Background: Enhanced recovery pathways can be further improved for postoperative sore throat (POST) that occurs after surgery under general anesthesia. Medications have shown some effectiveness in preventing POST, but acupuncture or related techniques with better safety and lower cost can be used as an alternative or adjuvant therapy to treat perioperative symptoms by stimulating acupuncture point (acupoint). Therefore, we aimed to conduct a meta-analysis to assess whether acupoint stimulation helps patients prevent POST in adults undergoing tracheal intubation for general anesthesia.Methods: Publications in PubMed, the Cochrane Central Register, ScienceDirect, and ClinicalTrial.gov were surveyed from January 2000 through August 2020. Studies that compared interventions between true acupoint stimulation and no or sham acupoint stimulation were included. The primary outcomes were the incidence and severity of POST at 24h.Results: Four randomized control trials and 1 comparative study involving 1478 participants were included. Compared with the no or sham acupoint stimulation, the true acupoint stimulation was associated with a reduced incidence (risk ratio, 0.32; 95% confidence interval (CI), 0.18-0.55; P < .001) and decreased severity (standardized mean difference, −2.79; 95% CI, −4.59 to − 0.99; P = .002) of POST. There were no significant adverse events related to acupoint stimulation. The finding for POST was assured by subgroup, sensitivity, and trial sequential analyses.Conclusions: Acupoint stimulation may reduce the occurrence of POST. It can be considered as one of nonpharmacological methods to prevent POST in enhanced recovery pathways. Further rigorous studies are needed to determine the effectiveness of acupoint stimulation.

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 to 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.