Effect of Transcutaneous Electrical Acupoint Stimulation on Perioperative Stress and Inflammatory Responses: A Systematic Review and Meta-Analysis
5 affiliations
- 1School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
- 2School of Public Health and General Practice, Tongji University School of Medicine, Shanghai, People’s Republic of China
- 3Yuyuan Community Health Service Center, Shanghai, People’s Republic of China
- 4School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
- 5Department of Anesthesia, Shanghai Pulmonary Hospital of Tongji University, Shanghai, People’s Republic of China
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 (I2 = 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.
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BibTeX
@article{zheng2026effect,
title = {{Effect of Transcutaneous Electrical Acupoint Stimulation on Perioperative Stress and Inflammatory Responses: A Systematic Review and Meta-Analysis}},
author = {Wanyi Zheng and Jiangfei Gao and Yang Zhang and Biying Wang and Yiwei Zhou and Junxiong Wen and Chaomin Zhang and Jianming Liu and Xianglong Xu and Hualing Song},
journal = {Journal of Pain Research},
year = {2026},
month = oct,
doi = {10.2147/jpr.s644024},
url = {https://doi.org/10.2147/jpr.s644024},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Effect of Transcutaneous Electrical Acupoint Stimulation on Perioperative Stress and Inflammatory Responses: A Systematic Review and Meta-Analysis
AU - Wanyi Zheng
AU - Jiangfei Gao
AU - Yang Zhang
AU - Biying Wang
AU - Yiwei Zhou
AU - Junxiong Wen
AU - Chaomin Zhang
AU - Jianming Liu
AU - Xianglong Xu
AU - Hualing Song
PY - 2026
DA - 2026/10/30
JO - Journal of Pain Research
DO - 10.2147/jpr.s644024
UR - https://doi.org/10.2147/jpr.s644024
AB - 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 (I2 = 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.
SN - 1178-7090
ER -