Effect of transcutaneous electrical acupoint stimulation on perioperative hypothermia in video-assisted thoracoscopic surgery: a randomized controlled trial

Background Perioperative hypothermia is common during video-assisted thoracoscopic surgery (VATS) and is associated with adverse clinical outcomes. Transcutaneous electrical acupoint stimulation (TEAS) is a noninvasive neuromodulation technique that may modulate thermoregulation; however, evidence from randomized controlled trials remains limited. This study evaluated whether TEAS prevents perioperative hypothermia in patients undergoing VATS. Methods Adults scheduled for elective VATS under general anesthesia were randomized (1:1) to receive TEAS at predefined acupoints from 30 min before anesthesia induction until the end of surgery, or sham stimulation. The primary outcome was the incidence of perioperative hypothermia, defined as a core temperature <36 °C. Secondary outcomes included intraoperative temperature trajectories, hemodynamic parameters, postoperative recovery metrics, and complications. Results Of 92 enrolled patients, 88 completed the trial (mean age, 52.8 ± 10.0 years; 41 women) and were included in the final analysis (44 per group). The incidence of perioperative hypothermia was lower in the TEAS group than in the control group (15.9% [7/44] vs. 40.9% [18/44]; p = 0.009; OR, 0.273; 95% CI, 0.100–0.748). Patients receiving TEAS maintained higher intraoperative core temperatures. The incidence of postoperative complications was lower in the TEAS group than in the control group (2.3% [1/44] vs. 18.2% [8/44]; p = 0.030; OR, 0.105; 95% CI, 0.012–0.877). However, these findings were primarily driven by differences in postoperative shivering. No between-group differences were observed in other secondary outcomes. No TEAS-related adverse events were observed. Conclusion Perioperative TEAS improved thermoregulation, reduced the incidence of perioperative hypothermia and shivering in VATS. As a safe, noninvasive intervention, TEAS may be a useful adjunct to standard perioperative temperature management. Clinical trial registration https://itmctr.ccebtcm.org.cn/mgt/project/view/-7254737145961978300 , Identifier ITMCTR2024000425.