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

Anesthesiology and Perioperative Science Pub Date : 2025-08-08 DOI:10.1007/s44254-025-00118-1

Fan Yao, Kairui Liu, Shengnan Shi, Lili Wang, Jiale Zhao, Shugen Xiao, Ying Shen, Xingrui Gong, Mazhong Zhang

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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.

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经皮电刺激喜、元穴对鼻内镜术后疼痛的疗效：一项随机对照试验

目的阿片类药物用于术后疼痛控制常产生副作用，影响术后恢复。联合电刺激喜、元穴有镇痛作用。在一项随机对照试验中，我们评估了经皮穴位电刺激（tea）对鼻手术后疼痛的影响。方法60例接受鼻窦内窥镜手术或鼻中隔成形术的患者按1:1的比例随机分为Sham组和TEAS组。主要观察指标为术后第1天疼痛的数值评定量表（NRS）。次要结果包括术中异丙酚和瑞芬太尼用量、麻醉后拔管时间和15项恢复质量量表（QoR15）。使用意向治疗分析对数据进行分析。结果steas术后第1天NRS下降（P = 0.020，与术前及手术部位NRS比较）。混合模型重复测量分析表明，在鼻内镜手术后的前3天，tea降低了NRS （P = 0.035）。tea还显著降低术中丙泊酚（P = 0.001）和瑞芬太尼（P = 0.009）的需用量，缩短拔管时间（P = 0.003），改善术后QoR15 （P < 0.05）。值得注意的是，鼻中隔成形术和术前疼痛被确定为术后第1天较高的术后疼痛强度的危险因素。结论：电刺激Xi穴和Yuan穴可显著降低鼻内镜手术术后第1天及术后前3天的疼痛强度。试验注册：在中国临床试验注册中心注册（https://www.chictr.org.cn/showproj.html?proj=230970），注册号：ChiCTR2400084850，于2024年5月27日发布。首席研究员：龚兴瑞。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Anesthesiology and Perioperative Science

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