BACKGROUND: Acupuncture therapy for preventive and treatment of postoperative nausea and vomiting (PONV), a condition which commonly present after anaesthesia and surgery is a subject of growing interest. OBJECTIVE: This paper included a systematic review and meta-analysis on the effect of different type of acupuncture and acupoint selection in PONV prevention and treatment. METHODS: Randomised controlled trials (RCTs) comparing acupuncture with non-acupuncture treatment were identified from databases PubMed, Cochrane, EBSCO, Ovid, CNKI and Wanfang Data. Meta-analysis on eligible studies was performed using fixed-effects model with RevMan 5.2. Results were expressed as RR for dichotomous data, with 95%CI. RESULTS: Thirty RCTs, 1,276 patients (intervention) and 1,258 patients (control) were identified. Meta-analysis showed that PC6 acupuncture significantly reduced the number of cases of early vomiting (postoperative 0 to 6 h) (RR 0.36, 95%CI 0.19 to 0.71; p = 0.003) and nausea (postoperative 0 to 24 h) (RR 0.25, 95%CI 0.10 to 0.61; p = 0.002), but not early nausea (postoperative 0 to 6 h) (RR 0.64, 95%CI 0.34 to 1.19; p = 0.150) and vomiting (postoperative 0 to 24 h) (RR 0.82, 95%CI 0.48 to 1.38; p = 0.450). PC6 acupressure significantly reduced the number of cases of nausea (RR 0.71, 95%CI 0.57 to 0.87; p = 0.001) and vomiting (RR 0.62, 95%CI 0.49 to 0.80; p = 0.000) at postoperative 0 to 24 h. PC6 electro-acupoint stimulation significantly reduced the number of cases of nausea (RR 0.49, 95%CI 0.38 to 0.63; p < 0.000) and vomiting (RR 0.50, 95%CI 0.36 to 0.70; p < 0.000) at postoperative 0 to 24 h. Stimulation of PC6 with other acupoint(s) significantly reduced the number of cases of nausea and vomiting (RR 0.29, 95%CI 0.17 to 0.49; p < 0.000) at postoperative 0 to 24 h. Stimulation of other acupoint(s) (non PC6) also significantly reduced the number of cases of nausea and vomiting (RR 0.63, 95%CI 0.49 to 0.81; p = 0.000) at postoperative 0 to 24 h. However, the quality of study was generally low in studies of PC6 combined with other acupoint(s) and other acupoint(s). Details of blinding were not reported in most reports. CONCLUSIONS: Besides PC6, PC6 combined with other acupoint(s) and other alternative acupoint(s) might be beneficial in prevention and treatment of PONV, the evidence justifies future high-quality studies.

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