Transcranial direct current stimulation as a tool for postoperative pain management : a review of the current clinical evidence

Abstract

Adequate control of acute postoperative pain remains a challenge, and many patients still experience moderate to severe pain. Surgery is also a major cause of chronic pain, which cannot reliably be prevented with available interventions. Current analgesic regimens are also associated with severe side-effects. Consequently, we are in need of new techniques to better manage pain in the perioperative period. Transcranial direct current stimulation (tDCS) – a non-invasive neuromodulation technique – affects pain perception in human volunteers. Its ease of use, relatively low cost and absence of serious side effects make it an ideal candidate for clinical practice and a recent review concluded that it reduces pain intensity and improves quality of life of chronic pain patients. This article aims to review the clinical evidence for its use as a tool for postoperative pain management. In summary, seven randomized controlled trials have included over 310 patients and report encouraging results, most notably a considerable reduction in postoperative opioid use. More studies are needed to better establish the place of tDCS in this setting and to determine the optimal stimulation protocols.