Evaluation of Percutaneous Electrical Nerve Stimulation of the Auricle for Relief of Postoperative Pain Following Cesarean Section

Abstract

Objective: Percutaneous electrical nerve stimulation is a nonpharmacologic modality of analgesia. This study was conducted to evaluate such a technology (ANSiStimÔ, DyAnsys Inc., San Mateo, CA) prospectively, in conjunction with standard analgesia per patient demand, for managing postoperative pain following lowersegment cesarean section. Materials and Methods: One hundred parturients were randomized into 2 equal groups (controls and study cases). The latter cohort consisted of parturients for whom nerve stimulation was exerted on the pinna. Pain scores were compared across subjects at corresponding time points with 17 intervals in 48 hours, and, in totality, using estimated area under the curves of numerical scores. Conditional inference analysis was also performed. Results: Ninety-six parturients were finally included. The device was well-tolerated by a majority of parturients. Pain scores were significantly lower in the study group, both at corresponding time intervals and in totality. (H-15)*(0.74-H)*(H 2-17H + 110)/440, where H was the corresponding hour, fit the pain scores in the control group. Controls could be detected at the 11 hour with greater pain scores (‡ 4), whereas smaller scores (£ 2) at the 42nd hour mostly revealed that electrical stimulation was performed (p < 0.001). Requirements for supplementary analgesics were lower for subjects who were given the electroanalgesia. Conclusions: Neurostimulation via the ANSiStimÔ is a safe and reasonably effective ambulatory analgesic adjuvant following abdominal delivery. There are no serious adverse effects.

PROSPECT guideline for elective caesarean section: updated systematic review and procedure‐specific postoperative pain management recommendations

“…A total of 145 studies were included, of which 126 were randomised controlled trials and 19 were systematic reviews and meta‐analyses (Fig. 1) [9–153]. The methodological quality assessments of the 126 randomised controlled trials included in the final qualitative analysis are summarised in online Supporting Information Table S1.…”

“…Several investigators reported on the beneficial effects of transcutaneous electrical nerve stimulation on pain scores, rescue analgesia use and patient satisfaction [126,127]. A study demonstrated that self-administered oral opioid analgesia was as effective as parenteral nurse-administered drugs [128].…”

Klinische Wirksamkeit der aurikulären Vagusnervstimulation in der Behandlung chronischer und akuter Schmerzen

“…kurz nachaVNS festgestellt werden. [14,31,67,74], n = 115), abdominale Eingriffe (4 Studien [1,7,15,45], n = 67), Tonsillektomie (1 Studie [35], n = 16), und Backenzahnextraktion (1 Studie [48], n = 48). Von diesen waren 7 Studien [7,31,35,45,48,67,74] randomisierte kontrollierte Studien (RCTs) hoher Qualität mit einer durchschnittlichen Bewertung von 7,1 aus 9 Punkten (.…”

“…4). 2 weitere Studien [1,14] waren Fall-Kontrollstudien und 1 Studie [15] war eine Fallserie mit einer durchschnittlichen Bewertung von 3,8 Punkten.…”

The effect of transcutaneous electrical nerve stimulation (TENS) on pain control and phenylethanolamine-N-methyltransferase (PNMT) gene expression after cesarean section

“…on the effect of TENS on reducing pain after cesarean section showed that TENS significantly reduced analgesic drug use by up to 50%, as well as the severity and duration of pain in the case group (13). Other studies have also generally shown the effect of TENS in reducing pain by up to 70% compared to not using it (14)(15)(16).…”