Effect of acupuncture on the prevention of nausea and vomiting after laparoscopic cholecystectomy: a randomized clinical trial

Laparoscopic gallbladder removal surgery, known as laparoscopic cholecystectomy, is one of the most frequently performed surgical procedures in Brazil and around the world. Although it is considered a safe and minimally invasive surgery, one of the most common and unpleasant complications affecting patients in the postoperative period is nausea and vomiting. These symptoms can cause great discomfort, prolong hospital stay, increase treatment costs, and, in some cases, lead to more serious clinical complications such as dehydration and changes in serum chemistry. Traditionally, the management of these symptoms is carried out exclusively with medications, which are not always fully effective and may have unwanted side effects.

As a result, there is growing interest in complementary therapies that can help control these symptoms.

This Brazilian study aimed to investigate whether auricular acupuncture, a specific Traditional Chinese Medicine technique that uses needles applied to specific points in the ear, could help prevent nausea and vomiting after laparoscopic gallbladder surgery. The research was conducted at the Oswaldo Cruz University Hospital in Pernambuco between December 2016 and September 2017. The study involved 68 adult women, between 18 and 70 years of age, who underwent uncomplicated gallbladder removal surgery. Participants were randomly divided into two groups: one received auricular acupuncture treatment in addition to standard medical care, and the other received only conventional medical care.

To ensure the reliability of the results, neither the patients, nor the surgeons, nor the anesthesiologists knew which group was receiving acupuncture. In the auricular acupuncture group, very fine sterile needles were inserted at five specific points of the ear before the start of anesthesia, remaining in place for 20 minutes. The points chosen were based on Traditional Chinese Medicine and on previous studies that showed efficacy in controlling nausea and vomiting.

The study results demonstrated that auricular acupuncture was effective in significantly reducing both the incidence and intensity of nausea and vomiting in the postoperative period. Specifically, 46% of patients in the control group experienced nausea, while only 27% of those who received auricular acupuncture had this symptom. With regard to vomiting, the difference was even more striking: 45% of patients in the control group vomited, compared with only 11% of those treated with acupuncture. The benefits were most evident in the second and sixth postoperative hours, periods that are critical for the development of these symptoms.

The intensity of nausea, measured using a visual scale that allows the patient to indicate the degree of discomfort, was also significantly lower in the group that received auricular acupuncture. Importantly, no complications or adverse effects related to the use of acupuncture were observed in any of the patients.

From a clinical standpoint, these results suggest that auricular acupuncture may be a valuable and safe tool for improving patient comfort after gallbladder surgery. For health care professionals, the study offers scientific evidence that integrating complementary therapies with conventional medical protocols can result in better outcomes for patients. The technique is relatively simple to apply, has low cost, requires specific but not overly complex training, and can easily be incorporated into surgical routines. For patients, it represents an additional non-pharmacological option that can significantly reduce postoperative discomfort without additional risk.

It is important to emphasize that auricular acupuncture proved effective as a complementary therapy — that is, it was used in conjunction with conventional medications, not as a complete substitute for standard treatment.

The study has some limitations that should be considered when interpreting the results. Because it was conducted at a single hospital, with a specific team of surgeons and anesthesiologists, the results may not be fully generalizable to other medical centers. Additionally, the research included only women at low risk for developing nausea and vomiting, excluding more complex cases or prolonged surgeries. The sample size, although adequate to demonstrate statistical differences, was relatively small, and the observation period was limited to the first six postoperative hours.

Future studies involving multiple medical centers, more diverse populations including men and more complex cases, longer observation periods, and larger samples could further strengthen the evidence on the effectiveness of auricular acupuncture. Despite these limitations, this research represents an important contribution to the Brazilian medical literature, offering rigorous scientific evidence on a safe and potentially effective complementary therapy for a common and clinically relevant problem in surgical practice.