Transcranial Electrical Stimulation for Chronic Post-Mastectomy Pain Syndrome: Analgesic Effect and Changes in Cortisol and β-Endorphin Levels

BACKGROUND: Chronic post-mastectomy pain syndrome (CPMPS) affects 20%–50% of patients and significantly impairs quality of life. Venlafaxine is commonly used as part of comprehensive rehabilitation; however, side effects limit its efficacy. Transcranial electrical stimulation (TES) is being considered as a potential alternative. AIM: The work aimed to assess the efficacy of transcranial electrical stimulation as an alternative to venlafaxine in reducing pain and improving plasma cortisol and β-endorphin levels in patients with CPMPS within the recommended comprehensive rehabilitation algorithm. MATERIALS AND METHODS: The study included 90 outpatients with CPMPS randomized into two groups: the treatment group (n=45), in which TES was used instead of venlafaxine within the recommended comprehensive rehabilitation algorithm, and the comparison group (n=45), which received the recommended algorithm. Efficacy was assessed after 56 days using visual analog scale pain scores and plasma cortisol and β-endorphin levels. The control group included 80 individuals without CPMPS. RESULTS: After 56 days of comprehensive rehabilitation, significant intergroup differences were found in the number of patients who achieved complete pain relief (p=0.017), as well as in cortisol levels (p = 0.001) and β-endorphin levels (p 0.001). CONCLUSIONS: The findings support the use of TES as an effective and safe alternative to antidepressant pharmacotherapy in the comprehensive rehabilitation of patients with CPMPS.