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Clinical Trial
. 2022 Jul 14:15:1949-1958.
doi: 10.2147/JPR.S370589. eCollection 2022.

Effect of Transauricular Vagus Nerve Stimulation on Rebound Pain After Ropivacaine Single Injection Femoral Nerve Block for Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Qi Zhou  1 , Lili Yu  2 , Chunping Yin  1 , Qi Zhang  3 , Yanlei Tai  1 , Lian Zhu  4 , Jiangtao Dong  5 , Qiujun Wang  1
Affiliations
Clinical Trial

Effect of Transauricular Vagus Nerve Stimulation on Rebound Pain After Ropivacaine Single Injection Femoral Nerve Block for Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Qi Zhou et al. J Pain Res. .

Abstract

Purpose: The aim of this study was to investigate whether transauricular vagus nerve stimulation (taVNS) could reduce the incidence of rebound pain in patients undergoing anterior cruciate ligament reconstruction (ACLR) under general anesthesia combined with preoperative femoral nerve block.

Methods: In total, 78 patients were enrolled in this prospective, randomized, double-blind, and sham-controlled study. Patients were randomly assigned to 2 groups (n=39): Group taVNS received taVNS (1h /1time, 6times) within the first 12 h after surgery; Group SS received sham stimulation (SS) in the same manner. Pain scores at 0, 4, 8, 12, 24, 48 h after surgery were assessed with Numeric Pain Rating Scale (NRS). The incidence, duration and onset of rebound pain were recorded. In addition, additional analgesic requirements and side effects in the first 48 h postoperatively, as well as sleep disturbance on the night of surgery, were examined.

Results: The incidence and duration of rebound pain were lower in the taVNS group than in the SS group (P=0.025 and P=0.015, respectively). Pain scores at 8 h and 12 h postoperatively were significantly lower in the taVNS group compared with the SS group (P<0.05). The number of times to press the patient-controlled analgesia (PCA) pump and the number of patients requiring additional analgesic were significantly lower in the taVNS group than in the SS group until 12 h after surgery (P=0.021 and P=0.004, respectively). The number of patients with sleep disturbance in the taVNS group was lower than that in the SS group (P=0.030).

Conclusion: The taVNS exerts beneficial effect on rebound pain after femoral nerve block in patients undergoing ACLR, which reduces the incidence and duration of rebound pain, the need for postoperative additional analgesic, and the number of complications.

Keywords: anterior cruciate ligament reconstruction; femoral nerve block; rebound pain; transauricular vagus nerve stimulation.

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Conflict of interest statement

The authors declare no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Stimulation sites in the taVNS group (A) and the SS group (B).
Figure 2
Figure 2
Study flowchart.
Figure 3
Figure 3
Box-plot of NRS scores at different time points between the taVNS and SS groups. At 8 h and 12 h, *P<0.05 between the two groups. Box plot with median (solid line), interquartile range (box) are shown. Dots represent outliers.
See this image and copyright information in PMC

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