Abstract
Given the rising rate of opioid-related adverse drug events during postsurgical pain management, a nonpharmacologic therapy that could decrease analgesic medication requirements would be of immense value. We designed a prospective, placebo-and-randomized controlled trial to assess the clinical effect of transcutaneous acupoint electrical stimulation (TEAS) on the postoperative patient-controlled analgesia (PCA) requirement for morphine, as well as side effects and recovery profile after inguinal hernia repair. Seventy-one subjects undergoing inguinal hernia repair with a standardized anesthetic technique were randomly assigned to one of three analgesic treatment regimens: PCA + TEAS (n = 24); PCA + sham-TEAS (no electrical stimulation) (n = 24), and PCA only (n = 23). The postoperative PCA requirement, pain scores, opioid-related side effects, and blood cortisol levels were recorded. TEAS treatment resulted in a twofold decrease in the analgesic requirement and decreased pain level reported by the patients. In addition, a significant reduction of cortisol level was reported in the TEAS group at 24 h postoperatively compared to the sham and control groups. We conclude that TEAS is a safe and effective option for reducing analgesic consumption and postoperative pain following inguinal hernia repair.
Highlights
Opioid analgesia remains the mainstay for postsurgical pain management, yet the consequences of its use incur risks for patients before and after discharge [1]
Power analysis was performed to determine the number of patients per group sufficient to detect a decrease of 30% or more in the patient-controlled analgesia (PCA) opioid analgesic requirements during the first 24 h after surgery, based on the results of the previous studies [13,18,19]
The PCA therapy and transcutaneous acupoint electrical stimulation (TEAS)/sham were discontinued at 24 h
Summary
Opioid analgesia remains the mainstay for postsurgical pain management, yet the consequences of its use incur risks for patients before and after discharge [1]. Given the rising rate of opioid use disorder and opioid-related overdose in the clinical setting, evaluating a nonpharmacologic approach to managing postoperative pain, which could effectively reduce the opioid analgesic requirement, is of immense value. Transcutaneous electrical acupoint stimulation (TEAS) is a non-invasive, safe, and comfortable treatment modality, which combines the effects of transcutaneous electrical nerve stimulation (TENS) with acupuncture point stimulation. Given the relative advantages of TEAS over classical acupuncture and needle-based electrostimulation, which stem from its non-invasive character and the possibility of continuous, multiple stimulations, the modality emerges as a promising approach for the management of postoperative pain. The present prospective, randomized, sham-controlled, and single-blinded study was designed to assess the clinical effect of TEAS on the postoperative opioid analgesic requirement, as well as side effects and recovery profile in the early postoperative period after inguinal hernia repair
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