Bayindir O, Paker T, Akpinar B, Erenturk S, Askin D, Aytac A
Department of Cardiac Anesthesia, University of Istanbul, Haseki, Turkey.
J Cardiothorac Vasc Anesth. 1991 Dec;5(6):589-91. doi: 10.1016/1053-0770(91)90012-i.
The effect of continuous transcutaneous electrical nerve stimulation (TENS) on postoperative pain following median sternotomy was evaluated in 89 patients with severe chest pain who underwent cardiac surgery in a prospective, randomized, blinded trial. Pain was assessed by visual analog pain scores before and during treatment in each group. In the active TENS group, 79% of the patients were completely free of chest pain during rest at the end of 180 minutes (P less than 0.001). Among the remaining patients with TENS, 16% had slight pain not needing narcotic analgesics and 5% still had chest pain requiring narcotics. In the control group in which inactive TENS was used, the intensity of pain was reduced in 44% of the patients at the end of 90 minutes (P less than 0.001). However, this early placebo effect was noted to diminish with time and at the end of 180 minutes, 80% of the patients complained of severe chest pain and needed narcotics. These data suggest that TENS can be effective in controlling postoperative chest pain due to median sternotomy after cardiac surgery and its continuous application in the early postoperative period can reduce the need for narcotics.
在一项前瞻性、随机、双盲试验中，对89例接受心脏手术且有严重胸痛的患者评估了连续经皮电神经刺激（TENS）对正中开胸术后疼痛的影响。通过视觉模拟疼痛评分对每组治疗前和治疗期间的疼痛进行评估。在主动TENS组中，79%的患者在180分钟结束时休息期间完全没有胸痛（P小于0.001）。其余接受TENS治疗的患者中，16%有轻微疼痛，不需要使用麻醉性镇痛药，5%仍有需要使用麻醉剂的胸痛。在使用无效TENS的对照组中，44%的患者在90分钟结束时疼痛强度降低（P小于0.001）。然而，这种早期安慰剂效应随时间减弱，在180分钟结束时，80%的患者抱怨有严重胸痛且需要使用麻醉剂。这些数据表明，TENS可有效控制心脏手术后正中开胸引起的术后胸痛，并且在术后早期持续应用可减少对麻醉剂的需求。
