Likar R, Molnar M, Pipam W, Koppert W, Quantschnigg B, Disselhoff B, Sittl R
Abteilung für Anästhesiologie und Intensivmedizin, LKH Klagenfurt, Austria.
Schmerz. 2001 Jun;15(3):158-63. doi: 10.1007/s004820170017.
The aim of this study was to determine whether 3 days of TENS therapy postoperatively after shoulder operations would result in better pain relief and/or reduced analgesic intake when compared to placebo.
The study was carried out randomized, double-blind and placebo controlled. Thirty patients were randomized to two groups. The verum group received TENS SM1AKS 80 Hz 6 mA and the placebo group received TENS SM1AKS 80 Hz 0 mA. The pain was assessed pre-operatively using the Hamburg Pain Adjective List. Premedication and Anaesthesia were standardized. TENS was applied to the patients immediately postoperatively for 8 hours and then on the following days 5 times daily for 45 minutes. The effectiveness was evaluated postoperatively using a visual analogue scale (rest, activity), the Hamburg Pain Adjective List and postoperative analgesic consumption.
The visual analogue scale at rest and on activity showed no significant difference between the groups. Postoperative analgesic consumption of morphine hydrochloride in the first 24 hours was at time 8 hours postoperative significantly and at all other time points markedly less in the verum group compared to the placebo group. The sensory secondary scale score of the "Hamburg Pain Adjective List" was significantly lower postoperatively compared to preoperatively in the verum group.
We were able to show in this study that TENS applied postoperatively after shoulder surgery clearly reduced analgesic consumption in the first 72 hours. Furthermore there was a significant difference in the pain scores using the "Hamburg Pain Adjective List" in favour of the verum group. TENS applied postoperatively is a effective, simple modality with few side-effects.
本研究的目的是确定肩部手术后进行3天的经皮电刺激神经疗法(TENS)与安慰剂相比,是否能带来更好的疼痛缓解和/或减少镇痛药的摄入量。
本研究采用随机、双盲和安慰剂对照的方式进行。30名患者被随机分为两组。治疗组接受频率80Hz、电流6mA的TENS SM1AKS治疗,安慰剂组接受频率80Hz、电流0mA的TENS SM1AKS治疗。术前使用汉堡疼痛形容词列表评估疼痛情况。术前用药和麻醉均标准化。患者术后立即接受TENS治疗8小时,随后几天每天治疗5次,每次45分钟。术后使用视觉模拟量表(静息、活动时)、汉堡疼痛形容词列表和术后镇痛药消耗量评估疗效。
两组在静息和活动时的视觉模拟量表评分无显著差异。与安慰剂组相比,治疗组术后第8小时及其他所有时间点的术后24小时内盐酸吗啡的镇痛药消耗量均显著减少。治疗组术后“汉堡疼痛形容词列表”的感觉次级量表评分与术前相比显著降低。
我们在本研究中能够表明,肩部手术后应用TENS可明显减少术后72小时内的镇痛药消耗量。此外,使用“汉堡疼痛形容词列表”评估的疼痛评分在治疗组中存在显著差异。术后应用TENS是一种有效、简单且副作用少的方法。