Transcutaneous electrical acupoint stimulation for preventing postoperative nausea and vomiting in patients undergoing breast surgery: a systematic review and meta-analysis of randomized controlled trials

Background Postoperative nausea and vomiting (PONV) remains a frequent challenge for patients undergoing breast cancer surgery. Transcutaneous electrical acupoint stimulation (TEAS) is increasingly utilized as a needle-free, neuromodulatory adjunct in perioperative care. Although a prior meta-analysis evaluated TEAS for PONV across general surgical populations, breast surgery-specific evidence remains lacking. This meta-analysis evaluates the efficacy of TEAS for preventing PONV and enhancing early recovery in this specific surgical population. Methods We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and three Chinese databases (CNKI, VIP, Wanfang) for randomized controlled trials (RCTs) comparing perioperative TEAS with sham stimulation or routine care, up to March 10, 2026. The primary outcome was overall PONV incidence. Secondary outcomes included postoperative nausea, vomiting, pain scores, and early recovery quality (QoR). Data were synthesized using RevMan 5.4, and the certainty of evidence was assessed with GRADE. Results Fifteen RCTs comprising 1,752 patients were included. TEAS significantly reduced overall PONV risk RR = 0.61, 95% CI (0.49, 0.77), P 0.01 with no heterogeneity (I 2 = 0%). Patients receiving TEAS also experienced lower postoperative nausea, vomiting, pain scores, reduced need for rescue antiemetics, and improved early QoR scores. Conclusion TEAS might be an effective and non-pharmacological adjunct for reducing PONV and supporting early recovery in breast cancer surgery. These findings support its integration into perioperative care, although further large-scale, sham-controlled RCTs are warranted to establish standardized protocols. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261333755 .