Effect of transcutaneous electrical acupoint stimulation on perioperative hypothermia in video-assisted thoracoscopic surgery: a randomized controlled trial

BACKGROUND: Perioperative hypothermia is common during video‐assisted thoracoscopic surgery (VATS) and is associated with adverse clinical outcomes. Transcutaneous electrical acupoint stimulation (TEAS) is a noninvasive neuromodulation technique that may modulate thermoregulation; however, evidence from randomized controlled trials remains limited. This study evaluated whether TEAS prevents perioperative hypothermia in patients undergoing VATS. METHODS: Adults scheduled for elective VATS under general anesthesia were randomized (1:1) to receive TEAS at predefined acupoints from 30 min before anesthesia induction until the end of surgery, or sham stimulation. The primary outcome was the incidence of perioperative hypothermia, defined as a core temperature <36 °C. Secondary outcomes included intraoperative temperature trajectories, hemodynamic parameters, postoperative recovery metrics, and complications. RESULTS: Of 92 enrolled patients, 88 completed the trial (mean age, 52.8 ± 10.0 years; 41 women) and were included in the final analysis (44 per group). The incidence of perioperative hypothermia was lower in the TEAS group than in the control group (15.9% [7/44] vs. 40.9% [18/44]; p = 0.009; OR, 0.273; 95% CI, 0.100‐0.748). Patients receiving TEAS maintained higher intraoperative core temperatures. The incidence of postoperative complications was lower in the TEAS group than in the control group (2.3% [1/44] vs. 18.2% [8/44]; p = 0.030; OR, 0.105; 95% CI, 0.012‐0.877). However, these findings were primarily driven by differences in postoperative shivering. No between‐group differences were observed in other secondary outcomes. No TEAS‐related adverse events were observed. CONCLUSION: Perioperative TEAS improved thermoregulation, reduced the incidence of perioperative hypothermia and shivering in VATS. As a safe, noninvasive intervention, TEAS may be a useful adjunct to standard perioperative temperature management. CLINICAL TRIAL REGISTRATION: https://itmctr.ccebtcm.org.cn/mgt/project/view/‐7254737145961978300, Identifier ITMCTR2024000425.