Estimulação elétrica nervosa transcutânea no alívio da dor pós-operatória relacionada com procedimentos fisioterapêuticos em pacientes submetidos a intervenções cirúrgicas abdominais

Abstract

Rev Bras Anestesiol ARTIGO CIENTÍFICO 2006; 56: 6: 630-642 SCIENTIFIC ARTICLE RESUMO Tonella RM, Araújo S, Silva AMO -Estimulação Elétrica Nervosa Transcutânea no Alívio da Dor Pós-Operatória Relacionada com Procedimentos Fisioterapêuticos em Pacientes Submetidos a Intervenções Cirúrgicas Abdominais. JUSTIFICATIVA E OBJETIVOS:A eletroestimulação nervosa transcutânea (TENS) tem sido pouco estudada como método facilitador da fisioterapia pós-operatória. O objetivo do estudo foi verificar a eficácia da TENS no alívio da dor relacionada com fisioterapia pós-operatória em pacientes submetidos a intervenções cirúrgicas abdominais. MÉTODO: BACKGROUND AND OBJECTIVES:There are few studies on transcutaneous electrical stimulation (TENS) as an adjunct to postoperative physical therapy. The objective of this study was to determine the efficacy of TENS on relieving pain related to physical therapy after abdominal surgery. METHODS:A clinical, randomized, prospective study was undertaken with 48 patients on the first postoperative day, who presented a pain score ≥ 3 on the visual analogic scale (VAS). Patients were divided in three groups: Control Group: treated with the usual analgesic routine, without TENS, and with physical therapy; Study Group: treated with the usual analgesic routine associated with TENS and physical therapy; Contrast-Placebo Group: treated with the usual analgesic routine associated with physical therapy but TENS was off. A visual analogic scale of pain was presented to the patients before (M1), after TENS (M2), and after physical therapy (M3) -cough, incentive spirometry, changing lateral decubitus and sitting -to quantify the efficacy of the analgesia. Electrical stimulation was done during 30 minutes. RESULTS:The Study Group presented a significant relief of the pain when compared to the other two groups only for coughing at M3 (p= 0.015). In this group, there was a significant reduction in pain associated with coughing (p= 0.003) [M1 versus M3]; with lateral decubitus (p= 0.025), sitting (p= 0.001), and with incentive spirometry (p= 0.017) [M1 versus M2]; and when changing to the lateral decubitus (p= 0.03) and sitting (p= 0.001) [M1xM3]. There were no significant differences in the Contrast-Placebo Group. CONCLUSIONS:The Study Group presented a reduction in pain in a few moments and parameters. Further studies are needed since TENS is indicated only as an adjuvant in controlling postoperative pain.

A dor interfere na função respiratória após cirurgias cardíacas?

“…In a recent study, Tonella et al [26], using transcutaneous electrical stimulation have shown pain relief in postoperative abdominal surgery, on which the patients in the study group had lower pain scores during forced coughing and respiratory incentives. This type of therapy may also be used for patients in the postoperative of heart surgery with the benefit of reduced use of sedatives and their side effects.…”

Efeitos Da Eletrolipolise Na Adiposidade Abdominal: Revisão

“…Foi observado que 45,97% dos pacientes procuravam a fisioterapia dermatofuncional para tratamento da adiposidade localizada, seguindo de 19,30% para estrias, 7,15% para celulite, 7,6% para rugas, obesidade 3,6%, flacidez abdominal 3,15%, flacidez facial 2% entre outras doenças 11,50%. (10) Quanto aos equipamentos e parâmetros observou-se um frequente uso do tens para promoção da lipólise. O tens é um estimulador elétrico com a capacidade de ativar os nervos periféricos com eletrodos colocados na superfície do corpo, onde geram pulsos de tensão.…”

Estimulação elétrica nervosa transcutânea após cirurgia de revascularização miocárdica

“…The transcutaneous electrical nerve stimulation (TENS) is a physical therapy feature widely used for symptomatic relief of pain and it can be a useful adjunct in the management of postoperative pain [11][12][13][14][15][16]. This form of stimulation does not produce systemic effects, it is not invasive or pharmacological, it is not addictive, nor does it have side effects and absolute contraindications it is a lowcost procedure, in addition to allow the patient to participate more completely in physical therapy [11 , 17].…”

“…This form of stimulation does not produce systemic effects, it is not invasive or pharmacological, it is not addictive, nor does it have side effects and absolute contraindications it is a lowcost procedure, in addition to allow the patient to participate more completely in physical therapy [11 , 17]. It has been reported in the literature that pain relief after surgery by the use of TENS is associated to the reduction of the use of opiates [10,16,[18][19][20].…”

“…The basis of the effect of TENS is given as the Theory of Gates, developed in 1965 by Melzack & Wall, who claimed that the overstimulation of type A fibers promotes blocking of incoming stimulus by type C fibers in the gates of the posterior horn of the spinal cord in the jelly substance and the transmission cells (T cells) [16].…”