Key result
TENS significantly reduced the need for opioid administration and improved spirometric breath function during the 5-day postoperative period following posterolateral thoracotomy.
Why the study?
Does transcutaneous electrical nerve stimulation (TENS) reduce postoperative pain and opioid consumption in patients undergoing posterolateral thoracotomy?
RCT (n=116)
Double-blind
Randomized
No
Does transcutaneous electrical nerve stimulation (TENS) reduce postoperative pain and opioid consumption in patients undergoing posterolateral thoracotomy?
p-value: p=0.013
TENS is a safe and effective adjunctive therapy that significantly reduces opioid requirements and improves pulmonary function following posterolateral thoracotomy.
Supports TENS as opioid-sparing adjunct after thoracotomy; confirms benefit in high-pain thoracic procedures.
We investigated the efficacy of transcutaneous electrical nerve stimulation (TENS) for postthoracotomy pain control in a prospective, randomized, double-blind, placebo-controlled study. We studied two groups of patients undergoing posterolateral thoracotomy. In group 1, TENS was used postoperatively on 60 patients for 5 days. Group 2 contained 56 patients without TENS. In both groups a visual analog scale (VAS) was used to indicate if analgesia was needed. When the VAS was higher than 4, an analgesic was administered. We observed the forced expiratory volume in 1 second (FEV(1)), the forced vital capacity (FVC), partial arterial oxygen pressure (PaO2), partial arterial carbon dioxide pressure (PaCO2), and how many doses of analgesia were given at postoperative 0 (extubation time), 2, 6, 12, 24, 48, 72, and 120 hours. TENS was not employed in patients with cardiac or neurologic disease. In group 1, TENS reduced the need to administer opioids during the 5-day postoperative period. This result is statistically significant (P = 0.013). Additionally, following the sixth postoperative hour, TENS increased the spirometric breath function. The FEV1, FVC, and PaO2 were high and PaCO2 was low when the first group is compared to the second. All these results are statistically significant (P = 0.012, P = 0.01, P = 0.024, and P = 0.02 respectively). We observed that TENS produced no evidence of side effects or intolerance in the patients of group 1. TENS is thus beneficial for pain relief following thoracotomy and has no side effects. Consequently, the routine use of TENS following thoracic surgery is recommended.
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Erdoğan et al. (2005) conducted an RCT in Postthoracotomy pain (n=116). Transcutaneous electrical nerve stimulation (TENS) vs. Placebo TENS (inoperative) was evaluated on Need to administer opioids during the 5-day postoperative period (p=0.013). TENS significantly reduced the need for opioid administration and improved spirometric breath function during the 5-day postoperative period following posterolateral thoracotomy.
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