Abstract
PURPOSE: Laparoscopic hysterectomy(LH) is often associated with multimodal postoperative pain, which impedes patient recovery. This study aimed to evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative acute visceral,incisional, and low back pain (LBP) and recovery in patients undergoing LH. PATIENTS AND METHODS: Patients scheduled for elective LH at the First Affiliated Hospital of Wenzhou Medical University (February 2024-2025) were randomly divided (1:1 ratio) into a TEAS and control group. TEAS involved bilateral stimulation at Hegu-Neiguan, and Sanyinjiao-Zusanli 30 min before anesthesia induction and throughout surgery, while the control involved electrodes placed identically for sham stimulation. Pain intensity (visceral, incisional, and LBP) was evaluated using numerical rating scale on postoperative days (PODs) 0 (day of surgery), 1, and 2. Secondary outcomes comprised postoperative serum cytokine profiles, opioid consumption, rescue analgesia demands on POD 1, adverse events, and standardized recovery metrics. RESULTS: The TEAS group (n=45) demonstrated superior pain control compared to the control group (n=48), with significantly lower visceral pain scores (POD 0-1), decreased LBP scores (POD 0-2), and reduced incidence of moderate-to-severe visceral pain (POD 0-2) and LBP (POD 0) (all P < 0.017). TEAS resulted in lower interleukin-6 levels, total sufentanil consumption, and rescue analgesia demands on POD 1(all P < 0.05). TEAS was associated with a shorter time to pelvic drain removal, decreased postoperative hospitalization, earlier ambulation, and lower incidence of postoperative nausea and vomiting (all P < 0.05). No significant improvement in incisional pain was observed with TEAS intervention. CONCLUSION: TEAS provided differential postoperative analgesia, effectively alleviating visceral and LBP but not incisional pain. This primary benefit, coupled with reduced inflammation, opioid use, and adverse events, facilitated recovery in LH patients. These findings support the incorporation of TEAS as an effective non-pharmacological adjuvant within multimodal analgesia and ERAS protocols.