Summary of findings 2. Acupoint PC6 stimulation versus antiemetic drug for preventing postoperative nausea and vomiting.
| Acupoint PC6 stimulation versus antiemetic drug for preventing postoperative nausea and vomiting | ||||||
|
Patient or population: People at risk of postoperative nausea and vomiting
Settings: Surgery
Intervention: Acupoint PC6 stimulation Comparison: Antiemetic drug | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Antiemetic | Acupoint PC6 stimulation | |||||
| Nausea ‐ All antiemetics combined | Low | RR 0.91 (0.75 to 1.10) | 1332 (14 studies) | ⊕⊕⊕⊝ moderate1 | ||
| 200 per 1000 | 182 per 1000 (150 to 220) | |||||
| Moderate | ||||||
| 400 per 1000 | 364 per 1000 (300 to 440) | |||||
| High | ||||||
| 600 per 1000 | 546 per 1000 (450 to 660) | |||||
| Vomiting ‐ All antiemetics combined | Low | RR 0.93 (0.74 to 1.17) | 1708 (19 studies) | ⊕⊕⊕⊝ moderate2 | ||
| 200 per 1000 | 186 per 1000 (148 to 234) | |||||
| Moderate | ||||||
| 400 per 1000 | 372 per 1000 (296 to 468) | |||||
| High | ||||||
| 600 per 1000 | 558 per 1000 (444 to 702) | |||||
| Rescue antiemetic | 150 per 1000 | 130 per 1000 (97 to 174) | RR 0.87 (0.65 to 1.16) | 895 (9 studies) | ⊕⊕⊕⊝ moderate3 | |
| Adverse effects | See comment | See comment | Not estimable | 11 studies4 | Not applicable | See footnote4 |
| *The basis for the assumed risks for nausea and vomiting is from a consensus panel (Gan 2014) using Apfel's simplified risk score (Apfel 1999). The assumed risk for rescue antiemetic is the median antiemetic group risk across studies. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1Of the 14 trials, 5 had one or more high risk of bias domains (downgrade 1 point due to study limitations). 2Of the 19 trials, 10 had one or more high risk of bias domains (downgrade 1 point due to study limitations). 3Of the 9 trials, 3 had one or more high risk of bias domains (downgrade 1 point due to study limitations). 4Eight trials reported no side effects. Three trials reported adverse effects (e.g.. restlessness and pain with acupuncture; local tightness and discomfort with acupressure wristbands).