Table 1 Summary of the findings of the clinical trials included in the meta-analysis
Study | Age | Country | Sample size (female) | ASA | Type of Surgery | Anesthesia methods | Type of acupuncture | Paramenters for stimulation | Acupoints | Comparator | Timing of acupuncture | Type of PCC | Time of PCC | Assessment tool | Primary outcome | Other outcomes |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Acar et al. (2012) | 2-10yrs | Turkey | 50(25) | I-II | Adenoidectomy and/ or tonsillectomy | Sevo | capsicum plasters | NA | bilateral HT7 | inactive plasters | 30 min before anesthesia induction | agitation | 15 min after surgery | PAED scale | Incidence of agitation | Pain |
Gao et al. (2012) | > 65yrs | China | 120(68) | I-III | Non-cardiac surgery | Sevo | TEAS + electroacupuncture | 2/100 Hz | Hegu, Neiguan, Zusanli, Baihui | no acupuncture | 30 min before anesthesia induction to end of surgery | POCD | 2,4,6 d after surgery | MMSE | Incidence of POCD | PONV, MMSE scores |
Lin et al. (2013) | ≥ 65yrs | China | 124 (42) | II-III | Gastrointestinal surgery | Propofol | TEAS | 2/100 Hz | Baihui, Yintang, Neiguan | no acupuncture | 30 min before induction to end of surgery | POCD | 3d post-op | MMSE | Incidence of POCD | S100β |
Lin et al. (2014) | ≥ 65yrs | China | 83(29) | I-II | Gastrointestinal surgery | Propofol | electroacupuncture | 2/100HZ | Neiguan, Zusanli, Baihui | no acupuncture | 30 min before anesthesia induction to end of surgery | POCD | 3d after surgery | MMSE | Incidence of POCD | Time to awake, Remifentanil consumption,TNF-A, IL-1B, IL-6 |
Hijikata et al. (2016) | 18-96 months | Japan | 120(37) | I-II | Minor surgery | Sevo | TEAS | 1 Hz | HT7 | Sham (electrode without stimulation) | during surgery | emergence agitation | during PACU | PAED, Aono's scale | Incidence of agitation | Time to tracheal extubation, PACU stay duration and postoperative pain scores |
Yuan et al. (2016) | 29-72yrs | China | 122(ND) | I-III | Intervention neurosurgery | Propofol | TEAS | 1.5 Hz | Baihui, Yintang, Neiguan | no acupuncture | before anesthesia induction | POCD | post-op 7ds,30ds | MMSE | Incidence of POCD | NSE 、S-100β、IL-1β、IL-6 TNF-α |
Zhang et al. (2017) | > 65yrs | China | 90(42) | I-II | Spine surgery | Propofol | electroacupuncture | 2/15 Hz | Baihui, Dazhui, Zusanli | no acupuncture | 30 min before induction to end of surgery | POCD | post-op 3ds | MMSE | Incidence of POCD | Interleukin (IL)-6, IL-10, and S100b level; remifentanil, propofol consumption |
Gao et al. (2018) | > 65yrs | China | 64(31) | I-II | Spine surgery | Propofol | TEAS | 2/100 Hz | Hegu, Neiguan | Sham (electrode without stimulation) | 30 min before induction to end of surgery | POD | post-op 3ds | RASS,CAM | Incidence of POCD | TNF-α, IL-6, matrix MMP-9, and S100β level; remifentanil, propofol consumption |
Nakamura et al. (2018) | 18-96 months | Japan | 100(26) | I-II | Inguinal hernia repair or orchiopexy | Sevo | TEAS | 1 Hz | HT7 | Sham (electrode without stimulation) | during surgery | emergence delirium | In PACU | PAED, Aono's scale | Incidence of agitation | The severity of EA, PACU stay duration, and postoperative pain |
Zhao et al. (2018) | 65-75yrs | China | 60(34) | Not descripted | Knee replacement | Propofol | electroacupuncture | 2/100 Hz | Tou Sanshen, Baihui, Hegu, Taichong | placebo needle | 5 days before sugery, once daily | POCD | post-op 1d, 7d | MMSE | MMSE score | TNF-α, IL-6, and S100β |
Martin et al. (2020) | 1-6yrs | USA | 99(38) | I-III | Myringotomy tube placement | Sevo | acupuncture | NA | HT7, ear Shenmen | no acupuncture | during surgery | emergence delirium | in PACU | PAED | Highest PaeD score | Post-discharge agitation and sleep quality |
Liu et al. (2021) | ≥ 65yrs | China | 100(49) | I-II | Radical colon rectomy | Propofol | TEAS | 2/100 Hz | Hegu, Neiguan, Zusanli | Sham (electrode without stimulation) | 30 min before induction to end of surgery | POCD | 1d,3d post-op | MMSE | Incidence of POCD | IL-6, hs-CRP and CGRP Levels |