The effectiveness of acupuncture point stimulation for the prevention of post-operative sore throat: a meta-analysis

ABSTRACT Background Enhanced recovery pathways can be further improved for postoperative sore throat (POST) which usually occurs after surgery with general anesthesia. Medications have shown some effectiveness in treating and preventing POST, but acupuncture or related techniques with better safety and less cost likely can be used as an alternative or adjuvant therapy to treat perioperative symptoms by stimulating acupuncture point (acupoint). Therefore, we aim to conduct a meta-analysis to assess whether acupoint stimulation help patients prevent or treat POST in adults undergoing tracheal intubation for general anesthesia. Methods Publication in PubMed, the Cochrane Central Register, ScienceDirect, and ClinicalTrial.gov were surveyed from Jan. 2000 through Jan. 2020. Studies that compared intervention between point stimulation and none or sham point stimulation, were included. Primary outcomes were the incidence and severity of POST at 24h. Secondary outcomes were the incidence of postoperative nausea and vomiting, choking cough, and sputum. Results Three randomized control trials and one comparative study involving 1358 participants were included. Compared with control, acupoint stimulation was associated with a reduced incidence (risk ratio, 0.3; 95% confidence interval (CI), 0.2–0.45; p < 0.001) and severity (standardized mean difference, −2.21; 95% CI, −2.67 to −1.76; p < 0.001) of POST. Secondary outcomes are also in favor of acupoint stimulation. There were no significant adverse events related to acupoint stimulation. Subgroup, the sensitivity, and the trial sequence analyses confirmed that the finding for POST was adequate. Conclusions Acupoint stimulation with various methods may reduce the occurrence of POST. It could be considered as one of nonpharmacological ways to prevent POST in enhanced recovery pathways. Further rigorous studies are needed to determine the effectiveness of acupoint stimulation. Question Can acupoint stimulation prevent postoperative sore throat after tracheal intubation? Findings Acupoint stimulation by acupuncture or related techniques more significantly reduces the incidence and the severity of postoperative sore throat than non- /sham-treatment at 24 hours. Meaning Acupoint stimulation by acupuncture or related techniques could be an effective, nonpharmacological approach to prevent postoperative sore throat in enhanced recovery after tracheal intubation.