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Peer-reviewedCC BY 4.0Frontiers in Pharmacology

Transcutaneous electrical acupoint stimulation versus sham stimulation and dexamethasone versus amisulpride for preventing postoperative nausea and vomiting after laparoscopic gynecologic surgery: protocol for a randomized 2 × 2 factorial trial

  • Yu Li1
  • Jun Zhang2
  • Yu Xu3
  • Qin Liu1
  • Lijuan Yang2
  • Fuxiao Fang4
  • Youjia Yu5
  • Zhengjie Chen5
5 affiliations
  1. 1Department of Anesthesiology, Wenzhou Central Hospital
  2. 2Department of Anesthesiology, Deqing People’s Hospital
  3. 3Department of Anesthesiology, Suzhou Xiangcheng People’s Hospital
  4. 4Operating Room, Deqing People’s Hospital
  5. 5Department of Anesthesiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine
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Abstract

Background: Postoperative nausea and vomiting (PONV) remains a common complication after gynecologic laparoscopic surgery. Although multimodal prophylaxis is recommended, clinical practice still relies largely on pharmacologic interventions. Transcutaneous electrical acupoint stimulation (TEAS) at the P6 acupoint may have potential benefit for PONV prevention. However, its effectiveness when incorporated into pharmacologic prophylaxis, and whether its effect varies according to the antiemetic used, remain unclear. This trial aims to evaluate the effect of P6-TEAS on PONV prevention in patients receiving dexamethasone or amisulpride.

Methods: This multicenter, prospective, randomized, sham-controlled, 2 × 2 factorial trial will enroll 212 women undergoing gynecologic laparoscopic surgery under general anesthesia. Participants will be randomly assigned in a 1:1:1:1 ratio to receive one of four treatment combinations: TEAS plus dexamethasone, TEAS plus amisulpride, sham stimulation plus dexamethasone, or sham stimulation plus amisulpride. TEAS or sham stimulation will be delivered at the P6 acupoint in two 1-h sessions, before surgery and at 24 h after surgery. The primary outcome will be the incidence of PONV within 48 h after surgery. Secondary outcomes will include PONV-related symptoms and severity, use of rescue antiemetics, opioid consumption, pain scores, recovery milestones, patient satisfaction, QoR-15 scores, and length of hospital stay. Safety outcomes will include adverse events related to TEAS or study drugs and perioperative hemodynamic events requiring treatment.

Discussion: This trial will evaluate P6-TEAS versus sham stimulation as the primary comparison and provide exploratory estimates for the dexamethasone-versus-amisulpride comparison and the TEAS-by-drug interaction. The findings may inform integrated prevention strategies for PONV after gynecologic laparoscopic surgery.

Clinical Trial Registration: https://clinicaltrials.gov/study/NCT07631910 , identifier NCT07631910.

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Cite

BibTeXRIS
BibTeX
@article{li2026transcutaneous,
  title = {{Transcutaneous electrical acupoint stimulation versus sham stimulation and dexamethasone versus amisulpride for preventing postoperative nausea and vomiting after laparoscopic gynecologic surgery: protocol for a randomized 2 × 2 factorial trial}},
  author = {Yu Li and Jun Zhang and Yu Xu and Qin Liu and Lijuan Yang and Fuxiao Fang and Youjia Yu and Zhengjie Chen},
  journal = {Frontiers in Pharmacology},
  year = {2026},
  month = oct,
  doi = {10.3389/fphar.2026.1934841},
  url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1934841/full},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Transcutaneous electrical acupoint stimulation versus sham stimulation and dexamethasone versus amisulpride for preventing postoperative nausea and vomiting after laparoscopic gynecologic surgery: protocol for a randomized 2 × 2 factorial trial
AU  - Yu Li
AU  - Jun Zhang
AU  - Yu Xu
AU  - Qin Liu
AU  - Lijuan Yang
AU  - Fuxiao Fang
AU  - Youjia Yu
AU  - Zhengjie Chen
PY  - 2026
DA  - 2026/10/29
JO  - Frontiers in Pharmacology
DO  - 10.3389/fphar.2026.1934841
UR  - https://www.frontiersin.org/articles/10.3389/fphar.2026.1934841/full
AB  - Background: Postoperative nausea and vomiting (PONV) remains a common complication after gynecologic laparoscopic surgery. Although multimodal prophylaxis is recommended, clinical practice still relies largely on pharmacologic interventions. Transcutaneous electrical acupoint stimulation (TEAS) at the P6 acupoint may have potential benefit for PONV prevention. However, its effectiveness when incorporated into pharmacologic prophylaxis, and whether its effect varies according to the antiemetic used, remain unclear. This trial aims to evaluate the effect of P6-TEAS on PONV prevention in patients receiving dexamethasone or amisulpride.  Methods: This multicenter, prospective, randomized, sham-controlled, 2 × 2 factorial trial will enroll 212 women undergoing gynecologic laparoscopic surgery under general anesthesia. Participants will be randomly assigned in a 1:1:1:1 ratio to receive one of four treatment combinations: TEAS plus dexamethasone, TEAS plus amisulpride, sham stimulation plus dexamethasone, or sham stimulation plus amisulpride. TEAS or sham stimulation will be delivered at the P6 acupoint in two 1-h sessions, before surgery and at 24 h after surgery. The primary outcome will be the incidence of PONV within 48 h after surgery. Secondary outcomes will include PONV-related symptoms and severity, use of rescue antiemetics, opioid consumption, pain scores, recovery milestones, patient satisfaction, QoR-15 scores, and length of hospital stay. Safety outcomes will include adverse events related to TEAS or study drugs and perioperative hemodynamic events requiring treatment.  Discussion: This trial will evaluate P6-TEAS versus sham stimulation as the primary comparison and provide exploratory estimates for the dexamethasone-versus-amisulpride comparison and the TEAS-by-drug interaction. The findings may inform integrated prevention strategies for PONV after gynecologic laparoscopic surgery.  Clinical Trial Registration: https://clinicaltrials.gov/study/NCT07631910 , identifier NCT07631910.
SN  - 1663-9812
ER  -