This randomized, sham-controlled clinical trial aims to evaluate the effect of acupressure on postoperative pain following laparoscopic totally extraperitoneal (TEP) inguinal hernia repair. A total of 90 participants will be randomly assigned to one of three groups: standard postoperative care alone (control group), true acupressure plus standard care, or sham acupressure plus standard care. Acupressure will be applied at postoperative hours 1, 4, and 8 using the bilateral P6 (Neiguan), LI4 (Hegu), ST36 (Zusanli), and SP6 (Sanyinjiao) acupoints. The sham group will receive pressure at non-acupuncture points. The primary outcome is postoperative pain intensity measured using the Visual Analog Scale (VAS). Secondary outcomes include analgesic consumption, postoperative nausea and vomiting, time to mobilization, patient satisfaction, and postoperative complications.
Postoperative pain after laparoscopic totally extraperitoneal (TEP) inguinal hernia repair remains an important clinical problem despite advances in minimally invasive surgery. Acupressure is a non-invasive complementary therapy that may reduce postoperative pain and improve recovery. This prospective, randomized, sham-controlled, three-arm clinical trial will enroll 90 adult patients undergoing elective laparoscopic TEP inguinal hernia repair. Participants will be randomly allocated in a 1:1:1 ratio into: * Control group: Standard postoperative care only. * Acupressure group: Standard postoperative care plus bilateral acupressure applied at P6 (Neiguan), LI4 (Hegu), ST36 (Zusanli), and SP6 (Sanyinjiao). * Sham acupressure group: Standard postoperative care plus pressure applied to non-acupuncture points. Each intervention will be administered at postoperative hours 1, 4, and 8. Pressure will be applied manually for approximately 3 minutes at each point bilaterally by trained personnel. Pain intensity will be evaluated using the Visual Analog Scale (VAS) at predetermined postoperative time points. Secondary outcomes include total analgesic consumption, incidence of postoperative nausea and vomiting, time to mobilization, patient satisfaction, and postoperative complications. The study is designed to determine whether true acupressure provides additional benefit beyond standard care and whether its effects differ from sham acupressure, thereby distinguishing specific therapeutic effects from placebo responses.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
90
Bilateral acupressure is applied at P6, LI4, ST36, and SP6 for 3 minutes per point at postoperative 1, 4, and 8 hours.
Manual pressure is applied to non-acupuncture points using the same duration and schedule as the active acupressure intervention.
Fatih Sultan Mehmet Training and Research Hospital
Istanbul, Istanbul, Turkey (Türkiye)
RECRUITINGPostoperative Pain Intensity Assessed by Visual Analog Scale
Postoperative pain intensity will be assessed using a Visual Analog Scale ranging from 0 to 10, where 0 indicates no pain and 10 indicates the worst imaginable pain. VAS scores will be recorded at postoperative hours 2, 4, 6, 12, and 24 and compared among the study groups.
Time frame: At postoperative hours 2, 4, 6, 12, and 24
Rescue Analgesic Requirement
The requirement for rescue analgesic medication and the number of analgesic administrations will be recorded from the patient medication chart and compared among the study groups.
Time frame: During the first 24 postoperative hours
Incidence of Postoperative Nausea and Vomiting
The presence of postoperative nausea and the number of vomiting episodes will be recorded and compared among the study groups.
Time frame: During the first 24 postoperative hours
Early Postoperative Complications
The occurrence and type of early postoperative complications will be recorded and compared among the study groups.
Time frame: During the first 24 postoperative hours
Rescue Antiemetic Requirement
The requirement for rescue antiemetic medication and the number of antiemetic administrations will be recorded from the patient medication chart and compared among the study groups.
Time frame: During the first 24 postoperative hours
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