Effects of perioperative electroacupuncture on postoperative β-endorphin levels and pain in patients: a meta-analysis

doi:10.16098/j.issn.0529-1356.2025.03.005

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Acta Anatomica Sinica ›› 2025, Vol. 56 ›› Issue (3) : 284-293. DOI: 10.16098/j.issn.0529-1356.2025.03.005

Neurobiology

Effects of perioperative electroacupuncture on postoperative β-endorphin levels and pain in patients: a meta-analysis

HU Ran¹ LIU Zi-chen² XU Chang-yi¹ XIE Chen-xing¹ WU Chen³ CAO Yang³ LIU Fan^4* ZHANG Li^5* LIU Guo-kai^1*

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Abstract

Objective To evaluate the changes in postoperative plasma β-endorphin(β-EP) levels in patients who had received perioperative electroacupuncture（EA） treatment in 10 randomized controlled trials (RCTs) and examine the impact of EA on postoperative pain. Methods This meta-analysis evaluated the changes in plasma β-EP levels and visual analog scale (VAS) 12, 24 and 48 hours after surgery in patients receiving perioperative EA. It also assessed the changes in plasma serotonin (5-hydroxytryptamine, 5-HT) and prostaglandin E2 (PGE2) levels at 24 hours postsurgery. A comprehensive search was conducted in the China National Knowledge Infrastructure (CNKI), Wanfang, Chongqing VIP database, Chinese Biomedical Database (CBM), Web of Science, and PubMed databases. RCTs on perioperative EA and β-EP published from the inception of the websites up to July 25, 2023, were retrieved. Effect size aggregation, literature quality assessment, and bias analysis were performed using RevMan 5.3 software, and sensitivity analysis was conducted via R 4.3.1. Results A total of 10 RCTs involving 706 patients were included. EA in conjunction with conventional anesthesia significantly increased plasma β-EP levels at 12 hours postsurgery ［standard mean difference (SMD)=2.79, 95% CI (1.85, 3.72), Z=5.81, P<0.00001］, 24 hours postsurgery ［SMD=1.87, 95% CI (0.9, 2.83), Z=3.79, P=0.0001］, and 48 hours postsurgery ［SMD=2.02, 95% CI (1.49, 2.54), Z=7.50, P<0.00001］. EA reduced plasma PGE2 levels at 24 hours postsurgery and plasma 5-HT levels at 24 hours postsurgery, and the VAS at 12, 24 and 48 hours after surgery also decreased. Conclusion These findings suggest that perioperative EA markedly elevates plasma β-EP levels, reduces pain-inducing factors in plasma, and effectively alleviates acute postoperative pain.

Key words

Perioperative electroacupuncture

/ Postoperative pain / β-endorphin / 5-Hydroxytryptamine / Prostaglandin E2 / Human

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HU Ran LIU Zi-chen XU Chang-yi XIE Chen-xing WU Chen CAO Yang LIU Fan ZHANG Li LIU Guo-kai. Effects of perioperative electroacupuncture on postoperative β-endorphin levels and pain in patients: a meta-analysis[J]. Acta Anatomica Sinica. 2025, 56(3): 284-293 https://doi.org/10.16098/j.issn.0529-1356.2025.03.005

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