Erdogan Mükerrem, Erdogan Abdullah, Erbil Nazmiye, Karakaya Hanife Kabukcu, Demircan Abid
Department of Thoracic Surgery, Akdeniz University Faculty of Medicine, GKDC Anabilim Dali, Antalya, 07058, Turkey.
World J Surg. 2005 Dec;29(12):1563-70. doi: 10.1007/s00268-005-7934-6.
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.
我们在一项前瞻性、随机、双盲、安慰剂对照研究中，调查了经皮电刺激神经疗法（TENS）对开胸术后疼痛控制的疗效。我们研究了两组接受后外侧开胸手术的患者。在第1组中，60例患者术后使用TENS，持续5天。第2组有56例患者未使用TENS。两组均使用视觉模拟量表（VAS）来表明是否需要镇痛。当VAS高于4时，给予镇痛药。我们观察了术后0小时（拔管时间）、2小时、6小时、12小时、24小时、48小时、72小时和120小时的第1秒用力呼气量（FEV₁）、用力肺活量（FVC）、动脉血氧分压（PaO₂）、动脉血二氧化碳分压（PaCO₂）以及给予镇痛药物的剂量。患有心脏或神经疾病的患者不使用TENS。在第1组中，TENS减少了术后5天内使用阿片类药物的需求。这一结果具有统计学意义（P = 0.013）。此外，术后第6小时后，TENS改善了肺量计呼吸功能。与第2组相比，第1组的FEV₁、FVC和PaO₂较高，而PaCO₂较低。所有这些结果均具有统计学意义（分别为P = 0.012、P = 0.01、P = 0.024和P = 0.02）。我们观察到第1组患者中TENS未产生副作用或不耐受的迹象。因此，TENS对开胸术后的疼痛缓解有益且无副作用。因此，建议在胸外科手术后常规使用TENS。
