429: Electrical auricular vagus nerve stimulation after Caesarean Section.

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Acute postsurgical pain, Non-pharmacological treatments, Neuromodulation (e.g. TMS, TDCS, FUS, SCS, MCS, DBS, vagus nerve stimulation), Pain in special populations (e.g. neonates, children, teens, elderly, neurodegenerative diseases)

Background and Aims: Complementary and alternative medicine (CAM) is popular and considered as a safe alternative to standard care in women and especially in pregnant women or mothers. Auricular vagus nerve stimulation (aVNS) has emerged as a non-pharmaceutical treatment option. Innervation of the vagus nerve can lead to the release of endorphins and enkephalins, parasympathetic activation and activation of the cholinergic anti-inflammatory reflex This prospective double-blind randomized pilot study aims to explore the potential benefits of aVNS in post-caesarean pain, gastrointestinal motility, lactogenesis, and postpartal wellbeing.

Methods: This study includes 90 primiparous patients randomly assigned to intervention (aVNS), sham (inactive aVNS) or control group.
The primary outcomes are perceived
postoperative pain and time to onset of lactogenesis. Secondary outcomes are medication use, gut motility and postnatal maternal mental wellbeing. The data is collected from patients on the basis of questionnaires, the pain scale on the basis of the VAS score at defined time points, and the medication requirement on the basis of the patient's medical history.

Results: This study is still in the end of recruitement phase. Results will be ready for presentation at the IASP 2026.

Conclusions: Outlook of the study:
This study is offering valuable insights to non-pharmacological approaches in obstetric care. The study protocol and the aVNS devices have been well received by patients so far. The recruitement phase is ongoing, 67 patients recruited so far. Conclusions will be presented at the IASP 2026.

References: 1. Harris PE, Cooper KL, Relton C, Thomas KJ. Prevalence of complementary and alternative medicine (CAM) use by the general population: a systematic review and update. International Journal of Clinical Practice. 2012 Oct;66(10):924–39.
2. Farmer AD, Strzelczyk A, Finisguerra A, Gourine AV, Gharabaghi A, Hasan A, et al. International Consensus Based Review and Recommendations for Minimum Reporting Standards in Research on Transcutaneous Vagus Nerve Stimulation (Version 2020). Front Hum Neurosci. 2020;14:568051.
3. Kaniusas E, Kampusch S, Tittgemeyer M, Panetsos F, Gines RF, Papa M, et al. Current Directions in the Auricular Vagus Nerve Stimulation I - A Physiological Perspective. Front Neurosci. 2019;13:854.

Presenting Author: Sonja Granser
Submitting Author: Sonja Granser

Senior Author: Tina Linder

IASP 2026 Global Year theme of Neuropathic Pain: No

• Alex Farr: Ap.Prof. Priv.-Doz. DDr., MPH - Medical University of Vienna
• Tina Linder: Dr. - Medical University of Vienna
• Florian Heinzl: Mag, - Medical University of Vienna
• Stefan Kampusch: DI - AURIMOD GmbH