P-075 - (Poster #75) The opioid-sparing effect of acupuncture after abdominal surgery: a systematic review and meta-Analysis of randomized controlled trials

Background: Opioids remain a cornerstone for postoperative analgesia, yet their use after abdominal surgery carries significant risks, including adverse effects and chronic dependence. Acupuncture has increasingly been explored as a non-pharmacological adjunct to reduce postoperative opioid use. 
 

 

Purpose/Objectives: This systematic review and meta-analysis assessed acupuncture’s effectiveness and safety in minimizing postoperative opioid consumption specifically after abdominal surgery
 

 


Methods: We systematically searched eleven electronic databases to identify randomized controlled trials (RCTs) comparing acupuncture with sham acupuncture or no-acupuncture (standard care) in adults undergoing abdominal surgery. The primary outcome was cumulative postoperative opioid consumption at 8, 24, and 72 hours post-surgery, standardized into intravenous morphine milligram equivalents (MME). Secondary outcomes included postoperative pain intensity, opioid-related adverse effects, and acupuncture-associated adverse events. Random-effects models synthesized data, and subgroup and sensitivity analyses addressed heterogeneity. Evidence quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
 

 


Results: Twenty-five RCTs involving 2,154 patients were included. Acupuncture significantly reduced cumulative opioid consumption at 24 hours compared to sham acupuncture (mean difference [MD] -6.60 mg; 95% CI -7.92 to -5.28; high certainty) and no-acupuncture controls (MD -7.93 mg; 95% CI -11.61 to -4.25; low certainty). Significant opioid-sparing effects were also noted at 8 hours for both sham and no-acupuncture controls (moderate and low certainty, respectively). At 72 hours, acupuncture showed a significant reduction only compared to no-acupuncture controls (low certainty). In subgroup analysis, preoperative acupuncture provided the most substantial opioid reduction, followed by perioperative and postoperative applications. Electrically stimulated acupuncture (electroacupuncture and TEAS) demonstrated slightly greater opioid-sparing efficacy compared to manual acupuncture. Overall, acupuncture exhibited a favorable safety profile with minimal adverse events. Secondary analyses revealed acupuncture significantly decreased postoperative pain intensity at 24 hours compared to sham (MD -9.57 mm; 95% CI -14.82 to -4.32) and no-acupuncture controls (MD -11.00 mm; 95% CI -14.59 to -7.42). Additionally, acupuncture reduced opioid-related side effects such as nausea, vomiting, and dizziness, although the impact on pruritus was inconsistent.
 

 

Conclusions/Implications for future research and/or clinical care: Acupuncture effectively reduces cumulative postoperative opioid consumption, particularly within 24 hours after abdominal surgery, with evidence certainty ranging from very low to moderate. Its integration into multimodal analgesic protocols can enhance postoperative recovery and mitigate opioid-related risks. Further high-quality research is needed to optimize acupuncture timing and stimulation parameters.