Efficacy of Acupuncture Assisted Anesthesia in Laparoscopic Cholecystectomy: A Systematic Review and Meta-Analysis

Hengfeng Lv,1,* Jiayuan Xu,2,* Zhiyuan Bian,1 Yongyuan Lu,1 Xingzhen Li,1 Yurong Jiang,1 Jianqiao Fang,1 Yingjun Liu1 1The Third School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Nursing, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yingjun Liu; Jianqiao Fang, The Third School of Clinical Medicine, Zhejiang Chinese Medical University, 548 Binwen Road, Hangzhou, Zhejiang, 310053, People’s Republic of China, Email [email protected]; [email protected]: Acupuncture assisted anesthesia (AAA) has received increasing attention in the procedure of laparoscopic cholecystectomy. Therefore, we conducted a systematic review and meta-analysis assessing the potential advantages and safety of AAA in patients undergoing laparoscopic cholecystectomy.Methods: Randomized controlled trials (RCTs) on AAA in the procedure of laparoscopic cholecystectomy from 8 online databases were retrieved. Review Manager 5.3 software was used to merge and statistically analyze the extracted data, RoB 2.0 was used to assess the risk of bias, and GRADEprofiler was used to assess the quality of evidence.Results: Twenty-three RCTs were included, with a total of 2031 participants. The meta-analysis results indicated that compared with the control group, AAA reduced postoperative pain intensity (P < 0.05) and the incidence of postoperative nausea and vomiting (P < 0.05), and shortened the time to first flatus (P = 0.002). AAA also reduced postoperative IL-6 (P = 0.01) and TNF-alpha (P < 0.00001) levels compared with the control group. However, no significant difference on IL-10 level was found (P = 0.09) between AAA and control group. Furthermore, AAA also reduced the use of intraoperative anesthetics (P < 0.05) and postoperative analgesics (P < 0.00001) compared to the control group.Conclusion: This study demonstrates that AAA in the procedure of laparoscopic cholecystectomy has potential advantages on alleviating postoperative pain and gastrointestinal symptoms, reducing pro-inflammatory cytokines levels, and lowering the dosage of intraoperative and postoperative analgesics. This highlights the potential benefits of applying AAA in laparoscopic cholecystectomy to alleviate patient suffering.Protocol and Registration: PROSPERO registration number: CRD42024549645.Keywords: anesthesia, acupuncture, analgesia, safety, systematic review, meta-analysis