Skip to main content


Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Table 1 Study characteristics of all randomized, controlled trials included in the analysis

From: Distal acupoint stimulation versus peri-incisional stimulation for postoperative pain in open abdominal surgery: a systematic review and implications for clinical practice

Study ID anesthesia type Surgery type Number of patients (A/C) Stimulation style Points used in the real acupuncture treatment Sham/control Duration time select
Peri-incisional stimulation
 Binder et al. (2011) [23] EDA cesarean section 22/20 Hi-TENS Incision: 2–3 cm distance from the wound Non treatment 24 h*1 day Post-surgery:immediately after surgery, at least 24 h/one day
 Bjersa and Andersson(2014) [50] GA pancreas resection 9/11 High frequency TENS Incision:cranial of the incision, sacral of the incision, and columna innervating the dermatome for Th5 to Th9 ‘increase stimulation until first sensitivity occurs and keep the stimulation as low as possible At least 30 min, as much as possible Post-surgery:two to four hours prior to epidural anlgesia ended
 Smith et al. (1986) [30] GA caesarean section 9/9 TENS Incision:the incision site No electrical current was applied 3 days, with the stimulator being turned off only occasionally, for short intervals (less than 15 min), Post-surgery:As soon as the patient’s admission to the recovery room
 Rakel et al. (2003) [31] GA abdominal surgery 32/32 TENS Incision:parallel to the incision, No stimulation No reported Post-surgery: After surgery,details
 Hamza et al. (1999) [32] GA gynecologic surgery 25/25 TENS Incision:surgical incision No electrical current was applied 30 min, every 2 h Post-surgery::in the postanesthesia care unit for 30 min at intervals of 2 h or longer
 Jaafarpour et al. (2008) [25] SA ceserean section 54/54 TENS Incision: paraspinus muscles at T10-L1, and S2–4. 5 cm above and below the surgical incision, Non-acu continuously used for first 24 h except temporary breaks for walking, Post-surgery: After surgery
 Galloway et al. (1984) [36] GA Cholecystectomy with or without choledochotomy 14/14 tes Incision:details Nonsegmental TES Not reported Post-surgery: In the recovery room
 Kayman-Kose et al. (2014) [24] GA cesarean section 50/50 TENS Incision:above and below the incision line in women no electrical current was transmitted in the placebo group Not reported Post-surgery: 30 min after childbirth was completed.
 Gary et al. (1993) [33] GA gynecological operations. 17/13 TENS Incision:2 cm away from and parallel to the incision No current applied 24 h, and 20 min on days 2 and 3 Post-surgery: first 24 h after the operation.
 Hershman et al. (1989) [37] GA cholecystectomy or colorectal surgery 23/22 TENS Incision: Non-functioning batteries Not reported Post-surgery: until the end of the second post-operative day,
 Lim et al. (1983) [51] GA upper abdominal surgery 15/15 TENS Incision:1 cm away from the incision Reversed batteries Not reported Post-surgery: After surgery, the stimulator was turned on in the recovery room
 Sodipo et al. (1980) [52] GA upper abdominal surgery 15/15 TENS Incision:2 cm away from the incision Non-acu Not reported Post-surgery: post operation, details
 Conn et al.(1986) [39] GA Appendectomy 15/13 TENS Incision:either side of the wound The machine was switched off Not reported Post-surgery: At the end of the procedure
 Hargreaves et al. (1989) [53] Not mentioned abdominal surgery 25/25 TENS Incision: NR No stimulation Maybe 2 days Post-surgery:depended on both time of return from surgery and time of dressing change.
 Dougal T et al. (1991) [38] GA Cholestectomy 15/15 TENS Incision:each side of incision Non-acu Not reported Post-surgery: in recovery room
 CUSCHIERI et al. (1985) [54] GA abdominal surgery 53/53 TENS Incision:bilaterly in the paravertebral area;electroacupuncture: The batteries are reversed 30 min Post-surgery: In the recovery room
 Bjersa et al. (2015) [43] EDA COLON SURGERY 15/13 TENS Incision:bilaterally of the incision,and columna innervating Th10 to L1 “increase stimulation until first sensitivity occurs and keep the stimulation as low as possible” no time limitations Post-surgery: 1 h prior to EDA termination
Distal acupoint stimulation
 Hui et al. (2002) [20] EDA caesarean section 20/20 EA Distal:Zusanli, Sanyinjiao Non-acu 30 min Combined: pre-operation and 4 h or 8 h after surgery
 Baoguo et al. (1997) [44] GA lower abdominal surgery 25/25 EA Distal:hegu No electrical current was applied 30 min, every 2 h Post-surgery::After surgery,details
 He et al. (2007) [41] GA radical operation of intestinal cancer 30/30 EA Distal:scalp Non-acu until the end of surgery Pre-surgery: 20 min before surgery
 Chen et al. (1998) [27] GA hysterectomy or myomectomy 25/25 EA Distal:Zusanli Nonacupoint and no-current every 2–3 h Post-surgery:On arrival in the PACU,
 Lin et al.(2002) [45] GA lower abdominal surgery 25/25 EA Distal:Zusanli, with the indicator light on but with no actual current 20 min Pre-surgery: 20 min prior to anesthesia.
 Feng et al.(2013) [28] EDA Gynecological surgery 20/20 EA Distal:Zusanli, Sanyinjiao Non-acu Not reported Pre-surgery:details
 Feng et al.(2010) [29] EDA Gynecological surgery 20/20 EA Distal:Zusanli, Sanyinjiao Non-acu Not reported Pre-surgery: Before surgery
 Adib-Hajbaghery et al. (2013) [40] GA appendectomy 35/35 Acupressure Distal:Le7 the button placed right in opposite side of the Le7 point (as sham point) 1 h Post-surgery: After surgery, started after the full patient’s consciousness
 Kim et al.(2006) [35] GA Abdominal hysterectomy 30/30 Capsicum Plaster Distal:Zusanli inactive tape (5 _ 5 mm2) without PAS was applied to the Zusanli point of both legs. 8 h per day/3 days Combined: before induction of anesthesia
 Hsiung et al.(2015) [42] GA subtotal gastrectomy 26/28 Acupressure Distal:Neiguan (P6) and Zusanli (ST36) Non-acu Three12-min Post-surgery:consecutive days following surgery.
 Ntritsou et al. (2014) [46] GA radical prostatectomy 35/35 EA Distal:LI4,ST36 No current was applied 30 min Post-surgery: when the closure of the abdominal walls was initiated
 Lee et al.(2011) [47] GA hysterectomy 13/12 EA Distal:Zusanli (ST36) no stimulation 30 min combined: before general anesthesia, and initiated once regained consciousness
 Kotani et al.(2001) [48] GA elective upper and lower abdominal surgery 50/48 Acupuncture Distal:BL18 –BL24 or BL20 –BL26 a needle was positioned at each acupoint 4 days Combined: Before induction of anesthesia,
 Wu et al. (2009) SA cesarean section 20/20 EA Distal:Sanyinjiao(Sp6) Non-acu 30 min Post-surgery: In the recovery room
 Li et al. (2012) [22] CESA cesarean section 60/60 EA Distal:auricular Shenmen point(TF4) No current applied 30 min Combined: before surgery and 3 h, 8 h after surgery
 Masatomo et al. (2003) [49] GA abdominal surgery. 23/30 Acupressure Distal:neiguan, Zusanli, Sanyinjiao, and Gongsunpoints Non-acu Not Post-surgery: On completion of surgery
 Tsang et al.(2011) [34] GA total abdominal hysterectomy 16/16 auricular acupuncture Distal: “uterus”“abdomen”“sympathetic” “shenmen” and“subcortex” The sham TENS group received auricular TENS delivered to the following five inappropriate points: “teeth,” “tongue,” “mandible,” “eye,” and “face” 20 min Post-surgery: after surgery,
Combined distal and peri-incisional stimulation
 Sim et al. (2002) [26] GA gynaecologic lower abdominal surgery 30/30 EA Distal:ST36 and PC6 bilaterally and subcutaneously along the skin incision. No electrical current was applied. 45 min Post-surgery:group1\2:45 min before induction of anesthesia (GA)Group 3–45 min of postoperative
  1. CESA combined epidural and spinal anesthesia, EA electroacupuncture, EDA epidural anesthesia, GA general anesthesia, NR not reported, SA spinal anesthesia, TENS Transcutaneous Electrical Nerve Stimulation