Efficacy of Nei-Guan (P6) Acupoint stimulation in reducing postoperative nausea and vomiting

Background: Despite advancements in antiemetic therapies, postoperative nausea and vomiting (PONV) continues to be a common complication after surgery. Conventional pharmacologic treatments are often only partially effective and can be associated with adverse side effects. This has led to increased interest in nonpharmacological approaches such as P6 acupoint stimulation, a method rooted in traditional Chinese medicine. Methods: A literature review was conducted, focusing on studies that evaluated various forms of P6 acupoint stimulation for treating and/or preventing PONV, including acupressure, wristbands, and transcutaneous electrical stimulation. The common mechanism underlying the efficacy of these nonpharmacologic interventions involves using physical methods to alter levels of endorphins and serotonin, while restoring the qi flow. This article reviews the efficacy of various physical methods for P6 acupoint stimulation in reducing PONV. Results: Evidence from multiple studies in the peer-reviewed literature indicates that P6 acupoint stimulation can reduce the incidence of PONV with minimal adverse effects. While some clinical trials have reported outcomes comparable to those of traditional antiemetic drugs, inconsistencies in study design have led to controversy regarding its clinical effectiveness. Given the noninvasive and cost-effective nature of these simple physical techniques supports their usefulness, either alone or combined with conventional antiemetic therapies is supported. Conclusions: P6 acupoint stimulation is a complementary nonpharmacologic approach to the management of PONV which can offer benefits to patients at high risk of PONV. However, further sham (placebo) controlled studies are needed to establish its efficacy alone and in combination with traditional antiemetic drugs to determine its optimal role in clinical practice.