Systematic review and meta-analysis of the effect of transcutaneous electrical acupoint stimulation on gastrointestinal function after laparoscopic surgery.

Abstract

Postoperative gastrointestinal dysfunction (PGD) leading to nausea, vomiting, and abdominal distension are common complications after laparoscopic surgery for abdominal diseases. However, drugs cannot completely stop PGD. Over the years, transcutaneous electrical acupoint stimulation (TEAS) therapy has shown potential in preventing PGD, but there is no medical evidence that TEAS represents the best choice for the treatment of PGD. This network meta-analysis sought to evaluate the effectiveness of TEAS therapy in preventing PGD in patients after abdominal laparoscopic surgery. Articles (published from the establishment of the databases to July 2021) were retrieved from the following databases: PubMed/Medline, Cochrane Library, Web of Science, Embase, China Biomedical Literature Database (CBM), China Technical Journal VIP Database (CQVIP), China Knowledge Infrastructure (CNKI), and the Wanfang Database. The Cochrane risk of bias tool was used to evaluate the quality of the included studies, and a network meta-analysis was performed using RevMan 5.20. A total of 7 randomized controlled trials, comprising 440 TEAS-treated patients and 468 control patients, were included in the meta-analysis. The meta-analysis showed that there was no significant difference between the TEAS treatment group and the control group in relation to postoperative nausea and vomiting [relative risk (RR) =0.66; 95% confidence interval (CI): 0.37-1.21; P=0.18], postoperative abdominal distension (RR =0.53; 95% CI: 0.40-0.72; P<0.0001), the time of first postoperative fart (imply gastrointestinal motility) [mean difference (MD) =-7.31; 95% CI: -11.33 to -3.30; P=0.0004], and the time of first postoperative bowel movement (MD =-5.28; 95% CI: -7.23 to -3.33; P<0.0001); there were significant differences among these 3 indicators. We found that TEAS can promote postoperative fart and bowel movement, and has good clinical value in promoting postoperative gastrointestinal function recovery.