*5.5.2 Current quality of evidence*

A growing number of studies have demonstrated the effectiveness of acupuncture in preventing and treating postoperative nausea and vomiting [26]. Fu et al.

reviewed 50 RCTs published from 1997 to 2020 with 5980 patients. Both single therapy-electroacupuncture, acupressure, transcutaneous electrical nerve stimulation (TENS), acupoint plaster, acupoint injection, and 5-hydroxytryptamine (5HTRA) receptor antagonists- and combination therapy (TENS + 5HTRA, acupressure + 5HTRA) had a better clinical effectiveness rate than placebo. However, the quality of evidence for acupuncture therapy in preventing PONV is moderate, low, and very low. None of the acupuncture therapy was regarded as high-quality evidence [25]. The results indicated that acupuncture was effective in reducing postoperative vomiting, both during the first 4 h (low quality) and within 24 h postoperatively (low quality); acupuncture was effective in reducing the first 4-h (moderate quality) and 0–24-h postoperative vomiting (moderate quality) when performed before and during anesthesia, respectively. Acupuncture was also effective in treating 0–24-h postoperative nausea (moderate quality) and in reducing the utilization of remedies during the first 4 h (moderate quality).
