Sedative-sparing effect of acupuncture in gastrointestinal endoscopy: systematic review and meta-analysis

Yun Yang; Haiyang Ji; Yunqiong Lu; Jue Hong; Guang Yang; Xiehe Kong; Jie Liu; Xiaopeng Ma

doi:10.3389/fmed.2023.1189429

Sedative-sparing effect of acupuncture in gastrointestinal endoscopy: systematic review and meta-analysis

Front Med (Lausanne). 2023 Jun 16:10:1189429. doi: 10.3389/fmed.2023.1189429. eCollection 2023.

Authors

Yun Yang^#¹, Haiyang Ji^#¹, Yunqiong Lu^#¹, Jue Hong², Guang Yang², Xiehe Kong², Jie Liu², Xiaopeng Ma^{1

2}

Affiliations

¹ Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
² Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

^# Contributed equally.

Abstract

Objective: This study aimed to perform a systematic review and meta-analysis to identify the efficacy of acupuncture therapy (including manual acupuncture and electroacupuncture) performed before or during gastrointestinal endoscopy with propofol as the main sedative, compared with placebo, sham acupuncture, or no additional treatment other than the same sedation.

Methods: A systematic search was performed through PubMed, Embase, Web of Science, Cochrane Library, Chinese Biomedical Databases (CBM), Wanfang database, China National Knowledge Infrastructure (CNKI), SinoMed, and Chinese Scientific Journal Database (VIP) to collect randomized controlled trials published before 5 November 2022. Bias assessment of the included RCTs was performed according to Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). Stata16.0 software was used to perform statistical analysis, sensitivity analysis, and publication bias analysis. The primary outcome was sedative consumption, and the secondary outcomes included the incidence of adverse events and wake-up time.

Results: A total of 10 studies with 1331 participants were included. The results showed that sedative consumption [mean difference (MD) = -29.32, 95% CI (-36.13, -22.50), P < 0.001], wake-up time [MD = -3.87, 95% CI (-5.43, -2.31), P < 0.001] and the incidence of adverse events including hypotension, nausea and vomiting, and coughing (P < 0.05) were significantly lower in the intervention group than in the control group.

Conclusion: Acupuncture combined with sedation reduces sedative consumption and wake-up time compared with sedation alone in gastrointestinal endoscopy; this combined approach allows patients to regain consciousness more quickly after examination and lower the risk of adverse effects. However, with the limited quantity and quality of relevant clinical studies, caution must be applied until more high-quality clinical studies verify and refine the conclusions.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?, identifier: CRD42022370422.

Keywords: acupuncture; adverse event; colonoscopy; gastrointestinal endoscopy; gastroscopy; propofol; sedation; wake-up time.

Publication types

Systematic Review

Grants and funding

This work was supported by National Natural Science Foundation of China (Nos. 82104985 and 81674073), Natural Science Foundation of Shanghai (Nos. 20ZR1453000 and 23ZR1460000), and Outstanding Leader Plan of Shanghai (No. 060).