Abstract
Ipsilateral shoulder pain (ISP) after video-assisted thoracoscopic (VATS) surgery is common, distinct from incisional pain, and frequently overlooked in clinical practice. Transcutaneous electrical acupoint stimulation (TEAS) is a non-invasive, safe non-pharmacological analgesic modality. This trial protocol aims to evaluate the potential preventive effect of TEAS on ISP after VATS surgery. We will conduct a multicenter, single-blind randomized trial of 216 patients undergoing unilateral VATS surgery. Patients will be randomized 1:1 to receive either TEAS or sham stimulation. The TEAS group will receive two 30-minute sessions at acupoints Hegu (LI4), Neiguan (PC6), Jianliao (SJ14), and Jianyu (LI15) on the evening before surgery and before anesthesia induction on the day of surgery. The sham stimulation group will receive sensory-matched sham stimulation. The primary outcome is the incidence of ISP during shoulder movement at 24 hours postoperatively. Pain intensity will be assessed using the verbal rating scale (VRS), and ISP is defined as a VRS score ≥ 1. Secondary outcomes are cumulative opioid consumption within 24 hours postoperatively and postoperative nausea and vomiting at 24 hours. Other outcomes include shoulder pain during movement and at rest at 48 and 72 hours, opioid consumption at other time intervals, postoperative quality of recovery assessed with the 15-item Quality of Recovery scale (QoR-15), time to first flatus, and nausea and vomiting at different time points. We hypothesize that TEAS reduces ISP incidence, opioid consumption, and improves postoperative recovery after VATS surgery. The findings of this trial will provide further evidence-based support for the prevention and management of perioperative ISP after VATS surgery, as well as a reference for the clinical application of non-pharmacological analgesic strategies. ClinicalTrials.gov, NCT07494591.