Wrist acupuncture effective for prevention of postoperative nausea and vomiting

Clinical question: 
How effective is P6 acupoint stimulation of the wrist in preventing postoperative nausea and vomiting (PONV)?
Bottom line: 
Compared with sham treatment, P6 acupoint stimulation significantly reduced nausea (NNT* 4), vomiting (NNT 4) and the need for rescue antiemetics. There was no clear difference in the effectiveness of P6 acupoint stimulation for adults and children; or for invasive and noninvasive acupoint stimulation. There was no evidence of difference between P6 acupoint stimulation and antiemetic drugs in the risk of nausea, vomiting, or the need for rescue antiemetics. *NNT = number needed to treat to benefit 1 individual.
Caveat: 
The quality of the included trials was variable. In 34 trials, the allocation concealment was unclear, and in 1 trial it was inadequate. Patients were not blinded in 1 study. There was no blinding of healthcare providers in 2 studies. The outcome assessor was not blinded in 2 studies. Twelve trials did not report all outcomes. There was 1 study with a low risk of bias. Of the 16 studies with a high risk of bias, 12 of these were due to selective reporting. The risk of bias in the remaining 23 studies was unclear.
Context: 
Postoperative nausea and vomiting (PONV) are two of the most common complications after anaesthesia and surgery. Drugs are only partially effective in preventing PONV and may cause adverse effects.
Review CD#: 
CD003281
PEARLS No: 
175
Date: 
July, 2009
Authored by: 
Brian R McAvoy