Perioperative Transcutaneous Electrical Acupoint Stimulation for Postoperative Pain Relief Following Laparoscopic Surgery: A Randomized Controlled Trial.

OBJECTIVES

This trial was conducted to assess the influence of transcutaneous electrical acupoint stimulation (TEAS) on postoperative pain intensity and the optimal time of TEAS application during perioperative period in patients undergoing laparoscopic surgery.

METHODS

From July 2012 to October 2013, 380 patients scheduled for laparoscopic surgery under general anesthesia were randomly assigned to receive sham TEAS (group SSS), preoperative TEAS (group TSS), preoperative TEAS combined with intraoperative TEAS (group TTS) or preoperative TEAS combined with postoperative TEAS (group TST) (n=95 each group). Primary outcomes included resting and activity pain intensity evaluated by visual analog scale at 1, 6, 24, and 48 hours after surgery.

RESULTS

At postoperative 6 hours, the activity pain intensity was significantly lower in groups TTS and TST compared with groups SSS and TSS (P<0.001). At postoperative 24 and 48 hours, activity pain intensity decreased in group TST compared with both groups SSS and TSS (P<0.001). The supplemental analgesic requirement was less in group TST compared with group SSS. There was no significant difference in intraoperative anesthetic consumption, postoperative nausea and vomiting and time of the first postoperative flatus or defecation among the 4 groups. The patient satisfactory rate was higher in groups TSS, TTS, and TST compared with group SSS. No side effect related to TEAS was observed during the postoperative 48 hours.

DISCUSSION

Combination of preoperative TEAS with intraoperative or postoperative TEAS, rather than preoperative TEAS alone, is an effective and safe adjunctive for management of postoperative pain following laparoscopic surgery.