Abstract: Objective To investigate the effect of general anesthesia combined with electroacupuncture on the incidence of perioperative opioid-related adverse events in patients undergoing intracranial aneurysm intervention, and to provide reference for anesthetic management in such procedures. Methods A total of 74 patients scheduled for elective intracranial aneurysm intervention under general anesthesia at the First Affiliated Hospital of Nanjing Medical University from March 2024 to October 2024 were enrolled. The patients were randomly divided into two groups (n=37): an electroacupuncture group and a control group. In the electroacupuncture group, electroacupuncture stimulation was applied to Baihui, Neiguan (bilateral), Hegu (bilateral), and Zusanli (bilateral) acupoints for 30 min before anesthesia induction, using continuous waves at a frequency of 4 Hz. After the operation began, the stimulation was adjusted to an alternating sparse-dense wave at 2/100 Hz until the end of surgery. In the control group, sufentanil was administered during induction, and remifentanil was used for intraoperative maintenance. Heart rate and blood pressure at the moment of intubation, incidence of intraoperative hypotension, norepinephrine dosage, extubation time, length of recovery room stay, and length of hospitalization stay were recorded for both groups. At 24 h postoperatively, blood samples were collected to measure serum levels of inflammatory cytokines, including interleukin (IL)-2, IL-4, IL-6, IL-10, IL-17, IL-12P70, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α. Neuropsychiatric status was assessed using a delirium rating scale one day before surgery and three days after surgery. Postoperative opioid-related adverse events were recorded, including postoperative delirium, nausea and vomiting, constipation, and oxygenation status at 10, 20, and 30 min after extubation. Results Compared with the control group, the electroacupuncture group showed a significantly decreased incidence of intraoperative hypotension and reduced norepinephrine use. Serum IL-6 and TNF-α levels decreased, while IL-10 levels increased. The incidence of postoperative delirium, nausea and vomiting, constipation, and hypoxemia was also reduced, with shorter extubation times and reduced length of recovery room stay (P<0.05). Although there was a slight upward trend in heart rate at intubation in the electroacupuncture group, the difference was not statistically significant (P>0.05). No statistically significant differences were found in other observed indicators (P>0.05). Conclusions General anesthesia combined with electroacupuncture can effectively reduce the incidence of perioperative opioid-related adverse events and improve prognosis in patients undergoing intracranial aneurysm intervention.