Transcutaneous auricular vagus nerve stimulation to prevent rebound pain after interscalene block for arthroscopic shoulder surgery
Authors' conclusion
Perioperative taVNS may reduce the incidence of rebound pain following single-shot ISB in patients undergoing arthroscopic shoulder surgery.
Study context
- Population
- Adults undergoing elective arthroscopic shoulder surgery with ultrasound-guided single-shot interscalene blockall completed, ITT
- Participants
- 120 adults
- Comparison
- Active transcutaneous auricular vagus nerve stimulation (taVNS) vs sham stimulation
- taVNSn = 60
- Shamn = 60reference
- Primary endpoint
- Incidence of rebound pain
- Follow-up
- Within 24 hours after surgery
Methodological detailssingle-centre, participant- and assessor-blinded, sham-controlled
- Single-centre
- Participant- and assessor-blinded
- Sham-controlled
Primary result
As reported in the abstract
Each group vs shamRelative risk (95% CI)P value
taVNS
0.46(0.26–0.82)
P = 0.006- taVNS
- absolute risk reduction 23.3% (95% CI 7.2%–39.5%)
- taVNS
- NNT 4.3 (95% CI 2.5–13.9)
Secondary outcomes
| Outcome | Mean difference (95% CI) | P value | |
|---|---|---|---|
| Resting pain scores | −0.50 (−0.63 to −0.37) | P < 0.001 | |
| Movement-evoked pain scores | −0.39 (−0.65 to −0.14) | P = 0.003 | |
| −1−0.500.5Difference (linear scale) |
Quality of recovery (QoR-15) and sleep quality (Richards-Campbell Sleep Questionnaire) · POD 1 and 2 (QoR-15); night of surgery and postoperative night 1 (sleep)
- Higher QoR-15 scores and better sleep quality with taVNS
- all p<0.01
Cumulative sufentanil consumption
- Between-group difference not statistically significant (GMR)
- 0.67
- 95% CI 0.44 to 1.01; p=0.056
Safety
- No stimulation-related adverse events observed
Original publication
Transcutaneous auricular vagus nerve stimulation to prevent rebound pain after interscalene block for arthroscopic shoulder surgery. Reg Anesth Pain Med. Published 15 September 2026. doi:10.
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