The effectiveness of transcutaneous electrical nerve stimulation (TENS) for postoperative pain after laparoscopic cholecystectomy: A systematic review and meta-analysis

To examine the role of Transcutaneous Electrical Nerve Stimulation (TENS) in pain management post-laparoscopic cholecystectomy (LC). An in-depth search was conducted on Google Scholar, PubMed, and Ovid MEDLINE from their inception until November 2024. We included randomized controlled trials and prospective studies that compared TENS for postoperative pain relief as determined by the Visual Analog Scale (VAS). The quality assessment using the GRADE and Cochrane risk of bias methods. Six trials, comprising a total of 423 patients, were included in the study. The meta-analysis of the VAS at different times yielded no significant reduction in pain observed postoperatively at 4 hours (MD: −0.70, CI: −1.97 to 0.57, P = 0.28); at 8 hours (MD: −0.75, CI: −2.15 to 0.65, P = 0.29); and at discharge (MD: −0.88, CI: −2.02 to 0.26, P = 0.13). While the included studies showed minimal risk of bias, the certainty of evidence by the GRADE assessment was deemed low. While some studies suggest a potential benefit of TENS in reducing postoperative pain, the current evidence remains inconclusive due to the variability in study design, TENS parameters, and outcome reporting. Additional high-quality RCTs are required.