Work

Effect of Transcutaneous Electrical Acupoint Stimulation on Perioperative Stress and Inflammatory Responses: A Systematic Review and Meta-Analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: Purpose: Perioperative stress and inflammatory responses are common complications that impair patients’ postoperative recovery. Transcutaneous electrical acupoint stimulation (TEAS) is a novel noninvasive therapy widely applied in perioperative care. This systematic review and meta-analysis aimed to evaluate the efficacy of TEAS in modulating perioperative stress and inflammatory responses, with primary outcomes defined as perioperative hemodynamic stress indicators (heart rate [HR] and mean arterial pressure [MAP]) assessed at the end of surgery, and postoperative inflammatory cytokines (interleukin-6 [IL-6] and tumor necrosis factor-α [TNF-α]) assessed 24 hours after surgery. Material and Methods: Following PRISMA 2020 guidelines, PubMed, CNKI, Web of Science, Ovid, Scopus and others were searched from inception to September 2026. Study eligibility criteria were restricted to randomized controlled trials (RCTs) investigating TEAS for perioperative stress or inflammatory responses. Researchers screened studies, extracted data, and assessed methodological quality using the Cochrane Collaboration’s tool for assessing risk of bias in randomized trials. Random-effects models were adopted for quantitative synthesis of the predefined primary outcomes. Results: Thirty RCTs involving 2224 participants were included. Meta-analysis results showed that TEAS significantly reduced perioperative HR (MD = − 2.80, 95% CI: − 4.72 to − 0.87), IL-6 (SMD = − 1.47, 95% CI: − 1.97 to − 0.97), and TNF-α (SMD = − 1.15, 95% CI: − 1.64 to − 0.66), with high heterogeneity (I 2 = 63– 94%). While TEAS had no significant improvement in MAP (MD = − 1.42, 95% CI: − 3.46 to 0.62). Conclusion: TEAS demonstrates potential as a non-pharmacological adjunct for modulating perioperative stress and inflammatory responses. While limitations of this study include high heterogeneity, language restriction, possible publication bias, and not assessed neuroendocrine biomarkers, etc. In future research, RCTs with standardized protocols, stratified analyses, and comprehensive outcome monitoring are warranted to confirm long-term efficacy of TEAS and reduce heterogeneity among studies. Registration Number: PROSPERO CRD420251004216. Keywords: transcutaneous electrical acupoint stimulation, TEAS, stress response, inflammatory response, systematic review, meta-analysis

Source: Journal of Pain Research

DOI: 10.2147/jpr.s644024