Intraoperative Transcutaneous Electrical Acupoint Stimulation Attenuates Postoperative Mechanical Pain Sensitization and Visceral Pain After Elective Cesarean Delivery: A Randomized Controlled Trial

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• Picked for Anesthesiology and Pain Medicine (top studies of the week, 23 August 2026): TEAS for cesarean delivery pain, obstetric analgesia study

Abstract

INTRODUCTION: Postoperative pain after cesarean delivery remains prevalent despite multimodal analgesia. This randomized controlled trial evaluated whether continuous intraoperative transcutaneous electrical acupoint stimulation (TEAS) attenuates postoperative mechanical pain sensitization and improves clinical pain outcomes. METHODS: Eighty parturients undergoing elective cesarean delivery under neuraxial anesthesia were randomized 1:1 to TEAS (PC6 and LI4; from 30 min before incision until 10 min after closure) or sham control. The primary outcome was mechanical pain sensitization, quantified by the 30-min postoperative-to-baseline pressure pain threshold (PPT) ratio. Secondary outcomes included PPT and pain tolerance threshold (PTO) at 30 min and 24 h, threshold change ratios, postoperative pain scores, patient-controlled intravenous analgesia (PCIA) use, adverse events, and hospital stay. RESULTS: Seventy-nine participants were analyzed. TEAS significantly increased the 30-min PPT ratio compared with control (mean difference 0.208, 95% CI 0.057-0.359; P = 0.008). PPT and PTO remained higher in the TEAS group at 24 h, and all four threshold change ratios favored TEAS (all P < 0.05). Clinically, TEAS reduced uterine cramping pain scores at 6 h and 24 h and lowered the incidence of severe visceral pain (15.38% vs. 40.00%; in the multivariable model, the adjusted OR was 0.26 [95% CI 0.08-0.73; P = 0.005]). Hospital stay was shorter in the TEAS group (median 6.00 vs. 7.00 days; P = 0.010). No intervention-related adverse events were observed. Static and dynamic incisional pain outcomes and cumulative analgesic consumption did not differ significantly between groups. CONCLUSION: Continuous intraoperative TEAS was associated with attenuated postoperative mechanical pain sensitization and reduced visceral pain burden after elective cesarean delivery. Its effects were less evident for incision-related pain and opioid consumption. TEAS may serve as a safe, valuable non-pharmacological adjunct to multimodal post-cesarean analgesia. Apart from the primary outcome, secondary findings (including visceral pain, hospital stay, and threshold change ratios) were not adjusted for multiple comparisons and should be regarded as exploratory and hypothesis-generating. Graphical Abstract available for this article. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2200058422).

Abstract as published, via PubMed.