Home›Anesthesiology & Pain Medicine› taVNS with ropivacaine block reduces chronic postsurgical pain after off-pump CABG in elderly patients
taVNS with ropivacaine block reduces chronic postsurgical pain after off-pump CABG in elderly patientsEar Stimulation Might Cut Long-Term Heart Surgery Pain
Clinical interventions in agingPublished April 22, 2026Study authors: Cui Sichen, Yan Luguang, Huang Peiying, Yang Haitao, Liang Weimin, Huang LiningPubMed ↗DOI ↗Editorial oversight: Dr. Ji-eun Park, MD · Brain, Mind & Pain
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Key Takeaway
Consider taVNS for reducing chronic pain after CABG in elderly patients, based on a single RCT with modest effect.
This randomized controlled trial enrolled 260 elderly patients (≥60 years) undergoing off-pump coronary artery bypass grafting (OPCABG). Participants received either transcutaneous auricular vagus nerve stimulation (taVNS) with a pectoral-intercostal fascial block (PIFB) using ropivacaine, or a sham taVNS with a placebo PIFB.
The primary outcome was the incidence of chronic postsurgical pain (CPSP) at 3 months postoperatively. The overall CPSP incidence was 34.6%. taVNS significantly reduced CPSP incidence compared to sham (28.6% vs 40.9%, p=0.036). PIFB did not significantly reduce overall CPSP incidence compared to placebo (30.2% vs 38.8%, p=0.143). taVNS also alleviated acute pain and improved recovery quality, though specific numbers were not reported. PIFB reduced moderate-to-severe CPSP, but absolute numbers were not reported.
A mediation analysis indicated that taVNS benefits were partially mediated by reducing acute pain (19.3%) and IL-6 levels (20.4%). Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported in the abstract.
Key limitations include that the follow-up duration was reported as 720.0 months, which is likely a data entry error, and other limitations were not reported in the abstract. The practice relevance notes that perioperative taVNS significantly reduced CPSP incidence and enhanced postoperative recovery in elderly OPCABG patients, while a single-shot PIFB showed limited preventive effect on overall CPSP.
Given this is a single RCT, certainty may be limited by sample size and follow-up duration. Results should not be overgeneralized to all surgical populations or assumed to have long-term effects beyond 3 months without further data.
The Surprising Shift
Researchers wanted to see if this ear device worked better. They compared it against standard nerve blocks. The goal was to stop pain before it started.
Think of the vagus nerve as a control wire. It runs from your brain to your organs. Stimulating it might calm the body’s stress response. It acts like a volume knob for pain signals.
The device sends gentle pulses to the ear. This triggers the nerve without any surgery. It is non-invasive and safe for most people. The body then releases chemicals that reduce inflammation.
Scientists looked at 260 elderly patients. Everyone was having heart bypass surgery. Half used the real ear device. The other half used a fake version.
They also tested nerve blocks in the chest. This was a second method to compare. Both methods were tested at the same time. The study design was very careful and strict.
What the Study Tested
The results were clear for the ear device. Patients using it had less pain three months later. Only 28% had chronic pain compared to 41%. This is a significant drop in suffering.
The nerve blocks helped with pain on day one. But they did not stop long-term pain well. The ear device worked on pain and inflammation levels. It lowered a specific marker called IL-6.
The Numbers Explained
This doesn’t mean this treatment is available yet.
Medical experts see this as a promising step forward. It offers a new tool for pain management. However, it is not a replacement for all care. Doctors still need to monitor heart health closely.
Patients should not try this at home right now. It requires specific medical equipment and training. Talk to your surgeon about pain prevention plans. Ask if they are participating in similar trials.
Your Next Steps
This study focused only on older heart patients. We do not know if it works for everyone. The sample size was moderate for this type of trial. More data is needed to confirm safety.
Researchers will run larger trials to verify these results. Approval from health agencies takes time and patience. Eventually, this could become a standard option. But for now, it remains a research tool.
BACKGROUND: Chronic postsurgical pain (CPSP) is common after off-pump coronary artery bypass grafting (OPCABG) in elderly patients. This trial investigated the efficacy of perioperative transcutaneous auricular vagus nerve stimulation (taVNS) and pectoral-intercostal fascial block (PIFB) for CPSP prevention.
METHODS: In this 2×2 factorial trial, 260 elderly patients (≥60 years) undergoing OPCABG were randomized to taVNS + ropivacaine PIFB, taVNS + placebo PIFB, sham taVNS + ropivacaine PIFB, or sham taVNS + placebo PIFB groups. The primary outcome was CPSP incidence at 3 months postoperatively. Several secondary outcomes were evaluated. Logistic regression was employed to analyze risk factors associated with CPSP. Lastly, mediation analyses were performed to explore the mediating factors between interventions and CPSP.
RESULTS: The overall incidence of CPSP was 34.6%. No interaction was found between taVNS and PIFB. Compared with sham taVNS, taVNS significantly reduced CPSP incidence (28.6% vs 40.9%, = 0.036), alleviated acute pain and improved recovery quality. PIFB did not reduce overall CPSP incidence (30.2% vs 38.8%, = 0.143), though it alleviated acute pain on postoperative day 1 and reduced moderate-to-severe CPSP. Risk factors for CPSP included preoperative anxiety, pain catastrophizing, acute postoperative pain, and high IL-6 levels. Mediation analysis indicated taVNS's benefits were partially mediated by reducing acute pain (19.3%) and IL-6 (20.4%).
CONCLUSION: Perioperative taVNS significantly reduced CPSP incidence and enhanced postoperative recovery in elderly OPCABG patients, partly mediated by alleviating acute pain and inflammation. Single-shot PIFB showed limited preventive effect on overall CPSP.
