Effect of transcutaneous electrical acupoint stimulation for preemptive analgesia on intraoperative opioid dosage in burn patients: a randomized, double-blind, controlled trial

Burn survivors may be at risk of various opioid-related adverse effects. We aimed to investigate whether transcutaneous electrical acupoint stimulation (TEAS) used for preemptive analgesia in burn patients reduces intraoperative opioid dosage. In this trial, 86 burn patients with wound debridement under general anesthesia were randomized to receive thirty minutes of TEAS (TEAS group, n = 43) at acupoints LI4 (Hegu), PC6 (Neiguan), ST36 (Zusanli), and SP6 (Sanyinjiao) before induction of anesthesia or false stimulation (control group, n = 43). The primary outcome was the intraoperative remifentanil dosage. Secondary outcomes included intraoperative propofol dosage, patients’ resting facial-visual analogue scale (F-VAS) scores before stimulation (F1), after stimulation (F2), at 24 h after surgery (F3), and 48 h after surgery (F4), the incidence of opioid-related adverse reactions, and the use of rescue analgesics until the first postoperative day (POD1). The dosage of remifentanil showed a significant difference between the two groups, with 0.65(0.45,1.00) in the TEAS group (T group) and 0.90(0.67,1.23) in the control group (C group) (P < 0.05). Meanwhile, there was no significant difference in the intraoperative propofol dosage between groups. F2 and F3 in the T group were lower than those in the C group (P < 0.05), and no significant differences were observed in F1 and F4 (P > 0.05) between the two groups. Until POD1, the incidence of nausea-vomiting and constipation (P < 0.05) in the T group was lower than that the C group, while there was no significant difference in the incidence of drowsiness and dizziness (P > 0.05). It is worth noting that the use of rescue analgesics between the two groups was comparable (P > 0.05). The preoperative application of TEAS for preemptive analgesia can reduce intraoperative remifentanil dosage. Meanwhile, it has a positive effect on early postoperative analgesia and gastrointestinal adverse reactions. This study was registered in the Chinese Clinical Trials Registry (ChiCTR2300078615, date of registration: 14/12/2023, retrospectively registered).