Background:
Transcutaneous Electrical Nerve Stimulation (TENS) is a non-invasive
pain therapy that uses the sensory effects of an electrical current applied to the skin. Some clinical
studies demonstrated that this treatment helps to reduce acute and chronic pains, while others gave
sometimes contradictory or uncertain conclusions about the performances of this strategy according
to pathology classification. The purpose of this study is the development and evaluation of a
new modulated version of transcutaneous electrical nerve stimulation called PWM-TENS. The
principle is based on an automatic variation of the stimulation parameters (frequency, amplitude,
duration, shape, cyclic ratio) according to the pain evolution.
Methods:
The study was a controlled clinical trial involving 15 participants, divided into 2 groups.
The first experimental group performed modulated PWM-TENS electro-stimulation sessions applied
to the painful areas 3 to 4 times a day, for one month. The second control group did parallel
treatments by Placebo. The evaluation of the pain intensity is done with the Visual Analog Scale
(EVA), the DN4 and SF36 questionnaires.
Results:
The tests and measurements with our embedded PWM-TENS technique demonstrated
that we succeeded to increase the analgesic effect after stopping the stimulation and reduced the
pain sensation by about 60%. An improvement in pain intensity scores and questionnaires (EVA,
DN4), as well as the quality of life score (SF36), was observed. Also, a reduction of the treatment
period from 3 to 1 month was also obtained.
Conclusion:
The first results clinically observed in the PWM-TENS technique are encouraging.
The findings of this study confirm that this noninvasive strategy is suitable and useful for acute
pains coming from the nociceptive, neuropathic and musculoskeletal origin. However, its efficiency
is moderated and less adapted for low back pain. The experiments make it possible to estimate
whether this modulated TENS method could improve existing anti-pain therapies, taking into
account objective and subjective evaluation criteria. But this study must be followed by large
population samples to answer all the problems of acute and chronic pains.
Background. In intensive care, monitoring the depth of anesthesia during surgical procedures is a key element in the success of the medical operation and postoperative recovery. However, despite the development of anesthesia thanks to technological and pharmacological advances, its side effects such as underdose or overdose of hypnotics remain a major problem. Observation and monitoring must combine clinical observations (loss of consciousness and reactivity) with tools for real-time measurement of changes in the depth of anesthesia. Methodology. In this work, we will develop a noninvasive method for calculating, monitoring, and controlling the depth of general anesthesia during surgery. The objective is to reduce the effects of pharmacological usage of hypnotics and to ensure better quality recovery. Thanks to the overall activity of sets of neurons in the brain, we have developed a BIS technique based on bispectral analysis of the electroencephalographic signal EEG. Discussion. By collecting the electrical voltages from the brain, we distinguish light sleep from deep sleep according to the values of the BIS indicator (ranging from 0 : sleep to 100 : wake) and also control it by acting on the dosage of propofol and sevoflurane. We showed that the BIS value must be maintained during the operation and the anesthesia at a value greater than 60. Conclusion. This study showed that the BIS technology led to an optimization of the anesthetic management, the adequacy of the hypnotic dosage, and a better postoperative recovery.
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