Vagus nerve stimulation: a potential tool to further improve perioperative anesthesia management quality and postoperative recovery?

Vagus nerve stimulation (VNS) is a promising neuromodulation technique that exerts organ-protective effects through the activation of cholinergic anti-inflammatory pathways and the modulation of the autonomic nervous system. In recent years, its potential applications in perioperative medicine have garnered increasing research attention. A limited body of clinical evidence indicates that VNS can alleviate the inflammatory response induced by surgical stress by inhibiting the α7 nicotinic acetylcholine receptor (α7nAChR)-mediated NF-κB signaling pathway. It may reduce the demand for opioids in perioperative pain management, potentially accelerate patients' postoperative recovery, and show promise for improving outcomes in cardiac, abdominal, and neurosurgical procedures. Herein, this article explores the potential further application directions of VNS in the perioperative period and summarizes the possible mechanisms based on previous studies, including preoperative anxiety management, intraoperative adjuvant anesthesia, postoperative pain management, and complication prevention. In summary, this review explores the potential of VNS to contribute to personalized perioperative management, while acknowledging that its widespread clinical integration necessitates further rigorous investigation.