A total of 15 RCTs were included in this review (n=1,166, of which 668 received acupuncture or related interventions). All trials used standardised anaesthetic and post-operative analgesia regimes. Ten trials were suitable for meta-analysis; the remaining five were excluded from numerical analyses due to unsuitable data presentation.
Three trials (n=195) reported significantly lower pain scores at eight hours post-operative assessment in the active acupuncture group, WMD= -14.57 mm (95% CI: -23.02, -6.13; p=0.00001). The trend continued in the eight trials (n=529) that reported post-operative pain at 24hrs, but was not statistically significant (although significant heterogeneity was present, I2=76.8%, in this group of studies). Three trials (n=139) reported significantly less pain at 72 hours in the acupuncture group, WMD= -9.75 (95% CI: -13.82, -5.68; p=0.00001).
Post operative opioid consumption:
Opioid consumption was significantly lower in the active acupuncture groups at all time points and the morphine-sparing effect was significantly higher. Three trials (n=195) reported a WMD = -3.14 mg at 8 hrs (95% CI: -5.15, -1.14; p=0.002), eight trials (n=574) reported a WMD = -8.33 mg at 24 hrs (95% CI: -11.06, -5.61; p=0.00001), and three trials (n=139) reported a WMD = -9.14 mg at 72 hrs (95% CI: -16.07, -2.22; p=0.010). Again, significant heterogeneity was present in the eight trials reporting 24 hour data (I2=49.5%). The morphine sparing effect was 21 per cent at eight hours, 23 per cent at 24 hours and 29 per cent at 72 hours post-operatively.
Opioid related side effects:
Nausea, pruritis, dizziness, incidence of sedation and urinary retention occurred significantly less often in the active treatment group. Vomiting occurred less often in the active group, but the difference was not statistically significant.
No significant difference in length of recovery room stay was noted between treatment groups. There were no significant differences in the numbers of side effects reported; all side effects resolved spontaneously. Subgroup and sensitivity analyses were performed, but did not substantially change the original results.