The efficacy of transcutaneous electrical stimulation of the Xi and Yuan acupoints on postoperative pain after endoscopic nasal surgery: a randomized controlled trial

Abstract Purpose Opioids for postoperative pain control often cause side effects and affect postoperative recovery. Combined electrical stimulation of the Xi and Yuan acupoints has been reported to exhibit an analgesic effect. We evaluated the effect of transcutaneous electrical acupoint stimulation (TEAS) of the Xi and Yuan acupoints on postoperative pain after nasal surgery in a randomized controlled trial. Methods Sixty patients undergoing either endoscopic sinus surgery or septoplasty surgery were randomized to Sham or TEAS (Xi and Yuan acupoint stimulation) groups in a 1:1 ratio. The primary outcome was the numeric rating scale (NRS) for pain on postoperative day 1. The secondary outcomes included intraoperative propofol and remifentanil consumption, time to extubation after anesthesia, and 15-item Quality of Recovery scale (QoR15). Data were analyzed using intention-to-treat analysis. Results TEAS decreased NRS on postoperative day 1 ( P = 0.020, with NRS before surgery and surgery site adjusted). A mixed-model repeated-measures analysis demonstrated that TEAS decreased NRS over the first 3 days after endoscopic nasal surgery ( P = 0.035). TEAS also significantly reduced intraoperative propofol ( P = 0.001) and remifentanil ( P = 0.009) requirements, shortened time to extubation ( P = 0.003), and improved postoperative QoR15 ( P < 0.05). Notably, septoplasty and preoperative pain were identified as risk factors for higher postoperative pain intensity on postoperative day 1. Conclusions These results demonstrate that electrical stimulation of both the Xi and Yuan acupoints significantly reduces pain intensity on postoperative day 1 and throughout the first 3 postoperative days following endoscopic nasal surgery. Trial registration Registered on the Chinese Clinical Trial Registry ( https://www.chictr.org.cn/showproj.html?proj=230970 ), No. ChiCTR2400084850, on May 27, 2024. Principal investigator: Xingrui Gong.