Transcranial electrical stimulation in chronic pain syndrome after mastectomy: analgesic effect, changes in cortisol and β-endorphin levels

BACKGROUND: Chronic postmastectomy pain syndrome (СPPS) occurs in 20–50% of patients and significantly reduces quality of life. Venlafaxine is used in complex rehabilitation protocols, but its effectiveness may be limited by side effects. Transcranial electrical stimulation (TES) is considered a potential non-pharmacological alternative.

AIM: To evaluate the effectiveness of transcranial electrical stimulation used as an alternative to venlafaxine within the recommended complex rehabilitation algorithm in achieving pain relief and normalizing plasma cortisol and β-endorphin levels in patients with СPPS.

MATERIALS AND METHODS: The study included 90 outpatients with СPPS, randomized into two groups: the main group (n = 45), which received TES instead of venlafaxine within the recommended rehabilitation protocol, and the comparison group (n = 45), which received the standard algorithm including venlafaxine. Effectiveness was assessed on day 56 using the visual analog scale (VAS) and plasma levels of cortisol and β-endorphin. The control group included 80 patients without СPPS.

RESULTS: After 56 days of rehabilitation, statistically significant differences were observed between the study groups in the proportion of patients achieving complete pain relief (p = 0,-17), as well as in cortisol (p = 0,001) and β-endorphin levels (p < 0,001).

CONCLUSION: The results suggest that TES can be considered an effective and safe alternative to antidepressant pharmacotherapy within complex rehabilitation programs for patients with СPPS.