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Updated: Apr 30, 2026
Author Spotlight: Methodologies and Advancements of Chronic Pain Management Research
Published on: January 5, 2024
Transcutaneous electrical nerve stimulation for pain relief after orthopedic surgery: a systematic review and
Jiangtao Yang1, Chuanhua Zheng2, Chunyuan Zhang2
1Department of Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Introduction:
Transcutaneous electrical nerve stimulation (TENS) is a potential adjunct therapy for postoperative pain management following orthopedic surgery. A systematic review and meta-analysis was conducted to evaluate the efficacy of TENS in postoperative pain management following orthopedic surgery.
Evidence Acquisition:
PubMed, Embase, and Cochrane Library databases were comprehensively searched for randomized controlled trials (RCTs) evaluating the efficacy of TENS in patients undergoing orthopedic surgery. The primary outcome was the postoperative pain scores. Secondary outcomes included opioid consumption and postoperative nausea or vomiting (PONV). The intention-to-treat principle was applied in this meta-analysis.
Evidence Synthesis:
Thirteen RCTs involving 849 participants were included in this meta-analysis. Compared with the control group, TENS significantly reduced resting pain scores at 24 hours (MD -0.95; 95% CI: -1.51, -0.40; P=0.0007), 48 hours (MD -0.81; 95% CI: -1.27, -0.35; P=0.0005), and 72 hours (MD -1.01; 95% CI: -1.58, -0.44; P=0.0005) after orthopedic surgery. Subgroup analysis suggested that the analgesic benefit of TENS on resting pain score at 24 hours was not statistically significant in patients receiving patient-controlled analgesia (PCA) (MD -0.29; 95% CI: -1.10, 0.53; P=0.49). Similarly, TENS significantly reduced movement pain scores at 24 hours (MD -1.22; 95% CI: -2.09, -0.35; P=0.006), 48 hours (MD -1.02; 95% CI: -1.81, -0.23; P=0.01), and 72 hours (MD -1.52; 95% CI: -2.48, -0.55; P=0.002) after orthopedic surgery. Furthermore, TENS significantly reduced opioid consumption within 24 hours (SMD -1.33; 95% CI: -1.90, -0.77; P<0.00001), 48 hours (SMD -2.27; 95% CI: -3.52, -1.02; P=0.0004), and the incidence of PONV (RR 0.5; 95% CI: 0.30, 0.85; P=0.001) after orthopedic surgery.
Conclusions:
TENS is effective in alleviating acute postoperative pain and reducing opioid requirements in patients undergoing orthopedic surgery. However, its analgesic benefit may be attenuated in patients receiving PCA, which should be carefully considered in clinical decision-making and individualized pain management strategies.
