Transcutaneous Electrical Nerve Stimulation: An Effective Treatment for Pain Caused by Renal Colic in Emergency Care

Mora, Bruno; Giorni, Elisabetta; Dobrovits, Michael; Barker, Renate; Lang, Thomas; Gore, Carmen; Kober, Alexander

doi:10.1016/s0022-5347(05)00980-8

Cited by 29 publications

(21 citation statements)

References 16 publications

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“…TENS applied over the painful flank during prehospital transport, reduced pain scores, anxiety and nausea in patients with renal colic (Mora et al, 2006 Level II).…”

Section: Chaptermentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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“…TENS applied over the painful flank during prehospital transport, reduced pain scores, anxiety and nausea in patients with renal colic (Mora et al, 2006 Level II).…”

Section: Chaptermentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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“…The additional searches of other resources detailed previously produced duplicates of the four identified articles, but no new studies. At completion of the literature-searching process, there were four randomized-controlled trials eligible for inclusion, enrolling a total of 261 patients [6][7][8][9]. The results of the search strategy are detailed in Fig.…”

Section: Study Selection and Search Resultsmentioning

confidence: 99%

“…The initial and final pain score was determined by the same medic who was blinded to group allocation throughout. No concurrent analgesics were administered in any study and all excluded patients who had received any analgesic within the previous 48 h. Although the initial pain severities were similar across the included studies, each study investigated a different aetiology of pain: acute renal colic [6], acute lower back pain [7], traumatic hip pain [8] and pelvic pain in women [9]. The duration of treatment and transport was similar for all studies.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Some countries, for example those operating under a Franco-German model of emergency medical services provision, also place legislative restrictions on medics that render provision of pharmacological analgesia infeasible [1]. Against this background, novel nonpharmacological avenues of analgesia such as active warming [2][3][4][5], acupressure [6][7][8] and transcutaneous electrical nerve stimulation (TENS) [6][7][8][9] have been explored in the prehospital setting to enhance frontline pain management capability.…”

Section: Introductionmentioning

confidence: 99%

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Transcutaneous electrical nerve stimulation for relieving acute pain in the prehospital setting

Simpson¹,

Fouche²,

Thomas³

et al. 2013

European Journal of Emergency Medicine

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Although medics in many services are equipped with pharmacological analgesia, legislative or logistical restrictions in some systems result in the need to rely on nonpharmacological avenues for the management of acute pain. Transcutaneous electrical nerve stimulation (TENS) has been proposed as an alternative to analgesic medication that could be feasible and effective in the prehospital setting. The aim of this systematic review was to determine the effectiveness and safety of TENS when administered by medics to patients with acute pain in the prehospital setting. A systematic literature review was carried out to identify randomized-controlled trials investigating the safety and efficacy of TENS compared with 'sham' (placebo) TENS in the prehospital setting. Quality assessment of included studies was carried out to identify potential for bias. Qualitative and quantitative synthesis of results was performed to determine effectiveness and safety. The studies included were meta-analysed using a random-effects model to produce pooled results for comparison of the mean post-treatment pain scores using a visual analogue scale (VAS). Four studies were included in the analysis, all of which were prospective clinical trials of good methodological quality. Meta-analysis indicated that TENS produced a clinically significant reduction in severity of pain [mean VAS reduction 38 mm (95% confidence interval 28-44); P<0.0001] for patients with moderate-to-severe acute pain. TENS produced post-treatment mean pain scores that were significantly lower than 'sham' TENS [33 mm VAS (95% confidence interval 21-44); P<0.0001]. TENS was also effective in reducing acute anxiety secondary to pain. No safety risks were identified. When administered by medics in the prehospital setting to patients with acute pain, TENS appears to be an effective and safe nonpharmacological analgesic modality that should be considered by emergency medical services organizations in which pharmacological pain management is restricted or unavailable.

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“…Sonuçta gerçek uygulama yapılanlarda ağrı, anksiyete, bulantı skoru ve kalp hızında belirgin azalma saptanmış. Yazarlar etkinin çok çabuk başladığını ve TENS'in önemli bir ilaç dışı alternatif olabileceğini öne sürmüşlerdir (38).…”

Section: K) Transkutanöz Elektriksel Sinir Stimulasyonuunclassified

Üriner Sistem Taş Hastalığı ve Ağrı Tedavisi: Yeni Ne Var?

Bayar¹,

Tanrıverdi²

2017

Endouroloji

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Transcutaneous Electrical Nerve Stimulation: An Effective Treatment for Pain Caused by Renal Colic in Emergency Care

Abstract: This trial shows that local TENS is a rapid and effective treatment for renal colic pain. We found TENS to be a good nondrug therapy under the difficult circumstances of out of hospital rescue.

Cited by 29 publications

References 16 publications

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Transcutaneous electrical nerve stimulation for relieving acute pain in the prehospital setting

Üriner Sistem Taş Hastalığı ve Ağrı Tedavisi: Yeni Ne Var?

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