Pain, Postoperative
Conditions
Keywords
Video-assisted thoracoscopic surgery(VATS), Enhanced Recovery After Surgery(ERAS), pain, postoperative, transcutaneous electrical acupoint stimulation, transcutaneous electrical nerve stimulation, acute pain, blood inflammatory biomarkers, quality of life, Anxiety and Depression
Brief summary
Thoracic surgery is known to be one of the most painful types of surgery. If acute postoperative pain is not properly managed, there is a high risk that it may develop into clinically significant chronic pain within six months after surgery, which can seriously affect quality of life. According to research on Enhanced Recovery After Surgery (ERAS), using multimodal pain management strategies can significantly reduce postoperative pain and decrease reliance on pain medications. This study aims to investigate whether combining transcutaneous Electrical Nerve Stimulation therapy with conventional pain management can further enhance pain relief and improve recovery outcomes.
Detailed description
This study aims to evaluate the efficacy of three postoperative analgesic strategies in patients undergoing lesion resection via video-assisted thoracoscopic surgery (VATS). Under standard postoperative care protocols, patients will be randomized into three groups: (1) conventional pharmacologic analgesia alone, (2) conventional analgesia combined with transcutaneous electrical nerve stimulation (TENS), and (3) conventional analgesia combined with both transcutaneous electrical nerve stimulation (TENS) and transcutaneous electrical acupoint stimulation (TEAS). The primary outcomes include the assessment of acute postoperative pain intensity, blood inflammatory biomarkers, health-related quality of life, and the incidence of postoperative complications. This investigation seeks to determine whether adjunctive use of neuromodulatory techniques such as TENS and TEAS can enhance analgesic efficacy and improve postoperative recovery profiles.
Interventions
Postoperative analgesic medications administered according to standard clinical practice and hospital guidelines
DEVICETranscutaneous Electrical Nerve Stimulation (TENS)
Non-invasive electrical nerve stimulation therapy applied to specific areas to reduce postoperative pain
Electrical stimulation applied to specific acupuncture points through the skin to enhance analgesic efficacy and modulate autonomic function.
Sponsors
Buddhist Tzu Chi General Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
15 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* People who are about to undergo thoracic surgery
Exclusion criteria
* Patients with epilepsy, * Pacemaker installed * Severe infections status
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative Pain Intensity Assessed Using the Visual Analog Scale (VAS) | Within 48 hours after surgery | Pain intensity will be assessed using a 10-point Visual Analog Scale (VAS), where 0 indicates no pain and 10 indicates worst imaginable pain. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Blood Inflammatory Markers | Within 48 hours after surgery | Blood inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR), will be calculated using complete blood count (CBC) parameters. NLR increases are commonly interpreted as indicators of elevated systemic inflammation, whereas decreases in LMR may reflect enhanced inflammatory activity or physiological stress following surgery. These ratios will be assessed at multiple perioperative time points to evaluate changes in inflammatory response. The relationship between postoperative pain levels, clinical recovery, and changes in NLR and LMR will be analyzed to determine whether inflammatory activation is associated with greater postoperative pain or adverse outcomes. Units of measure are expressed as ratios (NLR, LMR). |
| Hospital Anxiety and Depression Scale | At baseline (preoperative), and after surgery 6 and 48 hours later | The Hospital Anxiety and Depression Scale (HADS) will be used to evaluate participants' psychological status during the perioperative period. The scale consists of 14 items, with 7 items assessing anxiety (HADS-A) and 7 items assessing depression (HADS-D). Each item is scored from 0 to 3, yielding subscale scores ranging from 0 to 21. Higher scores indicate greater levels of anxiety or depression. Changes in HADS-A and HADS-D scores will be analyzed to determine postoperative psychological responses and the potential impact of different analgesic interventions. |
Countries
Taiwan
Outcome results
None listed