The healing power of transcutaneous electrical nerve stimulation: a systematic review on its effects after breast surgery.

Background: Transcutaneous electrical stimulation after breast cancer surgery has been utilized for various purposes, but the full efficacy of this treatment approach on postoperative symptoms remains unclear.

Aim: This study aimed to answer the question: Does transcutaneous electrical nerve stimulation significantly impact postoperative patient outcomes in individuals undergoing breast cancer surgery?

Methods: A systematic review of randomized controlled trials was conducted. Because of the limited number of studies included, it was not feasible to perform a meta-analysis. English-language publications from 2013 and 2024 that investigated the effects of transcutaneous electrical stimulation in breast cancer surgery patients were included. Electronic databases such as Web of Science, PubMed, Scopus, EBSCO, ScienceDirect, Cochrane Central Register of Controlled Trials, and Wiley Online Library were searched. Two independent investigators assessed the studies using the revised JBI risk of bias tool. Data from randomized trials were extracted by two researchers using the Cochrane data collection tool.

Results: Our comprehensive literature review identified 251 studies. After rigorous assessment, 12 articles met our inclusion criteria. Title and abstract screening excluded seven studies that did not involve surgery, used treatments other than TENS, included acupuncture, or did not measure pain outcomes. Among these, five studies involving 776 patients examined the effects of transcutaneous electrical stimulation on pain management in breast cancer surgery. In all of the studies reviewed, transcutaneous electrical stimulation had a beneficial effect on postoperative pain.

Conclusion: Transcutaneous electrical stimulation has significantly alleviated pain associated with breast cancer surgery. This therapeutic modality has improved patient satisfaction with analgesia by relieving pain; reducing analgesic use; reducing postoperative nausea and vomiting; increasing blood levels of IL-2, IFN-γ, and IL-2/IL-4 ratio; and reducing skin sensitivity. Transcutaneous electrical stimulation devices may improve postoperative patient outcomes and enhance the recovery process in people undergoing breast cancer surgery. The results of this study are limited by heterogeneity and the small number of included studies. Future research should prioritize standardization of intervention procedures and investigation of the long-term effects of TENS in postoperative care.

Registration: This study was registered in the PROSPERO registration system under the number CRD42024523558.