Effects of Transcutaneous Electrical Nerve Stimulation on Pain, Pulmonary Function, and Respiratory Muscle Strength After Posterolateral Thoracotomy: A Randomized Controlled Trial

Abstract

Purpose To evaluate the effects of transcutaneous electrical nerve stimulation (TENS) compared to placebo TENS and a control group on pain, pulmonary function, respiratory muscle strength, and analgesic medications in the postoperative period of thoracotomy in an Intensive care unit (ICU). Methods Patients who had undergone posterolateral thoracotomy were randomly allocated to receive TENS during ICU stay, or placebo TENS, or into the control group. All groups received conventional physiotherapy. We analysed the intensity of pain, pulmonary function, respiratory muscle strength, and use of analgesia medications. Outcomes were evaluated before surgery, immediately after, 24 and 48 h after ICU admission. Results Forty-five patients were included. Regarding pain perception, there was no difference between groups (p = 0.172), but there was a significant reduction in pain intensity for patients receiving TENS after first physiotherapy session compared to baseline (4.7 ± 3.2 vs 3.3 ± 2.6; p < 0.05). All groups had a decrease in forced vital capacity (FVC) after surgery (p < 0.001). There was no difference between the groups regarding the use of analgesic medications, but a higher intake of morphine and acetaminophen were observed for the control (p = 0.037) and placebo group (p = 0.035), respectively. Conclusion The use of TENS provides a little benefit of pain (in the first 12 h) but failed to demonstrate any improvement in the recovery of ICU patients after 48 h of posterolateral thoracotomy. Trial Registration NCT02438241.

High frequency transcutaneous electrical stimulation in the immediate postoperative period of anterior cruciate ligament reconstruction: a randomized clinical trial

“…However, some studies demonstrate the effects of TENS on other orthopedic trauma surgeries 4,9,10,[12][13][14][15] . Moreover, many studies address the effects of TENS on other types of surgery 8,11,[16][17][18][19][20][21][22][23] The results showed that almost continuous stimulation by high-frequency TENS associated with a predefined exercise and mobilization protocol during the first phase of ACL reconstruction rehabilitation led to a significant additional effect in improving acute postoperative pain. Forogh et al 3 added TENS to the immediate postoperative protocol in 70 athletes who underwent ACL reconstruction surgery.…”

“…These findings corroborate previous studies that analyzed analgesic intake with TENS application after several types of surgeries. Some authors addressed the use of opioids after thoracic surgery and showed a lower intake for patients receiving TENS compared to the control group 21 . Silva et al 10 showed that continuous TENS application for 72 after proximal femoral fracture surgery significantly decreases drug intake.…”

Effects of electrical stimulation on skin surface

“…TENS can also be used as an adjuvant therapy after surgery. Hush et al [90] show that after thoracotomy in the intensive care unit (ICU), TENS adjuvant therapy can relieve pain in the first 12 h. As one of the difficult to treat diseases, eye pain usually cannot be relieved because of the difficulty of treating the ocular surface. In a recent TNES assisted long-term treatment of eye pain, the TENS experimental group reduced pain by 27.4% compared to the control group, which can assist in the treatment of eye pain [91].…”

High Frequency Transcutaneous Electrical Nerve Stimulation in the Immediate Postoperative Period of Anterior Cruciate Ligament Reconstruction and Its Effects on Drug Costs During Hospitalization

“…A study analyzed the use of opioids after thoracic surgery and demonstrated a lower opioid intake for patients receiving TENS in comparison to the control group. (11). Silva et al (15) demonstrated that continuous use of TENS (24 hours a day, ending 72 hours after surgery) for proximal femoral fracture significantly decreased drug intake (15).…”

“…In comparison to other analgesic methods, it also has the advantage of minor side effects (10). Due to this analgesic effect, TENS can be administered in the postoperative routine of several surgical conditions as an adjunct to conventional opioid analgesia (11). This study evaluates the effects of using high frequency TENS on pain, function, and opioid analgesic consumption in the immediate postoperative period of ACL reconstruction.…”