Review Article

Efficacy of Acupuncture in Reducing Preoperative Anxiety: A Meta-Analysis

Table 1

Characteristics of included studies.

Author (year, location)Subject age (years)Number of participants (Acua/Shamb/Conc1/Con2)SurgeryType of designType of intervention (duration, side, and type of stimulation)Treated acupointsType of control groupOutcome measure reported (value)Adverse events reported ()

Wang et al. (2001, USA) [19]19–6691 (31/32/27)Elective ambulatory surgery (orthopedic, gynecologic, genitourinary, otolaryngologic, plastic, general ophthalmologic)RCTdAuricular acupressure needle (30 min, nondominant hand side)Relaxation
Tranquilizer
Mmaster cerebral
(1) Traditional Chinese medicine group
(2) Sham acupuncture
STAIe (.01)NRf

Wang et al. (2007, USA) [20]18–6556 (29/27)Elective lithotripsy procedureRCTAuricular acupressure needle (dominant, 30 min)
Bilateral body acupuncture with 2 Hz, 25 V electrical stimulation
Relaxation
valium, master cerebral, kLI4, lLV3
(1) Sham auricular acupressure, no electrical stimulation, superficial insertion in the same locationsSTAI (.029)PONVg-acu (4%) con (15%)
= .412

Wang et al. (2008, USA) [18]8–1752 (26/26)General anesthesia for GI endoscopy (upper endoscopy and colonoscopy)RCTAcupressure beads (30 min)Yin Tang(1) Sham acupressureSTAIC (.012)PONV-acu (5) con (8)

Paraskeva et al. (2004, Greece) [15]NR49 (25/24)Minor or moderate surgeryRCTAcupuncture (15 min)Yin Tang(1) Sham acupunctureVSSh (NS)NR

Gioia et al. (2006, Italy) [21]71.3 (mean age)75 (25/25/25)Cataract surgery under topical anesthesiaRCTBody acupuncture (20 min, dominant)
Auricular (manually rotated De Qi) acupuncture
LI4, LV3 mPC6, nHT7 oTE5
Shenmen
(1) Nontreatment
(2) Sham acupuncture
VASi (.037)NR

Cabrini et al. (2006, Italy) [22]18+48 (16/16/16)Elective diagnostic fiberoptic bronchoscopyRCTBilateral body acupuncture and auricular (20 min, manually rotated De Qi) acupuncture pLU7, PC6 LI4, HT7 Shenmen(1) Nontreatment
(2) Sham acupuncture
VAS (.002)None

Karst et al. (2007, German) [10]18–6567 (19/19/19/10)Dental extractionsRCTAcupuncture (nondominant, 25 min)Relaxation
Tranquilizer
Master cerebral
(1) Placebo auricular acupuncture
(2) Intranasal midazolam
(3) Nontreatment
STAI (<.001)
VAS (.012)
Nasal burning (7)
None in the other groups

Mora et al. (2007, German) [23]65–90100 (50/50)Transported by ambulance before receiving ESWLRCTBilateral auricular acupressure (NR, 1 mm plastic ball)Relaxation(1) Sham acupressureVAS (.001)NR

Michalek-Sauberer et al. (2012, Austria) [24]18+182 (61/60/61)Dental treatmentRCTAuricular acupuncture (20 min, dominant)Relaxation
Tranquilizer
Master cerebral
(1) Sham acupuncture
(2) Nontreatment
STAI (.008)Acupuncture (14), Sham (12)

Acar et al. (2013, Turkey) [14]18–6552 (26/26)General/regional anesthesiaRCTAuricular acupuncture (20 min, ear-press needle)Yin Tang(1) Sham acupressureSTAI (<.05)NR

Kober et al. (2003, Austria) [25]23–8936 (17/19)Transported by ambulance for gastrointestinal illnessRCTBilateral auricular acupressure (NR)Relaxation(1) Sham acupressureVAS (.002)NR

Agarwal et al. (2005, India) [8]18–5076 (36/36)Elective surgical procedureRCTAcupressure (10 min, 20–25 cyc/min manually rotated)Yin Tang(1) Sham acupressureVSS (<.001)NR

Borimnejad et al. (2012, China) [16]9–1280 (40/40)Elective surgeryRCTAcupressure (30 min, 1.3 psi acupressure bead)Yin Tang(1) Sham acupressureSTAIC (NSj)NR

Valiee et al. (2012, Iran) [17]44.04 ± 11.25 (mean age)70 (35/35)Abdominal surgery (cholecystectomy, hysterectomy, herniorrhaphy, laparoscopy)RCTAcupressure (10 min, nondominant, 20–25 cyc/min, acupressure bead)
Auricular acupressure
Shenmen
Yin Tang
(1) Sham acupressureVAS (<.001)NR

aAcu: acupuncture; bSham: sham acupuncture; cCon: control group; dRCT: randomized controlled trials; eSTAI: the State-Trait Anxiety Inventory; fNR: not reported; gPONV: postoperative nausea and vomiting; hVSS: verbal-scale score; iVAS: visual analogue scale; jNS: not significant; kLI: large intestine; lLV: liver; mPC: pericardium; nHT: heart; oTE: triple energizer; pLU: lung.