New method for postoperative pain relief using a combination of noxious and non-noxious stimuli after impacted wisdom tooth extraction

Abstract

Although in clinical dentistry the major method used for pain relief is oral administration of analgesics, alternative methods are available, such as transcutaneous electrical nerve stimulation (TENS), acupuncture, vibration and conditioned pain modulation (CPM), formerly termed diffuse noxious inhibitory control. The aim of the present study was to investigate the combined effects of non-noxious (TENS) and noxious (CPM) stimuli on postoperative pain after extraction of an impacted wisdom tooth. The study involved 44 patients who were scheduled to undergo impacted wisdom tooth extraction. The patients were randomly allocated into four groups: noxious stimuli, non-noxious stimuli, combined noxious and non-noxious stimuli, and a sham group. On the day after tooth extraction, stimulation procedures for pain relief were performed and changes in the level of perceived pain were scored using a visual analog scale (VAS). The combination of non-noxious and noxious stimuli decreased the VAS scores by 63.7%, indicating a more potent analgesic effect than that in the non-noxious, noxious, and sham groups. This method of analgesia using a combination of nonnoxious and noxious stimuli can be applied to patients who are unable to tolerate analgesics, such as those with allergy, hypersensitivity or digestive disorders, and those who are pregnant.

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

“…Postoperative TENS has been proposed to minimize the need for opioid and nonopioid analgesics (5) in many types of procedures (6–12). The efficacy of TENS demonstrated in this meta‐analysis support the findings of Sbruzzi et al and reinforces the benefits of TENS in postoperative care.…”

“…TENS can be used as an effective adjunct for managing postsurgical pain and to minimize the need for opioid and nonopioid analgesics as part of a multimodal approach to pain (5). TENS has been shown to be effective in noncardiothoracic procedures, and has been implemented following abdominal, hip, knee and shoulder surgeries, amputations, and oocyte retrievals (6–12). Excessive use of narcotics to control pain following such procedures can lead to side effects such as respiratory depression, sedation, nausea, vomiting, and pruritus.…”

Postextractional pain management

“…Zmniejszenie natężenia bólu poekstrakcyjnego oraz zapobieganie rozwojowi zapalenia kości zębodołu jest możliwe poprzez odpowiednie działania podczas zabiegu. Oprócz nienagannej techniki [30], pomocna jest śródzabiegowa irygacja chlorheksydyną [3] lub ozonowaną podwójnie destylowaną wodą [11].…”

“…Do metod alternatywnych, oprócz akupunktury [34], należą: elektroakupunktura, przezskórna stymulacja nerwu (trancutaneous nerve stimulation, TENS), wykorzystująca zjawisko "bólu hamującego ból", warunkowana modulacja bólu (conditioned pain modulation, CPM). Połączenie tych metod daje korzystny skutek, zmniejszając dolegliwości po usunięciu zęba [11].…”

Pain Relief in Dental Local Anaesthesia with Vibrational Devices: Much Ado about Nothing? A Scoping Review

“…Even orthodontic therapy, regardless of the type of device used, is often perceived by patients as a painful and unpleasant [ 15 , 16 , 17 , 18 , 19 ]. For a long time, great attention has been paid to the possibility that alternative methods to the oral administration of analgesics, properly conveyed, can reduce the perception of various types of dental pain by promoting a state of well-being in the patient [ 20 ]. Transcutaneous electrical nerve stimulation (TENS), acupuncture, vibration, and conditioned pain modulation (CPM) are methods capable of controlling mechanisms underlying pain inhibition [ 20 , 21 ].…”