Article Text

Download PDFPDF

OP055 Transcranial direct current stimulation for postoperative pain management in orthopedic surgery – a systematic review and meta-analysis
  1. Maria Luísa Assis1,
  2. Marcela Tatsch Terres2,
  3. Eduardo Cirne Toledo3,
  4. Catarina Rodrigues e Silva4 and
  5. Sara Amaral5
  1. 1Anesthesiology, Hospital das Clínicas de Porto Alegre, Porto Alegre, Brazil
  2. 2Anesthesiology, Universidade do Sul de Santa Catarina, Palhoça, Brazil
  3. 3Anesthesiology, Tufts Medical Center, Boston, USA
  4. 4Anesthesiology, Hospital Santa Maria, Lisbon, Portugal
  5. 5Anesthesiology, Hospital Regional Deputado Afonso Guizzo, Ararangua, Brazil


Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page)

Application for ESRA Abstract Prizes: I apply as a Trainee/Resident/Fellow (no age limit)

Background and Aims Effective postoperative pain management is a pivotal determinant of recovery following orthopedic surgery. While opioids have traditionally been used for this purpose, their side effects have prompted the search for alternative methods.Transcranial direct current stimulation (tDCS) has emerged as a promising modality for opioid-sparing and pain reduction. To this end, we conducted a meta-analysis to assess the relative efficacy of active tDCS compared to sham tDCS in patients undergoing orthopedic procedures.

Methods PubMed, EMBASE, Scopus, and Cochrane were searched for randomized controlled trials (RCTs) comparing active versus sham tDCS in the postoperative period of orthopedic surgery. We assessed outcomes such as opioid consumption, and pain scores. We used RevMan 5.4 for statistical analyses and evaluated the risk of bias using the RoB-2 tool.

Results Active tDCS was associated with significantly lower opioid consumption (Mean Difference -2.43; 95% CI -4.09 to -0.77; p<0.004; I2 = 69%; 4RCTs; 180 patients; figure 1) and lower pain scores (Standard Mean Difference -0.33; 95% CI -0.33 to -0.03; p<0.03; I2 = 0%; 4 RCTs; 191 patients; figure 2) when compared to sham tDCS.

Abstract OP055 Figure 1

Opioid consumption was lower for the tDCS group when compared to the sham group

Abstract OP055 Figure 2

Pain scores favoured the tDCS group

Conclusions The findings of our meta-analysis suggest that transcranial direct current stimulation (tDCS) holds promise as an adjunctive therapy to opioid-based pain management during the postoperative phase of orthopedic procedures. tDCS has demonstrated potential advantages, such as diminishing opioid consumption and decreasing pain intensity.

  • transcranial direct current stimulation
  • tDCS
  • pain management
  • orthopedic surgery
  • perioperative pain
  • opioid consumption

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.