Transcutaneous Electrical Nerve Stimulation for Acute Postoperative Pain After Video-Assisted Thoracoscopic Surgery

• Active TENS (Device): Active transcutaneous electrical nerve stimulation (TENS) is administered in addition to standard postoperative care. Four electrodes are placed around the surgical site. Electrical stimulation is delivered at a frequency of 100 Hz with a pulse width of 200 microseconds for 30 minutes per session, twice daily for three consecutive days. The stimulation intensity is adjusted to the highest level tolerated without discomfort.
• Sham TENS (Device): Sham transcutaneous electrical nerve stimulation (TENS) uses identical electrode placement and treatment procedures as the active TENS intervention but delivers no therapeutic electrical stimulation. Participants continue to receive standard postoperative care.

Primary outcomes

• Pain intensity (Numeric Rating Scale, NRS) [Preoperative baseline; 24 hours after initiation of the intervention; 72 hours after initiation of the intervention; and on the day of hospital discharge.]: Pain intensity will be assessed using the 11-point Numeric Rating Scale (NRS), ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity.

Secondary outcomes

• Sleep quality (Richards-Campbell Sleep Questionnaire, RCSQ) [Preoperative baseline; 24 hours after initiation of the intervention; 72 hours after initiation of the intervention; and on the day of hospital discharge.]: Sleep quality will be assessed using the Richards-Campbell Sleep Questionnaire (RCSQ), a validated instrument that evaluates perceived sleep depth, sleep latency, number of awakenings, efficiency of returning to sleep, and overall sleep quality. The RCSQ consists of five items scored from 0 to 100, with higher scores indicating better sleep quality.
• Health-related quality of life (PROMIS Global Health Scale) [Preoperative baseline; 24 hours after initiation of the intervention; 72 hours after initiation of the intervention; and on the day of hospital discharge.]: Health-related quality of life will be assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health, which evaluates participants' overall physical and mental health. Each domain (Global Physical Health and Global Mental Health) is calculated from four items, with scores ranging from 4 to 20. Higher scores indicate better health-related quality of life.

Sex: All, ages: 15 Years to 85 Years

Inclusion Criteria

* Aged 15 to 85 years.
* Participants younger than 18 years of age must have written informed consent provided by a parent or legal guardian.
* Able to communicate and read/write in Chinese.
* Scheduled to undergo video-assisted thoracoscopic surgery (VATS) as determined by the treating physician.
* Have stable vital signs.
* Willing to participate in the study and able to complete all study procedures.

Exclusion Criteria

* History of a bleeding disorder.
* Patients undergoing emergency surgery.
* Patients undergoing bilateral video-assisted thoracoscopic surgery (VATS).
* History of cardiac disease, including cardiac arrhythmia or implantation of a cardiac pacemaker.
* Known allergy or hypersensitivity to TENS electrodes or adhesive pads.
* Cognitive impairment or inability to comply with the study procedures

• Hui-Fang Yeh, phD, Study chair, Fooyin University
• JIA-XIN LIN, NP, Principal investigator, Fooyin University