OBJECTIVE: Cheek acupuncture, a recently established microneedle therapy, has been proven to effectively reduce pain, but its potential antiemetic effects remain unconfirmed. Thus, This study aimed to compare the antiemetic efficacy of cheek acupuncture with ondansetron and evaluate the cumulative effect in patients undergoing laparoscopic gynecological surgery. DESIGN: A single-center randomized controlled trial. SETTING: A university teaching hospital. PATIENTS: A Total of 150 Adult patients who underwent laparoscopic gynecological surgery between July 2023 and December 2023. INTERVENTIONS: Cheek acupuncture, IV ondansetron, or both. MEASUREMENTS AND MAIN RESULTS: The incidence and severity of postoperative nausea and vomiting as well as the postoperative requirement of rescue antiemetic agent were comparable between the cheek acupuncture and ondansetron group in 48 hours postoperatively (p >
.05), but all of which were significantly reduced in the combination group (p <
.05). Compared with the ondansetron group, the cheek acupuncture and combination group exhibited reduced pain intensity at 3 and 48 hours postoperatively (p <
.05). The use of cheek acupuncture was associated with higher satisfaction scores with anesthesia and shorter time of first flatus. Furthermore, no significant differences in other outcomes were found among the three groups (p >
.05). CONCLUSION: Cheek acupuncture had a prominent antiemetic effect in reducing the incidence and severity of postoperative nausea and vomiting in patients undergoing gynecological laparoscopic surgery.