Transcutaneous electrical nerve stimulation effect on postoperative complications

Abstract

Objectives Transcutaneous electrical nerve stimulation has been used to control post-thoracotomy pain, with conflicting results. We aimed to assess its efficacy on post-thoracotomy pain and early complications. Methods Between January 2012 and December 2014, 87 patients underwent a standard posterolateral thoracotomy and were randomized in 2 groups: group T was 43 patients who had transcutaneous electrical nerve stimulation and group C was 44 patients who had placebo stimulation with an inoperative device. Pain score was measured using a visual analogue scale ranging from 0 to 10. The frequency of the device was set at 100 Hz and pulse width at 100 ms. Results There were no statistically significant differences in the demographic characteristics of the 2 groups, and there was no difference in the duration of hospitalization (4.74 ± 1.6 vs. 5.23 ± 1.5 days; p = 0.06). Postoperative pain scores of the two groups showed that on postoperative day 0, 1, and 2, the mean pain scores of group T were significantly lower ( p = 0.001, p < 0.001, and p = 0.003). There were no significant differences in early complications or surgical technique. Conclusion We concluded that electrical stimulation is a safe and effective adjunctive therapy for acute post-thoracotomy pain control. However, it does not affect the duration of hospitalization or early pulmonary complications.

Efficacy of Transcutaneous Electrical Nerve Stimulation for Postoperative Pain, Pulmonary Function, and Opioid Consumption Following Cardiothoracic Procedures: A Systematic Review

“…After duplicates were removed, 30 studies underwent the title and abstract screening. After this screening, ten studies remained for a full text review (14,15,26–32). These results are summarized in the PRISMA flow diagram (Fig.…”

“…Two studies involved cardiac procedures (myocardial revascularizations, aortic and valve replacements, myxoma resections, atrial septal defect corrections, and CABG) (26,31). Six studies involved different thoracotomy approaches for lung cancer and lung nodule resection, pleural effusions, mediastinal adenopathy, emphysema, and pleural thickening (15,27–30,32). In each study, the addition of TENS was compared to pharmacological therapy alone.…”

“…Five studies used a placebo TENS device with modified pulses or an inactive device (15,26–28,31). Three studies did not specify that a placebo device was used (29,30,32). Pharmacological therapy for pain management and the timing of initiation, frequency, and termination of TENS varied in each study.…”

“…All eight studies included in the review used the VAS to measure patient‐reported postoperative pain (15,26–32), where 0 indicated “no pain” and a score of 10 was “the worst imaginable pain.” (33) Four studies specified levels of pain at rest and with coughing (26,27,30,31). Two studies evaluated pain with movement of the upper extremities (27,28).…”

Post-thoracotomy analgesia

“…[ 84 ] In combination with traditional post-thoracotomy analgesia, TENS has been shown to decrease pain and analgesic consumption without significant side effects or prolongation of hospital stay. [ 85 86 87 ] However, these benefits seem to be short-lived and only last while the TENS is in use. [ 88 ] Similarly, cold therapy in the form of ice packs can be used to decrease incisional pain and inflammation and decrease opioid requirements.…”