Transcutaneous Electrical Acupoint Stimulation Reduces Postoperative Analgesic Requirement in Patients Undergoing Inguinal Hernia Repair: A Randomized, Placebo-Controlled Study

Given the rising rate of opioid-related adverse drug events during postsurgical pain management, a nonpharmacologic therapy that could decrease analgesic medication requirements would be of immense value. We designed a prospective, placebo-and-randomized controlled trial to assess the clinical effect of transcutaneous acupoint electrical stimulation (TEAS) on the postoperative patient-controlled analgesia (PCA) requirement for morphine, as well as side effects and recovery profile after inguinal hernia repair. Seventy-one subjects undergoing inguinal hernia repair with a standardized anesthetic technique were randomly assigned to one of three analgesic treatment regimens: PCA + TEAS (n = 24); PCA + sham-TEAS (no electrical stimulation) (n = 24), and PCA only (n = 23). The postoperative PCA requirement, pain scores, opioid-related side effects, and blood cortisol levels were recorded. TEAS treatment resulted in a twofold decrease in the analgesic requirement and decreased pain level reported by the patients. In addition, a significant reduction of cortisol level was reported in the TEAS group at 24 h postoperatively compared to the sham and control groups. We conclude that TEAS is a safe and effective option for reducing analgesic consumption and postoperative pain following inguinal hernia repair.

Clinical preventive services to reduce pandemic deaths

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High utilization of clinical preventive services reduces mortality during outbreaks.

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The prevention of comorbidities can reduce the COVID-19 death toll.

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Prevention of hypertension bears the highest potential to decrease COVID-19 deaths.

The recent COVID-19 pandemic has highlighted inadequacies in both national and international preparedness. The outbreak has resulted in an overburdening and incapacitation of health systems worldwide, as well as numerous deaths of individuals with comorbidities.

We have performed a simulation study to examine the effect of comorbidities and their prevention on the clinical outcome and mortality of patients during the COVID-19 pandemic. The data from past and present outbreaks indicate that individuals with comorbidities are significantly more susceptible to infections and yield poorer clinical outcomes. Our simulation study revealed that the prevention of morbidities like hypertension, diabetes, and cardiovascular disease bears an enormous potential to decrease the COVID-19 death toll. The accumulating evidence emphasizes our ability to reduce both the susceptibility of uninfected individuals to pathogenic factors, as well as the mortality of infected individuals during pandemics, by adopting a more comprehensive approach to disease prevention. Higher utilization of clinical preventive services is critical to reduce pandemic deaths and increase our preparedness for future outbreaks.