*5.6.2 Current quality of evidence*

Yin et al. [27] found that acupuncture in combination with conventional treatment showed no statistical difference in pain reduction in Postcholecystectomy syndrome. The quality of the evidence for the overall outcomes was acceptable. The results showed that there was 7.7% of outcomes with very low-quality evidence, 46.15% with low-quality evidence, 46.15% with moderate-quality evidence, and none with high-quality evidence. However, it is difficult for therapists and patients to use blinding for acupuncture [27]. Qin et al. (2020) assessed the effectiveness of acupuncture and related techniques for postoperative pain after hemorrhoidectomy. They found that auricular acupressure plus acupuncture, acupuncture, other acupuncture techniques, and auricular acupressure were significantly superior over usual care, and auricular acupressure plus acupuncture ranked the most effective when analyzed for pain intensity, but the findings were limited by the quality of the evidence. Park et al. [29] assessed the quality of evidence in RCTs comparing pain scores between the EA and the sham groups, finding low cumulative evidence certainty across all studies. A low rating was given because there was inconsistency and a high risk of bias across all studies. However, according to data synthesized from previous studies, EA demonstrated the possibility of reducing pain for patients after thoracotomy with lower amounts of opioid analgesics [29].
