Wrist-Ankle Acupuncture on Postoperative Nausea and Vomiting Prophylaxis in High-Risk Female Patients: A Pragmatic, Randomized, Single-Blind, Sham-Controlled Trial

BACKGROUND: Postoperative nausea and vomiting (PONV) affects up to 80% of high-risk patients, compromising Enhanced Recovery After Surgery (ERAS) outcomes and prolonging hospitalization. This randomized controlled trial evaluated wrist-ankle acupuncture (WAA) efficacy for PONV prevention in high-risk female surgical patients. METHODS: This single-center, randomized, patient- and assessor-blinded, sham-controlled trial enrolled female patients (aged 18-60 years, ASA I-II) scheduled for elective surgery under general anesthesia with documented motion sickness or previous PONV. Participants received either WAA (sterile needles at four standardized acupoints, 30-minute retention) or sham acupuncture postoperatively. The primary outcome was 24-h PONV incidence using the Rhodes Index of Nausea, Vomiting, and Retching (R-INVR). RESULTS: = 0.299). No adverse events occurred. CONCLUSIONS: WAA significantly reduced PONV incidence and severity with sustained effects and improved satisfaction, offering a promising non-pharmacological prevention strategy.