Addition of transcutaneous electric acupoint stimulation to transverse abdominis plane block for postoperative analgesia in abdominal surgery: A randomized controlled trial

Abstract

IntroductionTransverse abdominis plane block (TAP) and transcutaneous electric acupoint stimulation (TEAS) are commonly used for postoperative analgesia. Our study aimed firstly to investigate whether there was a superior effect resulting from postoperative analgesia of TAP combined with TEAS, and secondly to identify the postoperative adverse reactions and hemodynamic effect of TAP + TEAS. MethodsIn this randomized, three-arm, single blind controlled clinical trial, patients who met the inclusion criteria were randomly allocated into one of 3 groups: TAP group, TAP + TEAS group, and usual care group. All groups received patient-controlled intravenous analgesia (PCIA) after surgery. The TAP group received bilateral TAP blocks at the end of operation, and the TAP + TEAS group received bilateral TAP and TEAS (before living PACU and at 24 h after surgery). The primary outcome was the Visual Analogue Scale (VAS) administered at 2, 24 and 48 h after surgery. Secondary outcomes included postoperative adverse reactions at 24, 48 and 72 h after surgery and hemodynamic effect. ResultsNinety patients completed all assessments. At baseline there was no significant differences in general condition between three groups. Compared with the TAP group and the usual care group, the VAS of the TAP + TEAS group decreased significantly at 24 and 48 h after surgery (P = 0.03, P < 0.0001; P = 0.03, P = 0.004); similarly, TAP + TEAS group showed significant lower incidence of postoperative adverse reactions compared with the other two groups. The hemodynamic effect was significantly elevated after surgery (p = 0.04) in usual care group, while there were no significant changes in TAP group and TAP + TEAS group. ConclusionTAP combined with TEAS can improve postoperative analgesic effect and decrease the incidence of postoperative adverse reactions.