CASE REPORT article
Front. Neurosci.
Sec. Autonomic Neuroscience
Volume 19 - 2025 | doi: 10.3389/fnins.2025.1586632
This article is part of the Research TopicExpanding Therapeutic Horizons with Non-Invasive Vagus Nerve StimulationView all 9 articles
Effect of Transcutaneous auricular vagus nerve stimulation on acute pain after external fixation for bilateral open tibiofibular fractures
Provisionally accepted
- 1Tianjin Hospital, Tianjin University, Tianjin, China
- 2Institute of Sport, Exercise and Health, Tianjin University of Sport, tianjin, China
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A 50-year-old female patient sustained bilateral tibiofibular fractures due to a traffic accident and underwent open external fixation surgery on both lower limbs. Postoperatively, she reported severe pain (VAS ≥8). The patient had no significant underlying medical conditions or contraindications to vagal nerve stimulation. Transcutaneous auricular vagus nerve stimulation (taVNS)-a non-invasive modality that activates vagal pathways to modulate sympathetic-parasympathetic balance, suppress inflammation, and inhibit pain signaling-was trialed as an adjunctive analgesic intervention. Heart rate variability (HRV) was incorporated as an objective biomarker to quantify dynamic changes in autonomic function and their association with pain relief. After stabilization, taVNS was administered continuously for two weeks. Parameters monitored included immediate pressure pain thresholds (PPT) during intervention, daily postoperative analgesic consumption, and pre-/post-intervention Visual Analog Scale (VAS) and Generalized Anxiety Disorder-7 (GAD-7) scores. Dynamic electrocardiography was used to record HRV parameters (HR, SDNN, RMSSD, LF, HF, LF/HF). Post-intervention, the patient demonstrated significant reductions in VAS scores, a progressive increase in PPT, and alleviated anxiety. HRV analysis revealed enhanced parasympathetic activity and improved sympathovagal balance. This case suggests that taVNS may effectively alleviate acute postoperative pain by modulating autonomic function. Dynamic HRV monitoring provided objective evidence of pain-autonomic nervous system interactions, supporting taVNS as a complementary strategy for postoperative pain management. However, as a single-case report, this study has limited sample size, necessitating further large-scale randomized controlled trials to validate these findings.
Keywords: Postoperative tibiofibular fracture, Acute Pain, Transcutaneous auricular vagus nerve electrical stimulation, Analgesia, pain mangement
Received: 03 Mar 2025; Accepted: 09 Jun 2025.
Copyright: © 2025 Li, Zhao, Zhang, Du, Ding, Xing, Chu and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiaolei Chu, Tianjin Hospital, Tianjin University, Tianjin, 300072, China
Weiguo Xu, Tianjin Hospital, Tianjin University, Tianjin, 300072, China
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