An interventional study of Transcranial direct current stimulation and Transcranial direct current stimulation (placebo stimulation) in Itching Symptoms and Itching Caused by Epidural Use of Opioids, sponsored by Affiliated Hospital of Nantong University. Recruiting at 1 site in China. Open to participants aged 18 Years to 40 Years. Per ClinicalTrials.gov, last updated 2026-09-17.
Sponsored by Affiliated Hospital of Nantong University · Not applicable, Interventional, and Prevention
Cesarean section is the most common obstetric surgery worldwide. Epidural anesthesia has become the preferred anesthesia method for cesarean sections due to its definite analgesic effect and minimal impact on mother and baby. To ensure postoperative analgesia, intrathecal administration of morphine (the preferred opioid for obstetric intrathecal analgesia) is a routine clinical protocol, but morphine-induced postoperative pruritus is a common adverse reaction. A study targeting the cesarean section population confirmed that the incidence of pruritus after epidural morphine administration is as high as 40%-75%.Transcranial direct current stimulation (tDCS) can enhance the activity of GABAergic inhibitory interneurons in the spinal dorsal horn through the cortical-spinal descending pathway, reverse the inhibitory effect of morphine on them, and restore negative feedback regulation of itch-specific GRPR⁺ neurons; at the same time, it downregulates the phosphorylation level and membrane expression of μ-opioid receptors in the spinal dorsal horn, weakening the receptor activation efficiency of morphine. On the other hand, tDCS can reduce peripheral nerve excitability, decrease mast cell degranulation in the skin, and reduce the release of histamine and tryptase; simultaneously, it inhibits the activation of glial cells in the spinal cord/cortex, decreases the secretion of pro-inflammatory factors such as TNF-α and IL-6, and blocks the vicious cycle of 'inflammation-receptor upregulation-itch exacerbation,' thereby reducing the occurrence of itch.This study aims to explore the effect of transcranial direct current stimulation (tDCS) on the incidence of morphine-induced itching after cesarean section by inhibiting the central itch perception circuits in cesarean section patients and antagonizing the disinhibitory effects mediated by μ-opioid receptors in the spinal dorsal horn.
Exclusion Criteria:
Device: Transcranial direct current stimulation (placebo stimulation)
Device: Transcranial direct current stimulation
Patients in the transcranial direct current stimulation (tDCS) group had the anode of the tDCS device placed on the left dorsolateral prefrontal cortex (F3 area) and the cathode on the right mastoid. The tDCS was administered on the day of surgery (starting within 5 minutes after delivery of the fetus and ending upon transfer to the PACU after surgery). The current intensity was 1.5 mA.
Sham stimulation group (control group): The anode of the electrical stimulator is placed on the left dorsolateral prefrontal cortex (F3 region) and the cathode on the right mastoid area. A current of 1.5 mA is applied only during the first 30 seconds after the start of stimulation, after which the current is reduced to 0 mA. All other procedures (electrode placement, stimulation duration, intervention frequency) are the same as those in the experimental group.
Incidence of itching within 24 hours after surgery (defined as VAS itching score ≥1)
The VAS scoring standard for the degree of itching is a tool used to assess the severity of itching. VAS stands for Visual Analog Scale. The following are the standards for VAS scoring of itching severity: 0 points: No itching. 1-3 points: Mild itching, does not affect daily life. 4-6 points: Moderate itching, somewhat affects daily life. 7-9 points: Severe itching, seriously affects daily life, requires active treatment. 10 points: Extremely severe itching, unbearable, requires immediate treatment.
Time frame: 24 hours after surgery
Incidence of itching at 12 and 48 hours postoperatively; VAS scores for itching at each time point; duration of itching and time of peak appearance
Time frame: 12 hours post-operation and 48 hours post-operation
Number of times the analgesic pump was pressed and the doses of additional morphine within 48 hours postoperatively; VAS pain scores at 12, 24, and 48 hours postoperatively
Time frame: 12 hours, 24 hours, and 48 hours after surgery
Maternal adverse reactions (nausea and vomiting, drowsiness, dizziness, ear pain, skin erythema) incidence; neonatal 1-minute and 5-minute Apgar scores, birth weight, complications within 72 hours (jaundice, shortness of breath, feeding difficulties)
Time frame: Within 72 hours after surgery
Preoperative and postoperative 24h serum histaminelevels
Time frame: 24 hours before surgery and 24 hours after surgery
Preoperative and postoperative 24h trypsin-like enzymelevels
Time frame: 24 hours before surgery and 24 hours after surgery
Preoperative and postoperative 24h TNF-α levels
Time frame: 24 hours before surgery and 24 hours after surgery
Preoperative and postoperative 24h IL-6 levels
Time frame: 24 hours before surgery and 24 hours after surgery
Preoperative and postoperative 24h β-endorphin levels
Time frame: 24 hours before surgery and 24 hours after surgery
Preoperative and postoperative 24h gastrin-releasing peptide precursor (ProGRP) levels
Time frame: 24 hours before surgery and 24 hours after surgery
Plan to share: No
No publications or documents are linked to this record.
Eligibility is decided by the study team. Share this record with your doctor or contact the team directly.
Contact study teamGet an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Affiliated Hospital of Nantong University