Randomization is important in studies with pain outcomes: systematic review of transcutaneous electrical nerve stimulation in acute postoperative pain

Carroll, Dawn; Tramèr, Martin R.; McQuay, Henry J; Nye, B; Moore, Andrew

doi:10.1093/bja/77.6.798

Cited by 204 publications

(99 citation statements)

References 35 publications

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“…We know that if trials are of poor reporting quality, 17,18 or not randomised, 30 or not blind, or both, 31 then the tendency is to overestimate the benefits of treatment. The reviews included here all demanded that trials should be both randomised and double-blind as a minimum requirement for inclusion.…”

Section: Discussionmentioning

confidence: 99%

Relative efficacy of oral analgesics after third molar extraction

et al. 2004

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Section: Discussionmentioning

confidence: 99%

Relative efficacy of oral analgesics after third molar extraction

et al. 2004

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“…TENS is of limited benefit as a stand alone treatment for severe to moderate pain but may be useful in combination with pharmacotherapy. Systematic reviews on TENS and postoperative pain and labour pain have reported negative outcomes (7,8). A meta-analysis demonstrated that TENS reduced post-operative analgesic consumption and that adequate TENS technique was critical to outcome (9).…”

Section: Tens and Acute Painmentioning

confidence: 99%

Transcutaneous Electrical Nerve Stimulation: Mechanisms, Clinical Application and Evidence

2007

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• Transcutaneous electrical nerve stimulation (TENS) is a non-invasive, inexpensive, self-administered technique to relieve pain. • There are few side effects and no potential for overdose so patients can titrate the treatment as required. • TENS techniques include conventional TENS, acupuncture-like TENS and intense TENS. In general, conventional TENS is used in the first instance. • The purpose of conventional TENS is to selectively activate large diameter non-noxious afferents (A-beta) to reduce nociceptor cell activity and sensitization at a segmental level in the central nervous system. • Pain relief with conventional TENS is rapid in onset and offset and is maximal when the patient experiences a strong but non-painful paraesthesia beneath the electrodes. Therefore, patients may need to administer TENS throughout the day. • Clinical experience suggests that TENS may be beneficial as an adjunct to pharmacotherapy for acute pain although systematic reviews are conflicting. Clinical experience and systematic reviews suggest that TENS is beneficial for chronic pain.

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“…14 38 39 Surgical stress is a physiological reaction that produces endocrine, immune and haematological changes, which may contribute to negative outcomes and subsequent morbidity. Prominent among these changes are a rise in pancreatic secretion of glucagon and of liver glycogenolysis and gluconeogenesis, reduction of insulin release and rise in blood glucose.…”

Section: Discussionmentioning

confidence: 99%

Effects of Electroacupuncture on Local Anaesthesia for Inguinal Hernia Repair: A Randomised Placebo-Controlled Trial

Dias

Carneiro²,

Guerra³

et al. 2010

Acupunct Med

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Objective To assess the effect of electroacupuncture (EA), akin to percutaneous electroneurostimulation, on pain and biochemical measures during and after inguinal hernia repair. Methods Thirty-three patients were randomised to EA (n=16) or sham transcutaneous electrical nerve stimulation (TENS) control (n=17). EA was applied at different frequencies, through needles inserted around the incision, over selected peripheral nerve branches and in the ear, from 30 min before surgery until the end of surgery, when needles were removed. All patients also received routine sedation and local anaesthesia. Results There was no difference between the pain scores in the groups receiving EA and sham TENS in the immediate postoperative period, which may be owing to adequate levels of analgesia from conventional techniques. On the fourth and seventh postoperative days, less pain and lower consumption of analgesic drugs were reported in the treatment group. Seroma occurred more frequently in the control group, which also had higher glucose blood levels in the immediate postoperative surgery period. The single case of chronic postoperative pain occurred in the control group. Conclusions The sample size was too small to draw any conclusions about the effect of EA on pain and other parameters following inguinal hernia surgery, but our observations suggest that future studies in this area are justifi ed.

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Randomization is important in studies with pain outcomes: systematic review of transcutaneous electrical nerve stimulation in acute postoperative pain

Cited by 204 publications

References 35 publications

Relative efficacy of oral analgesics after third molar extraction

Relative efficacy of oral analgesics after third molar extraction

Transcutaneous Electrical Nerve Stimulation: Mechanisms, Clinical Application and Evidence

Effects of Electroacupuncture on Local Anaesthesia for Inguinal Hernia Repair: A Randomised Placebo-Controlled Trial

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