JMIR Publications

ABSTRACT

Background:

Postoperative pain after musculoskeletal surgery impedes early rehabilitation and reduces quality of life. Electroacupuncture (EA) is used as an adjunct for analgesia, but the optimal stimulation frequency and short-term response trajectory have not been established.

Objective:

The aim of this randomized, open-label, 2×2 crossover trial is to compare frequency-dependent analgesic responses of bilateral ST36–SP9 EA at 2 Hz and 100 Hz, and to generate effect-size estimates to inform future definitive trials.

Objective:

The aim of this randomized, open-label, 2×2 crossover trial is to compare frequency-dependent analgesic responses of bilateral ST36–SP9 EA at 2 Hz and 100 Hz, and to generate effect-size estimates to inform future definitive trials.

Methods:

This single-center, prospective, randomized, open-label, 2×2 crossover trial will enroll 30 adults (aged 19–80 years) experiencing pain (Numerical Rating Scale [NRS] score ≥4) after musculoskeletal surgery. They will undergo two 15-min EA sessions at bilateral ST36–SP9 (2 Hz and 100 Hz) separated by a washout period of ≥7 days.

Results:

The primary outcome is the change in pain NRS scores at 15 min and 2 h post‑intervention. The secondary outcomes include pain NRS scores immediately and 1, 4, and 24 h after EA; heart rate variability indices; radial pulse tonometry parameters; activity metrics from a wristband; and safety.

Conclusions:

The proposed protocol will quantify the immediate and short-term, frequency-dependent analgesic effects of bilateral ST36–SP9 electroacupuncture (2 Hz vs 100 Hz) after musculoskeletal surgery and delineate concurrent physiologic signatures. The findings are expected to yield clinically actionable evidence on the optimal stimulation frequency and timing within multimodal perioperative analgesia, supporting individualized pain management and early rehabilitation. Clinical Trial: The protocol was registered with the Clinical Research Information Service (CRIS), Republic of Korea, on 4 September 2025, CRIS number KCT0011009, prior to the initiation of the study, and was revised on September 10 2025.