{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T16:52:30Z","timestamp":1782492750267,"version":"3.54.5"},"reference-count":50,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T00:00:00Z","timestamp":1772668800000},"content-version":"unspecified","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Beijing Administration of Traditional Chinese Medicine","award":["No. BJZYYB-2025-34"],"award-info":[{"award-number":["No. BJZYYB-2025-34"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,2,18]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early mobilisation represents a core element of enhanced recovery after surgery (ERAS) and is recommended after minimally invasive spine surgery including unilateral biportal endoscopy (UBE). However, strategies to facilitate early mobilisation after UBE remain limited. Transcutaneous electrical acupoint stimulation (TEAS) may improve postoperative pain and recovery after spine surgery, but available evidence in UBE remains inconclusive.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate whether perioperative TEAS enhances postoperative recovery after UBE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-centre randomised controlled trial with blinded assessors will enrol 114 patients undergoing elective UBE discectomy. Participants will be randomly allocated (1:1) by simple randomisation to receive stimulation via self-adhesive electrodes, either single-session TEAS at Neiguan, Dazhui, Chengshan and Sanyinjiao initiated 30\u2009min before surgery until the end of the procedure using a disperse\u2013dense waveform (2\/100\u2009Hz) with individualised intensity (10\u201315 mA) or sham stimulation applied at four non-meridian, non-acupoint sites with brief initial stimulation followed by 0 mA output. Standardised general anaesthesia with bispectral index and analgesia nociception index monitoring will be provided following ERAS recommendations. The primary outcome is successful ambulation rate at 6\u2009hour postoperatively; baseline pain, nausea, quality of recovery and functional status will be assessed using the Numerical Rating Scale, Visual Analogue Scale, Quality of Recovery-15 questionnaire, Oswestry Disability Index (ODI) and Japanese Orthopaedic Association (JOA) score at baseline before intervention while postoperative pain, nausea and vomiting, opioid consumption and Quality of recovery will be evaluated at 6, 24 and 48\u2009hours after surgery, with ODI and JOA assessed during longer-term follow-up and surgery-related adverse events monitored postoperatively. Continuous outcomes will be analysed using parametric (repeated-measures analysis of variance) or non-parametric (Mann-Whitney U) tests, and categorical variables using \u03c7\u00b2 or Fisher\u2019s exact tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethical considerations and dissemination<\/jats:title>\n                    <jats:p>This study was approved by the Ethics Committee of Beijing Friendship Hospital (No: 2024-P2-087-01) and registered with Chinese Clinical Trial Registry. Results will be published in peer-reviewed journals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>ChiCTR2400083344.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-113729","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T14:40:13Z","timestamp":1772721613000},"page":"e113729","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of transcutaneous electrical acupoint stimulation on early mobilisation in patients undergoing unilateral biportal endoscopic discectomy: a study protocol for a randomised controlled trial"],"prefix":"10.1136","volume":"16","author":[{"given":"Xin","family":"Luo","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7295-8993","authenticated-orcid":false,"given":"Yuxuan","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Xin","family":"An","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,3,5]]},"reference":[{"key":"2026062609354273000_16.3.e113729.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.5921"},{"key":"2026062609354273000_16.3.e113729.2","doi-asserted-by":"crossref","DOI":"10.1016\/j.wnsx.2024.100279","article-title":"Lumbar disc herniation: Epidemiology, clinical and radiologic diagnosis WFNS spine committee recommendations","volume":"22","author":"Pojskic","year":"2024","journal-title":"World Neurosurg X"},{"key":"2026062609354273000_16.3.e113729.3","doi-asserted-by":"crossref","DOI":"10.3892\/etm.2023.12008","article-title":"Efficacy and safety of unilateral biportal endoscopy compared with microscopic decompression in the treatment of lumbar spinal stenosis: A systematic review and updated meta\u2011analysis","volume":"26","author":"Wang","year":"2023","journal-title":"Exp Ther Med"},{"key":"2026062609354273000_16.3.e113729.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.12.005"},{"key":"2026062609354273000_16.3.e113729.5","doi-asserted-by":"crossref","DOI":"10.1016\/j.wnsx.2022.100120","article-title":"Enhanced Recovery After Surgery Protocol in Minimally Invasive Lumbar Fusion Surgery Reduces Length of Hospital Stay and Inpatient Narcotic Use","volume":"14","author":"Band","year":"2022","journal-title":"World Neurosurg X"},{"key":"2026062609354273000_16.3.e113729.6","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1097\/ACO.0000000000001510","article-title":"Enhanced recovery after neurosurgery","volume":"38","author":"Canelli","year":"2025","journal-title":"Curr Opin Anaesthesiol"},{"key":"2026062609354273000_16.3.e113729.7","doi-asserted-by":"crossref","first-page":"E1039","DOI":"10.1097\/BRS.0000000000003495","article-title":"Enhanced Recovery Implementation and Perioperative Outcomes in Posterior Fusion Patients","volume":"45","author":"Fiasconaro","year":"2020","journal-title":"Spine (Phila Pa 1986)"},{"key":"2026062609354273000_16.3.e113729.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12891-024-07606-8","article-title":"Association between delayed ambulation and increased risk of adverse events after lumbar fusion surgery in elderly patients","volume":"25","author":"Wang","year":"2024","journal-title":"BMC Musculoskelet Disord"},{"key":"2026062609354273000_16.3.e113729.9","doi-asserted-by":"publisher","DOI":"10.1111\/os.12953"},{"key":"2026062609354273000_16.3.e113729.10","doi-asserted-by":"crossref","first-page":"2354","DOI":"10.1111\/os.13814","article-title":"Does Immediate Postoperative Early Ambulation Affect Clinical Results of Full-Endoscopic Lumbar Discectomy? 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