Effects of transcranial direct current stimulation on postoperative pain and opioid consumption in arthroplasty: a systematic review and meta-analysis.

INTRODUCTION

To evaluate the effectiveness of transcranial direct current stimulation (tDCS) on acute postoperative orthopedic pain and opioid depletion following arthroplasty.

EVIDENCE ACQUISITION: Two independent researchers searched PubMed, EMBASE, and the Cochrane Library databases from inception to May 2024 to identify eligible randomized controlled trials (RCTs). The methodological quality and potential biases of the included studies were assessed using the Cochrane risk of bias assessment tool, and the risk of bias and robustness of the literature were evaluated through funnel plots and sensitivity analyses. Additionally, statistical analysis of relevant outcome measures was conducted using STATA 17.0.

EVIDENCE SYNTHESIS: Preliminary screening yielded 417 articles, from which eight were selected for comprehensive analysis. Statistical analysis revealed that tDCS effectively alleviated acute postoperative pain following arthroplasty, whether during rest or movement. Additionally, tDCS was observed to reduce the consumption of opioid analgesics among patients, particularly in cases where the primary motor cortex (M1) was targeted for tDCS application.

CONCLUSIONS

Based on low-level evidence, tDCS shows promise in alleviating acute postoperative pain following arthroplasty and reducing the consumption of opioid analgesics in patients after surgery. These findings suggest that tDCS could potentially serve as a valuable adjunctive therapy for managing postoperative pain in orthopedic patients, providing a possible alternative or complement to traditional analgesic methods. However, it is important to note that further research, including more RCTs, is needed to confirm and extend these findings.