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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
90
Postoperative analgesic medications administered according to standard clinical practice and hospital guidelines
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.
Hualien Tzu Chi Hospital
Taipei, Hualien, Taiwan
Postoperative Pain Intensity Assessed Using the Visual Analog Scale (VAS)
Pain intensity will be assessed using a 10-point Visual Analog Scale (VAS), where 0 indicates "no pain" and 10 indicates "worst imaginable pain."
Time frame: Within 48 hours after surgery
Blood Inflammatory Markers
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).
Time frame: Within 48 hours after surgery
Hospital Anxiety and Depression Scale
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.
Time frame: At baseline (preoperative), and after surgery 6 and 48 hours later
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