Active rTMS to the DLPFC for patients undergoing major abdominal surgeryTrial plans to use magnetic pulses for abdominal surgery recovery

Major abdominal surgery is a primary therapeutic strategy for various abdominal diseases, but it is often related to severe postoperative pain, complications, and delayed recovery. Repetitive transcranial magnetic stimulation (rTMS), a noninvasive neuromodulatory technique, may influence pain processing, emotional regulation, and other neural functions relevant to postoperative recovery. However, its role in improving quality of postoperative recovery remains insufficiently investigated, particularly with respect to patient-reported recovery outcomes. This investigation is a single-center, prospective, randomized controlled study. A total of 208 participants undergoing major abdominal surgery will be classified into receiving either active or sham rTMS in a random manner. Active stimulation will be delivered to the dorsolateral prefrontal cortex (DLPFC) at 120% of the resting motor threshold (RMT) and 10 Hz. The primary outcome is the Quality of Recovery-15 (QoR-15) score at 24 h postoperatively. Exploratory secondary outcomes include QoR-15 scores at additional time points, pain intensity, delirium incidence, opioid consumption, postoperative nausea and vomiting (PONV), anxiety, patient satisfaction, and gastrointestinal recovery. Safety outcomes include adverse events (AEs). We will conduct the primary analysis according to the intention-to-treat (ITT) principle, comprising all randomized participants. This investigation is designed to estimate whether rTMS can enhance quality of postoperative recovery in participants experiencing a major abdominal operation. The outcomes will provide evidence about the potential role of rTMS as a noninvasive adjunct in perioperative care and inform future multicenter trials. Clinical Trial registration:https://www.chictr.org.cn/index.html, identifier ChiCTR2600119250.