Effect of transcutaneous auricular vagus nerve stimulation on postoperative liver injury in patients undergoing partial hepatectomy: a phase II clinical randomized trial

Perioperative liver injury is a common complication following partial hepatectomy in patients with hepatocellular carcinoma. Preclinical studies have shown that transcutaneous auricular vagus nerve stimulation (taVNS) has hepatoprotective effects, but clinical evidence remains limited. This study is a phase II, prospective, double-blind, randomized trial involving 140 patients undergoing partial hepatectomy, in which the active-taVNS group received 60-minute stimulation sessions at four time points: during the first hepatic pedicle clamping, after extubation in the post-anesthesia care unit, and on postoperative days 1 and 2 between 6:00 AM and 7:00 AM. The primary outcome measure was serum alanine aminotransferase (ALT) levels on postoperative day 2. Results showed that the median ALT level in the active taVNS group was significantly lower than that in the sham stimulation group (144.5 U/L vs. 224.0 U/L; P = 0.002). The results suggest that taVNS may have an early and transient protective effect against hepatocellular injury, providing preliminary clinical evidence for its potential as a non-invasive intervention strategy for early liver damage following partial hepatectomy. Trial registration: Chinese Clinical Trial Registry (ChiCTR2400092005). The authors reported a randomized trial showing that transcutaneous auricular vagus nerve stimulation reduces postoperative liver injury in patients undergoing partial hepatectomy.