Prospective, Randomized, Placebo‐controlled Study of the Effect of TENS on Postthoracotomy Pain and Pulmonary Function

Abstract

We investigated the efficacy of transcutaneous electrical nerve stimulation (TENS) for postthoracotomy pain control in a prospective, randomized, double-blind, placebo-controlled study. We studied two groups of patients undergoing posterolateral thoracotomy. In group 1, TENS was used postoperatively on 60 patients for 5 days. Group 2 contained 56 patients without TENS. In both groups a visual analog scale (VAS) was used to indicate if analgesia was needed. When the VAS was higher than 4, an analgesic was administered. We observed the forced expiratory volume in 1 second (FEV(1)), the forced vital capacity (FVC), partial arterial oxygen pressure (PaO2), partial arterial carbon dioxide pressure (PaCO2), and how many doses of analgesia were given at postoperative 0 (extubation time), 2, 6, 12, 24, 48, 72, and 120 hours. TENS was not employed in patients with cardiac or neurologic disease. In group 1, TENS reduced the need to administer opioids during the 5-day postoperative period. This result is statistically significant (P = 0.013). Additionally, following the sixth postoperative hour, TENS increased the spirometric breath function. The FEV1, FVC, and PaO2 were high and PaCO2 was low when the first group is compared to the second. All these results are statistically significant (P = 0.012, P = 0.01, P = 0.024, and P = 0.02 respectively). We observed that TENS produced no evidence of side effects or intolerance in the patients of group 1. TENS is thus beneficial for pain relief following thoracotomy and has no side effects. Consequently, the routine use of TENS following thoracic surgery is recommended.

Postthoracotomy Pain Management Problems

“…Many methods of pain management, each with attendant problems, have been tried with varied success, for example: intercostal nerve block (1;2), intrapleural analgesia (3;4), cryoanalgesia (5;6), lumbar epidural (7;8), thoracic epidural (9;10), paravertebral block (11)(12)(13), IV narcotics (8;14;15), intrathecal (16)(17)(18) or epidural (2;15;19;20) narcotics, NSAIDS (1;21;22), and transcutaneous nerve stimulation (23)(24)(25).…”

Postoperative Pulmonary Rehabilitation in Thoracic Surgery

“…Akciğer rezeksiyonunda posterolateral torakotomi sonrası TENS'in orta ve hafif ağrıda etkili, şiddetli ağrıda etkisiz olduğu saptanmıştır (58). Posterolateral torakotomi hastalarında TENS'in, plasebo TENS veya hasta kontrollü analjezi uygulamalarına göre istirahatte ve öksürme sırasında ağrı şiddetini, analjezik kullanı-mını azalttığı ve hastaların solunum fonksiyonlarında gelişmeler meydana getirdiği kanıtlanmıştır (56,59).…”

“…İlgili araştırmalara göre TENS; toraks cerrahisi sonrası akut ve kronik posterolateral torakotomi ağrısını azaltarak, PR programlarına hastanın aktif katılımını sağlayan, medikal bakımın uygulanmasını kolaylaştı-ran, diğer analjeziklerle kullanıldığında hastaların hastaneden kalış sürelerini azaltan, solunum fonksiyonlarına indirekt pozitif etkisi nedeniyle etkili öksürmeye katkıda bulunan, hastanın fiziksel fonksiyonel düzeyini geliştiren, kısaca cerrahi kazançlarını artıran ve iyileş-meyi hızlandıran, emniyetli ve etkili bir uygulama olarak kabul edilmektedir (58,59).…”

Fisioterapia no pós-operatório de cirurgia cardíaca: a percepção do paciente

“…Em relação a i.e., hypoventilation, changes in the mechanism of cough might leading to hypersecretion, alveolar collapse with resulting hypoxemia [3,[5][6][7].…”