Efficacy of Different Nonpharmacological Interventions as Adjunctive Treatments for Postoperative Nausea and Vomiting: A Systematic Review and Bayesian Network Meta-analysis.

If you have ever felt sick to your stomach after waking up from surgery, you are not alone. Postoperative nausea and vomiting, known as PONV, is one of the most common and uncomfortable side effects of surgery and anesthesia. Researchers wanted to find out whether natural, drug-free approaches could help reduce these symptoms when used alongside standard anti-nausea medications.

A large research team reviewed 54 high-quality studies involving more than 8,000 patients who had various non-gastrointestinal surgeries. They looked at nine different non-drug approaches, including acupuncture, ginger, and carbohydrate loading (drinking a special carbohydrate-rich drink before surgery). Their goal was to compare how well each method worked for different aspects of PONV.

Here is what they found. Drinking a carbohydrate-rich beverage before surgery was the top-ranked approach for actually preventing nausea and vomiting from happening in the first place. Ginger was most effective at reducing how severe nausea felt when measured on a discomfort scale. Acupuncture stood out as the most effective intervention for reducing the need for rescue anti-nausea medications after surgery, meaning patients who received acupuncture were less likely to need additional drugs to control their symptoms.

This is encouraging news for anyone looking for gentle, complementary options to support their surgical recovery. Acupuncture, a practice with thousands of years of history, may offer real, measurable benefits in a modern hospital setting. The researchers did note that the overall quality of evidence is still considered low, and more large, well-designed studies are needed before doctors can make firm recommendations.

If you are planning surgery and are curious about acupuncture as a supportive therapy, speak with your surgical team and seek care from a licensed, qualified acupuncture practitioner experienced in perioperative support.

This systematic review and Bayesian network meta-analysis evaluated nine nonpharmacological adjunctive interventions for postoperative nausea and vomiting (PONV) across 54 RCTs involving 8,275 participants undergoing non-gastrointestinal surgery. Pairwise and network meta-analyses were conducted with transitivity, consistency, and sensitivity analyses; evidence quality was assessed via the GRADE framework. Key findings by outcome: preoperative carbohydrate loading ranked highest for reducing PONV incidence (SUCRA 35%); acupuncture ranked highest for reducing rescue antiemetic usage (SUCRA 59%); and ginger ranked highest for reducing PONV severity on VAS (SUCRA 29%). Transitivity and sensitivity analyses supported result robustness. However, GRADE ratings were predominantly low to very low certainty due to risk of bias, indirectness, and imprecision. Clinically, acupuncture demonstrates the strongest ranking signal for minimizing postoperative rescue antiemetic requirements, supporting its consideration as a perioperative adjunct. Larger, methodologically rigorous RCTs are warranted to solidify clinical recommendations.