Transcutaneous electrical nerve stimulation is superior than placebo and control for postoperative pain relief

Borges, Maraísa Rodrigues; Oliveira, Nuno Miguel Lopes de; Antonelli, Izabella Barberato Silva; Silva, Maristella Borges; Crema, Eduardo; Fernandes, Luciane Fernanda Rodrigues Martinho

doi:10.2217/pmt-2019-0063

Cited by 10 publications

(5 citation statements)

References 64 publications

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“…To relieve postoperative pain, one physiotherapeutic resource is the use of electrical currents to reduce pain stimuli and produce a morphine-like effect. Borges et al evaluated the effect of TENS in patients in the postoperative period of abdominal surgery and found a reduction in postoperative pain in patients who received active TENS compared with those who received placebo and those in the control [ 22 ]. In our study, electroanalgesia reduced the pain levels in patients after all sessions; this result was not observed in the placebo group.…”

Section: Discussionmentioning

confidence: 99%

Role of Transcutaneous Electric Nerve Stimulation in Pain and Pulmonary Function in Patients after Bariatric Surgery

Luchesa

Lopes

2022

Rehabilitation Research and Practice

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Background. Changes in lifestyle, a carbohydrate-rich diet, and decreased physical activity are part of the context that led to an obesity pandemic. Treating obesity is a task that requires multidisciplinary care; however, in many cases, conventional therapy has no effect, requiring surgical intervention. This, in turn, is not without risks and causes important changes in lung function. Therefore, the aim of this study is to evaluate the effect of electroanalgesia through conventional transcutaneous electrical nerve stimulation (TENS) on the pain and lung function in the postoperative period of bariatric surgery. Methods. This is a controlled and blinded clinical trial with 66 subjects who underwent bariatric surgery. The participants were randomized into 2 groups as follows: an intervention group treated with TENS ( n = 33 ) and a placebo group ( n = 33 ). The participants underwent 4 TENS sessions, and the effect on pain was assessed using a visual analogue scale (VAS pain). Lung function was measured by spirometry. Results. There were no differences between the 2 groups regarding time of surgery and time of mechanical ventilation. Compared to placebo, TENS reduced pain in the intervention group ( p = 0.001 ). Regarding the effect of electroanalgesia on pulmonary function, the spirometric parameters were similar between the groups. However, regarding muscle strength between the preoperative and postoperative periods, maximal inspiratory pressure (MIP) was maintained in the intervention group and decreased in the placebo group ( p = 0.03 ). Compared with that in the intervention group, the respiratory rate in the placebo group increased during the application of TENS ( p = 0.003 ). Conclusion. Electroanalgesia reduces pain in patients who underwent bariatric surgery. Importantly, in these patients, the MIP is maintained between the preoperative and postoperative periods. However, electroanalgesia does not contribute to improvements in spirometric data. This trial is registered with NCT04800640.

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Section: Discussionmentioning

confidence: 99%

Role of Transcutaneous Electric Nerve Stimulation in Pain and Pulmonary Function in Patients after Bariatric Surgery

Luchesa

Lopes

2022

Rehabilitation Research and Practice

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“…The mean reduction in the pooled analysis was 30 mm (95% CI 21–4; P < 0.0001), with a range of 33–55 mm. In an RCT, postoperative pain was assessed in 78 adults undergoing cholecystectomy [ 102 ]. Pain was assessed before and after a 30 min TENS (150 Hz, 75 µs) treatment delivered at the maximally tolerated intensity without causing muscle contraction or noxious stimulation.…”

Section: Evidence Of Tens For Pain Managementmentioning

confidence: 99%

Using TENS for Pain Control: Update on the State of the Evidence

et al. 2022

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Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological intervention used in the treatment of acute and chronic pain conditions. The first clinical studies on TENS were published over 50 years ago, when effective parameters of stimulation were unclear and clinical trial design was in its infancy. Over the last two decades, a better understanding of the mechanisms underlying TENS efficacy has led to the development of an adequate dose and has improved outcome measure utilization. The continued uncertainty about the clinical efficacy of TENS to alleviate pain, despite years of research, is related to the quality of the clinical trials included in systematic reviews. This summary of the evidence includes only trials with pain as the primary outcome. The outcomes will be rated as positive (+), negative (−), undecided (U), or equivalent to other effective interventions (=). In comparison with our 2014 review, there appears to be improvement in adverse events and parameter reporting. Importantly, stimulation intensity has been documented as critical to therapeutic success. Examinations of the outcomes beyond resting pain, analgesic tolerance, and identification of TENS responders remain less studied areas of research. This literature review supports the conclusion that TENS may have efficacy for a variety of acute and chronic pain conditions, although the magnitude of the effect remains uncertain due to the low quality of existing literature. In order to provide information to individuals with pain and to clinicians treating those with pain, we suggest that resources for research should target larger, high-quality clinical trials including an adequate TENS dose and adequate timing of the outcome and should monitor risks of bias. Systematic reviews and meta-analyses should focus only on areas with sufficiently strong clinical trials that will result in adequate sample size.

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“…TENS employs alternating currents with varying frequencies and intensities to stimulate peripheral nerves 7 . Known for being safe, convenient, and low cost 8 , TENS has effectively mitigated various pain conditions, e.g., postoperative pain and low back pain [9][10][11][12] . TENS generally offers two primary modes: Conventional TENS generates analgesia within targeted dermatomes with higher frequency (~50-100 Hz) and lower intensity (evoking a nonpainful sensation); Acupuncture-Like TENS produces a diffuse analgesic effect that extends beyond the dermatome, with lower frequency (~2-4 Hz) and higher intensity (elicits a tolerable of painful sensation) 13,14 .…”

Section: Introductionmentioning

confidence: 99%

Cortico-spinal Mechanisms of Periphery Neuromodulation induced Analgesia

Wei,

Duan,

Zhu

et al. 2024

Preprint

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Nociceptive acute and chronic pain significantly impact the quality of life and create tremendous societal burdens. Given the side effects associated with pharmacological analgesia, noninvasive periphery neuromodulation techniques, like Transcutaneous Electrical Nerve Stimulation (TENS), have emerged as promising approaches for pain relief. Current human research, focusing partly on cerebral, brainstem, or peripheral mechanisms of neuromodulation, lacks comprehensive understanding from the perspective of the entire central nervous system. This study utilized a three-way mixed experimental design, combining cutting-edge cortico-spinal fMRI with thermal stimuli, to systematically explore the central analgesic mechanisms of two typical TENS modes: Conventional (high frequency, low intensity) and Acupuncture-Like (low frequency, high intensity). Behavioral and fMRI analysis revealed that, the direct spinal inhibition (PAG-spinal connectivity) partially mediated by PAG-vmPFC connectivity leads to local analgesic effects in Conventional TENS; a top-down diffuse noxious inhibition (PAG-S1 connectivity) fully mediated through PAG-spinal connectivity leads to diffuse analgesic effects in Acupuncture-Like TENS. Employing advanced cortico-spinal fMRI technique, our findings provide systematic neural evidence of the analgesic mechanisms induced by TENS and shed new light on future neuromodulation approaches.

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Transcutaneous electrical nerve stimulation is superior than placebo and control for postoperative pain relief

Cited by 10 publications

References 64 publications

Role of Transcutaneous Electric Nerve Stimulation in Pain and Pulmonary Function in Patients after Bariatric Surgery

Role of Transcutaneous Electric Nerve Stimulation in Pain and Pulmonary Function in Patients after Bariatric Surgery

Using TENS for Pain Control: Update on the State of the Evidence

Cortico-spinal Mechanisms of Periphery Neuromodulation induced Analgesia

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