Postoperative and Preincisional Electrical Nerve Stimulation TENS Reduce Postoperative Opioid Requirement After Major Spinal Surgery

Unterrainer, Axel F.; Friedrich, Catrin; Krenn, Michael H.; Piotrowski, W.; Golaszewski, Stefan; Hitzl, Wolfgang

doi:10.1097/ana.0b013e3181b7fef5

Cited by 35 publications

(32 citation statements)

References 17 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The RCTs with score of 3 or above were included for review [Table 2]. Eight RCTs[56789101112] with a total of 442 patients met the required criteria [Table 3]. …”

Section: Resultsmentioning

confidence: 99%

“…The surgical procedures included were thoracotomies,[56] inguinal hernia repair,[7] laparoscopic tubal ligation,[8] laparoscopic cholecystectomy,[9] spine surgery[1011] and total hip arthroplasty. [12] In all these studies TENS was used as a part of multimodal post-operative analgesia.…”

Section: Resultsmentioning

confidence: 99%

“…The evidence for efficacy of TENS as sole agent for acute pain is insufficient. [1] TENS was started in post-operative period in six studies, whereas in remaining two studies[1012] it was given before surgical incision and continued post-operatively.…”

Section: Resultsmentioning

confidence: 99%

“…[12] utilised TENS for 48 h at various time intervals and Silva et al . [9] used for 24 h. In two studies,[711] it was applied twice in immediate post-operative period, while in three studies[6810] it was used once. At each time interval when TENS was activated, it was applied for duration of 20-30 min in most of the studies.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Role of transcutaneous electrical nerve stimulation in post-operative analgesia

et al. 2014

View full text Add to dashboard Cite

The use of transcutaneous electrical nerve stimulation (TENS) as non-pharmacological therapeutic modality is increasing. The types of TENS used clinically are conventional TENS, acupuncture TENS and intense TENS. Their working is believed to be based on gate control theory of pain and activation of endogenous opioids. TENS has been used in anaesthesia for treatment of post-operative analgesia, post-operative nausea vomiting and labour analgesia. Evidence to support analgesic efficacy of TENS is ambiguous. A systematic search of literature on PubMed and Cochrane Library from July 2012 to January 2014 identified a total of eight clinical trials investigating post-operative analgesic effects of TENS including a total of 442 patients. Most of the studies have demonstrated clinically significant reduction in pain intensity and supplemental analgesic requirement. However, these trials vary in TENS parameters used that is, duration, intensity, frequency of stimulation and location of electrodes. Further studies with adequate sample size and good methodological design are warranted to establish general recommendation for use of TENS for post-operative pain.

show abstract

“…The RCTs with score of 3 or above were included for review [Table 2]. Eight RCTs[56789101112] with a total of 442 patients met the required criteria [Table 3]. …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Role of transcutaneous electrical nerve stimulation in post-operative analgesia

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Although not new techniques, intra-operative lidocaine infusion [99], TENS [100] and acupressure [101,102] have also been reported to improve intra-operative comfort and satisfaction and reduce postoperative pain scores and opioid consumption. The finding that intravenous intraoperative lidocaine infusion offers better analgesic quality, functional rehabilitation and quality of life at 1 month after complex spine surgery than placebo does not warrant a change of practice yet.…”

Section: Alternatives Other Than Conventional Pain Therapymentioning

confidence: 99%

Regional Analgesia Techniques for Spine Surgery: A Review with Special Reference to Scoliosis Fusion

N-M¹,

Mb²,

Sermeus³

et al. 2015

J Spine

View full text Add to dashboard Cite

The use of regional analgesia techniques for postoperative analgesia in spine surgery is less frequently used in comparison with conventional oral and parenteral treatment. This may be explained by the fact that surgery is mostly performed under general anesthesia. Although objections of the surgeon are comprehensible, there is a growing number of studies using regional techniques for the treatment of pain after this surgery.When postoperative analgesia is the focus then regional techniques can be initiated at any time-point of the procedure while all ages and types of surgery, even extensive scoliosis fusion may benefit from it. The present overview will focus on the feasibility of (loco)regional techniques to be used for postoperative analgesia, medications used alone or in combination, as a single bolus or through persistent catheters and with special attention to pain relief following scoliosis repair.In general neuraxial techniques offer lower pain scores and/or less need for opioid rescue in comparison with systemic conventional analgesia although much less benefit may be noticed in patients operated for spinal fusion than for disc surgery, laminectomy and adolescent scoliosis correction. The actual literature provides little evidence with respect to the best timing of initiation, the best route nor the best dose in relationship to the type of surgery. Besides neuraxial techniques several alternatives have found their way in this type of intervention. As all techniques described offered variable success rates, future research is mandatory to determine their superiority over general anesthesia and conventional pain therapy modalities.

show abstract

Thirty minute transcutaneous electric acupoint stimulation modulates resting state brain activities: A perfusion and BOLD fMRI study

Jiang¹,

Hao²,

Zhang³

et al. 2012

Brain Research

View full text Add to dashboard Cite

Postoperative and Preincisional Electrical Nerve Stimulation TENS Reduce Postoperative Opioid Requirement After Major Spinal Surgery

Abstract: Background and Objective: Preincisional and postoperative transcutaneous electrical nerve stimulation (TENS) administration reduces postoperative opioid demand in abdominal surgery. Aim of this study was to find out whether a comparable effect of TENS applies in major spinal surgery.

Cited by 35 publications

References 17 publications

Role of transcutaneous electrical nerve stimulation in post-operative analgesia

Role of transcutaneous electrical nerve stimulation in post-operative analgesia

Regional Analgesia Techniques for Spine Surgery: A Review with Special Reference to Scoliosis Fusion

Thirty minute transcutaneous electric acupoint stimulation modulates resting state brain activities: A perfusion and BOLD fMRI study

Contact Info

Product

Resources

About