Advances in the application of auricular neuromodulation in perioperative anxiety: A narrative review

Perioperative anxiety is a major challenge in the perioperative management of mental health. Statistics show that approximately 38.1% of surgical patients experience moderate-to-severe anxiety, which significantly impacts their quality of life and social function. In recent years, auricular neuromodulation (ANM) has emerged as a prominent research focus in the treatment of mood disorders, owing to its advantages, including safety, precision, and high efficacy. While preliminary studies have suggested the therapeutic potential of ANM in various chronic neurological and psychiatric conditions, robust clinical evidence specifically addressing the unique temporal window of the perioperative period is limited. Furthermore, the neurobiological mechanisms through which ANM alleviates perioperative anxiety are yet to be fully elucidated. This article is the first to comprehensively summarize the auricular targets, mechanisms, clinical efficacy and safety, existing technical limitations, and future development trends of auricular nerve electrical stimulation, binaural beat technology, and auricular therapy. We aim to provide a theoretical basis for the individualized treatment of perioperative anxiety with ANM and the development of innovative ANM technologies.