Efficacy and safety of transcutaneous electrical acupoint stimulation for postoperative pain following laparoscopic surgery: a systematic review and meta-analysis

Aim Postoperative pain remains a major barrier to early recovery after laparoscopic surgery. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) for postoperative analgesia following laparoscopic surgery. Methods We systematically searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, CNKI, VIP, and Wanfang from database inception to June 19, 2026. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Meta-analyses were performed, and the certainty of evidence was assessed using the GRADE approach. Results We included 59 RCTs involving 5,166 participants. Very low-certainty evidence suggests that, compared with blank control, TEAS may reduce postoperative pain intensity at 6 h (WMD: −0.60, 95% CI: −0.83 to −0.36) and 24 h (WMD: −0.56, 95% CI: −0.65 to −0.47), while the effect at 48 h was small (WMD: −0.37, 95% CI: −0.48 to −0.26). Moderate-certainty evidence suggests that TEAS may reduce postoperative adverse events compared with blank control (RR: 0.56, 95% CI: 0.49 to 0.65). Low-certainty evidence also suggests that, compared with drug analgesia, TEAS may result in little to no difference in postoperative pain intensity (WMD: 0.07, 95% CI: −0.04 to 0.17), but may reduce adverse events (RR: 0.43, 95% CI: 0.30 to 0.62). Conclusion Compared with blank control, TEAS may reduce pain intensity at 6 h and 24 h after surgery, with a smaller effect on pain at 48 h, and may also reduce the incidence of postoperative adverse events. Compared with drug analgesia, data were insufficient to draw firm conclusions about analgesic equivalence; however, TEAS may be associated with fewer adverse events. Systematic Review Registration https://www.crd.york.ac.uk/Prospero/view/ , identifier CRD420261455833.