To evaluate whether combining thumb-tack needle treatment with routine nursing can safely reduce pain after gastric endoscopic submucosal dissection (ESD).

Seventy-eight patients after gastric ESD were randomized into an intervention group (n=39) and a control group (n=39), with 2 cases drop-off in the intervention group. Patients in the control group received postoperative conventional treatment. Patients in the intervention group received thumb-tack needle therapy at bilateral Zusanli (ST36) and Hegu (LI4) acupoints within 1 h after surgery in addition to conventional treatment, which lasted for 72 h. The primary outcome was the incidence of moderate-to-severe pain (visual analog scale [VAS] score ≥4) within 72 h after surgery. The secondary outcomes included pain intensity, analgesic usage rate, anxiety/depression score, numbers of gastrointestinal symptoms, surgery-related complications, and treatment-related adverse events.

The incidence of moderate-to-severe pain was 21.6% (8/37) in the intervention group, significantly lower (absolute difference: –24.6%; OR: 0.322; 95% CI: 0.118—0.879; P<0.05) than that in the control group (46.2% [18/39]). Compared with the control group, the intervention group showed reduced scores in the Short-Form McGill Pain Questionnaire at the 6^th, 12^th, and 24^th hour after surgery (P<0.01), and the median VAS score decreased by 2—3 points compared to the control group (P<0.01, P<0.001). No statistical differences were observed between the two groups in analgesic usage rate, anxiety/depression score, numbers of gastrointestinal symptoms or surgery-related complications. Two patients (5.4%) removed the needles prematurely due to psychological reasons, which did not affect clinical outcomes.

Thumb-tack needling therapy can effectively reduce the incidence of moderate-to-severe pain after gastric ESD and improve early postoperative pain symptoms, with a favorable safety profile.