without differences in HRV dynamics. With sevoflurane use, HRV parameters did not recover to preoperative levels and were potentially associated with PONV.

Remifentanil as an analgesic adjunct in local/regional anesthesia and in monitored anesthesia care.

Postoperative nausea and vomiting (PONV) is one of the most common adverse complications associated with anesthesia and after surgical procedures. PONV is related to patient dissatisfaction and can lead to several postoperative complications. This study aimed to examine the efficacy and safety of penehyclidine combined with antiemetics in preventing PONV. We searched English databases (including PubMed, Web of Science, Ovid Medline, Embase and Cochrane Library), Chinese electronic databases (including China National Knowledge Infrastructure, Wanfang, VIP, and Chinese Biomedical Literature) and trial registry databases to find randomized controlled trials researching the clinical validity of penehyclidine combined with antiemetics for PONV. The retrieval time was up to January 2025, without publication date restrictions. Articles published in the English and Chinese languages were considered. The primary outcome was the incidence of PONV within and over 24 hours postoperatively. The secondary outcomes were the incidence of different severities of PONV, incidence of postoperative rescue antiemetic therapy and postoperative complications. Quality assessment was conducted with the Cochrane Collaboration's risk of bias tool and grading of recommendations assessment, development and evaluation method. Subgroup analyses were performed according to the postoperative observation period. Trial sequential analysis was performed to validate the reliability of the primary outcome. Publication bias was assessed by funnel plots and Egger's regression test. Sixteen randomized controlled trials comprising 1561 participants were included. Compared with the control group, penehyclidine combined with antiemetics provided a lower incidence of PONV (risk ratio [RR]: 0.65; 95% CI: 0.57-0.74; P < .00001; I2 = 11%; low quality), lower incidence of severe PONV over 24 hours postoperatively (RR: 0.29; 95% CI: 0.15-0.56; P = .0003; I2 = 0%; low quality), and a lower incidence of postoperative rescue antiemetic therapy (RR = 0.42, 95% CI: 0.26-0.69; P = .0006; I2 = 58%; low quality). However, it was associated with a higher incidence of dry mouth (RR: 3.10, 95% CI: 2.28-4.20; P < .00001; I2 = 19%; low quality), but did not increase the incidence of other anticholinergic-related complications (RR: 1.08; 95% CI: 0.91-1.28; P = .38; I2 = 2%; low quality). Compared with antiemetics, penehyclidine combined with antiemetics could provide better prevention efficiency for PONV, with lower incidence of PONV, lower incidence of severe PONV over 24 hours postoperatively and lower incidence of postoperative rescue antiemetic therapy.

To evaluate the anesthesia effect of etomidate and propofol on painless abortion surgery. After screening the Cochrane Library, Pubmed, China National Knowledge Infrastructure (CNKI), WANFANG, VIP database, the literatures regarding the anesthesia effect of etomidate and propofol on painless abortion surgery were collected from 1995 to 2014. The randomized controlled trials (RCTs) were selected, the quality evaluation was performed and the data was analyzed by using RevMan5.3 software. A total of 1 130 patients were included in 9 RCTs. The results of Meta analysis were as follows: the anesthesia induction time in the etomidate group was less than that in propofol group (MD=-0.14, 95% CI -0.24 to -0.04, P=0.004); there were more adverse reactions, such as myoclonus, nausea and vomiting, in the etomidate group compared with the propofol group (P<0.001); the incidence of pain in the etomidate group was less than that in the propofol group (P<0.001); there was no significant difference in the incidence of respiratory depression between the 2 groups (P>0.05); the surgery time, analgesia and duration from withdrawal to the wake-up was not significantly different between the 2 groups (P>0.05). Etomidate had a shorter anesthesia induction time than propofol in the painless abortion surgery. The incidence of reverse reactions such as myoclonus, nausea and vomiting, was more common in application of etomidate, whereas the incidence of injection pain was more common in the use of propofol group. There was no significant difference in respiratory depression between the 2 drugs. The comprehensive efficacy of propofol is better than etomidate.

To evaluate and compare the effects of ciprofol and propofol on postoperative nausea and vomiting (PONV) in patients undergoing outpatient hysteroscopy. Double-blind randomized controlled trial. This study included 1104 patients scheduled for elective outpatient hysteroscopy. Patients were randomly grouped to ciprofol Group (Group C, n = 539) and propofol Group (Group P, n = 547). Anesthesia was induced by sufentanil 0.1 ug/kg combined with ciprofol 0.3mg/kg or propofol 2.5mg/kg. Anesthesia was maintained by ciprofol 1 to 1.5mg/kg/h or propofol 3 to 5mg/kg/h. The primary outcome of the study was PONV after surgery 1h and 24h. Secondary outcomes included heart rate (HR), mean arterial blood pressure (MAP), SpO2 before anesthesia (T1), 3min after anesthesia (T2) and at the end of surgery (T3); the time of consciousness loss, recovery, hysteroscopy and discharge; and the incidence of adverse drug reactions such as hypotension, respiratory depression, bradycardia and injection pain was recorded in the two groups. Compared with group P, MAP and SpO2 at T2 were significantly increased in group C (P<0.05). Although there was no significant difference in the incidence of PONV at 1h and 24h after surgery between 2 groups (P > 0.05), the incidence of hypotension, injection pain and respiratory depression in group C were significantly reduced, compared with group P. (P<0.05). Compared with propofol, ciprofol has a similar incidence of PONV and lower adverse effects such as hypotension, injection pain and respiratory depression in outpatient hysteroscopy.

BackgroundRemimazolam tosilate (HR7056, RT), a novel ultrashort-acting benzodiazepine, can be used for procedural sedation and general anaesthesia. However, few studies have focused on the sedative effect of RT during gastrointestinal endoscopy in elderly patients. The purpose of this study is to compare the sedative effect of RT and propofol for gastrointestinal endoscopy in elderly patients.MethodsA total of 82 patients aged ≥65 years with an American Society of Anaesthesiologists (ASA) grade I-II and a body mass index (BMI) of 18.0 to 30.0 kg/m2 who were scheduled for gastrointestinal endoscopy from Jan 2021 to Aug 2021 were selected and randomly divided into a RT group and a propofol group. Alfentanil 5 μg/kg was used for analgesia in both groups. The RT group was given remimazolam tosilate 0.15 mg/kg with supplemental doses of 0.05 mg/kg as need, while the propofol group was given propofol 1.5 mg/kg with supplemental doses of 0.5 mg/kg. The supplemental doses were determined by the modified observational alertness/sedation assessment (MOAA/S) score and the patients’ body movements. Sedative effects, such as the time to loss of consciousness (LOC) (MOAA/S score ≤ 1), successful sedation in one dose, number of supplemental doses after successful induction, and recovery time, were evaluated. Sedation-related side effects, such as injection pain, haemodynamic events and respiratory depression, were also noted. Postoperative nausea and vomiting (PONV), visual analogue scale (VAS) scores at rest, remedial analgesics, and dizziness or headache were recorded. In addition, patients’ satisfaction and physician’s satisfaction of the procedure were compared between the two groups.ResultsData from 77 patients were analysed. The success rate of sedation in both groups was 100%. The time to LOC (MOAA/S score ≤ 1) in the RT group was longer than that in the propofol group (20.7 ± 6.1s vs. 13.2 ± 5.2s, P < 0.001). There were fewer patients in the RT group reporting injection pain than that in the propofol group (0/39 vs. 5/38, P = 0.025). Haemodynamic events and respiratory depression in the RT group were less frequent than those in the propofol group ((6/39 vs. 17/38, P = 0.005), (2/39 vs. 9/38, P = 0.026), respectively). The number of supplemental doses after successful induction in the RT group was greater than that in the propofol group (4/9/11/13/1/1 vs. 8/4/18/6/2/0 requiring 0, 1, 2, 3, 4 or 5 supplemental doses, P = 0.014). The characteristics of the patients enrolled, postoperative parameters of the patients, and patients’ and physician’s satisfaction of the procedure were comparable in the two groups.ConclusionsCompared with propofol, RT can be safely and effectively used for gastrointestinal endoscopy sedation in elderly patients, and the incidence of sedation-related adverse reactions, especially haemodynamic events and respiratory depression, is lower. When RT is used, the number of supplemental doses after successful induction may increase slightly.Trial registrationChictr.org.cn ChiCTR2000040498. Retrospectively registered (date of registration: December 1, 2020).

The changing role of monitored anesthesia care in the ambulatory setting.

Objective To investigate the efficacy of ultrasound-guided modified dorsal penile nerve block for circumcision in the pediatric patients. Methods Eighty pediatric patients, of American Society of Anesthesiologists physical status Ⅰ, aged 5-12 yr, weighing 15-52 kg, undergoing elective circumcision, were randomly divided into 2 groups (n=40 each) using a random number table: ultrasound-guided modified dorsal penile nerve block group (group A) and ultrasound-guided traditional dorsal penile nerve block group (group B). Propofol was given by target-controlled infusion (Marsh mode) to maintain anesthesia, the initial target effect-site concentration was 2 μg/ml, and the target effect-site concentration was increased by an increment of 1 μg/ml when necessary.The children were placed in the dorsal lithotomy position in group A. The ultrasound probe was placed in a coronal parallel plan just beneath the skin of the scrotum.The needle was inserted at the site 0.5 cm lateral to the probe, and advanced directly until the tip of the catheter was placed into the penile neurovascular sheath.When blood was not found after withdrawing from the catheter, the mixture (0.1 ml/kg) of 1% lidocaine and 0.375% ropivacaine was injected.The ultrasound image showed that the neurovascular sheath was infiltrated with drug liquid and expanded, and the equal volume of local anesthetics was given on the other side of the probe.Group B underwent traditional dorsal penile nerve block with the mixture (0.2 ml/kg) of 1% lidocaine and 0.375% ropivacaine 0.2 ml/kg.The total consumption of propofol, emergence time, and occurrence of bradycardia during operation and emergence, intraoperative body movement and respiratory depression, and adverse reactions such as postoperative agitation, nausea, vomiting, urinary retention and pruritus were also recorded.Paracetamol suppositories were used as rescue analgesic after operation, and the requirement was recorded.The puncturing time and success rate, and puncture-induced penile swelling were also recorded. Results No pediatric patients developed intraoperative and postoperative bradycardia, and postoperative nausea, vomiting, agitation, urinary retention and pruritus in the two groups.Compared with group B, the total consumption of propofol was significantly decreased, the emergence time was significantly shortened, the requirement for paracetamol suppositories and incidence of body movement and penile swelling were significantly decreased, the puncturing time was significantly shortened (P 0.05). The success rate of puncture was 100% in the two groups. Conclusion Ultrasound-guided modified dorsal penile nerve block is safe and effective when used for circumcision in the pediatric patients, and it is superior to ultrasound-guided traditional block. Key words: Ultrasonography; Child; Nerve block; Circumcision, male

Safety and efficacy of dexmedetomidine vs. midazolam in complex gastrointestinal endoscopy: A systematic review and meta-analysis

Background:A systematic review and meta-analysis of published randomized controlled trials (RCTs) were performed to assess the efficacy and safety of preoperative intravenous glucocorticoids versus controls for the prevention of postoperative acute pain and postoperative nausea and vomiting (PONV) after primary total hip arthroplasty (THA).Methods:A computer literature search of electronic databases, including PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, China National Knowledge Infrastructure (CNKI), and China Wanfang database, was conducted to identify the relevant RCTs comparing preoperative intravenous glucocorticoids versus placebos for reducing acute pain and PONV in THA patients. The primary outcomes included the use of the visual analog scale (VAS) with rest or mobilization at 6, 24, 48, and 72 hours and the occurrence of PONV. The secondary outcome was total morphine consumption. We calculated the risk ratio (RR) with a 95% confidence interval (95% CI) for dichotomous outcomes, and the weighted mean difference (WMD) with a 95% CI for continuous outcomes.Results:Pooled data from 7 RCTs (411 THAs) favored preoperative intravenous glucocorticoids against acute pain intensity at 4, 24, and 48 hours (P < .05). There was no significant difference between the VAS with rest or mobilization at 72 hours (P > .05). Subsequently, preoperative intravenous glucocorticoids provided a total morphine-sparing effect of 9.36 mg (WMD = −9.36, 95% CI = −12.33 to −6.38, P = .000). In addition, preoperative intravenous glucocorticoids were associated with a significant reduction of the occurrence of PONV (RR = 0.41, 95% CI = 0.30–0.57, P = .000).Conclusion:Intravenous glucocorticoids can decrease early pain intensity and PONV after THA. However, the low number of studies and variation in dosing regimens limits the evidence for its use. Thus, more high-quality RCTs are still needed to identify the optimal drug and the safety of intravenous glucocorticoids.

Nausea and vomiting are distressing symptoms which are experienced commonly during caesarean section under regional anaesthesia and can also occur in the period following the procedure. To assess the efficacy of pharmacological and non-pharmacological interventions given prophylactically to prevent nausea and vomiting in women undergoing regional anaesthesia for caesarean section. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (27 February 2012) and reference lists of identified studies. We included randomised controlled trials (RCTs) and excluded quasi-RCTs and cross-over studies. Review authors independently assessed the studies for inclusion, assessed risk of bias and carried out data extraction. Data entry was checked. Fifty-two studies met the inclusion criteria but only 41 studies, involving 5046 women, provided useable data for the review involving women having caesareans under regional anaesthesia. The majority of the studies involved women undergoing elective caesarean section. Only two studies included emergency surgery, however, they did not stratify data according to type of surgery. The studies covered numerous comparisons, but the majority of studies involved 5-HT(3) receptor antagonists, dopamine receptor antagonists, corticosteroids or acupressure. Studies were mainly small and of unclear quality.Three classes of intervention were found to be effective in at least three out of four of our primary outcomes (intraoperative nausea, intraoperative vomiting, postoperative nausea and postoperative vomiting). These interventions were 5-HT(3) antagonists, dopamine antagonists and sedatives. Other classes of intervention were effective for fewer than three of our primary outcomes.With 5-HT antagonists, we found a reduction in intraoperative nausea (average risk ratio (RR) 0.64, 95% confidence interval (CI) 0.46 to 0.88, eight studies, 720 women). There were also reductions in postoperative nausea (average RR 0.40, 95% CI 0.25 to 0.64, four studies, 405 women) and vomiting (average RR 0.50, 95% CI 0.32 to 0.77, five studies, 565 women). We did not detect a significant reduction in intraoperative vomiting (average RR 0.56, 95% CI 0.31 to 1.00, seven studies, 668 women).Dopamine antagonists demonstrated a reduction in intraoperative nausea (average RR 0.38, 95% CI 0.25 to 0.57, nine studies, 636 women) and intraoperative vomiting (average 0.39, 95% CI 0.24 to 0.64, eight studies, 536 women), with similar reductions in postoperative nausea (average RR 0.60, 95% CI 0.40 to 0.91, five studies, 412 women) and vomiting (average RR 0.57, 95% CI 0.36 to 0.91, six studies, 472 women). These differences were observed with both metoclopramide and droperidol.Sedatives (most commonly propofol) demonstrated a reduction in intraoperative nausea (average RR 0.71, 95% CI 0.52 to 0.96, four studies, 285 women) and intraoperative vomiting (average RR 0.42, 95% CI 0.26 to 0.68, four studies, 285 women), also with a reduction in postoperative nausea (average RR 0.25, 95% CI 0.09 to 0.71, two studies 145 women) and vomiting (average RR 0.09, 95% CI 0.03 to 0.28, two studies, 145 women).Acupressure was found to be effective for intraoperative nausea (average RR 0.59, 95% CI 0.38 to 0.90, six studies, 649 women) but not postoperative nausea (average RR 0.83, 95% CI 0.68 to 1.00, three studies, 429 women). Acupressure was not effective at reducing vomiting either intraoperatively (average RR 0.74, 95% CI 0.46 to 1.18, six studies, 649 women) or postoperatively (average RR 0.69, 95% CI 0.45 to 1.06, three studies, 429 women).Other effective intervention classes included corticosteroids, antihistamines, and anticholinergics.There were insufficient data to demonstrate any class of intervention was superior to another. There were no significant differences observed in the comparison of combined versus single interventions.Few studies assessed our secondary outcomes or the incidence of adverse effects. However, one study showed an increase in respiratory depression with sedation (midazolam) compared with dopamine antagonists. This review indicates that many different interventions have efficacy in preventing nausea and vomiting in women undergoing regional anaesthesia for caesarean section. There is little evidence that combinations of treatment are better than single agents.

Background Postcholecystectomy syndrome (PCS) has become a common postoperative syndrome that requires systematic and comprehensive therapy to achieve adequate clinical control. Acupuncture and related therapies have shown clinical effects for PCS in many studies. However, systematic reviews/meta-analyses (SRs/MAs) for them are lacking. Objective To evaluate the efficacy and safety of acupuncture in the treatment of PCS using randomized controlled trials (RCTs). Methods Potentially eligible studies were searched in the following electronic databases up to 1 February 2020: PubMed, Embase, Cochrane Library, Web of Science (WoS), Chinese databases (Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), WanFang Database (WF), and China Science and Technology Journal Database (VIP)), and other sources (WHO ICTRP, ChiCTR, Clinical Trials, and Grey Literature Database). The RevMan 5.3 was employed for analyses. The Cochrane Collaboration' risk of bias tool was used to assess the risk of bias (ROB). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of the evidence. Results A total of 14 RCTs with 1593 participants were included in this SR. MA showed that acupuncture in combination with conventional medicine (CM) did not show statistical differences in reduction in pain. However, acupuncture in combination with CM significantly reduced the incidence of postoperative nausea and vomiting (PONV) (RR, 0.71; 95% CI, 0.55–0.92) and improved gastrointestinal function recovery compared to the CM group. Acupuncture combined with traditional Chinese medicine and CM, and acupuncture as monotherapy may improve gastrointestinal function recovery with acceptable adverse events. Conclusion Acupuncture may be an effective and safe treatment for PCS. However, this study lacks conclusive evidence due to poor quality evidence, limited data, and clinical heterogeneity of acupuncture methods in the included studies.