Desantana Josimari M, Sluka Kathleen A, Lauretti Gabriela Rocha
Graduate Program in Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA.
Clin J Pain. 2009 Jan;25(1):12-9. doi: 10.1097/AJP.0b013e31817d1070.
Transcutaneous electrical nerve stimulation (TENS) is an effective adjunctive therapy for postoperative pain; however, effects of different frequencies of stimulation have not been systematically investigated. Laparoscopic sterilization (LS) causes significant pain in the early postoperative period and requires substantial postoperative medication. Therefore, we studied the effects of TENS on postoperative pain after LS through placement of Yoon fallopian rings in a prospective, randomized, double-blinded, and placebo-controlled study.
Sixty-four patients undergoing LS for uterine tube ligation were randomly allocated to receive either active TENS or placebo TENS. Postoperative pain was evaluated using a standard 11-point numeric rating scale and the McGill Pain Questionnaire (MPQ)-pain rating index and number of words chosen. Both high frequency (100 Hz) and low frequency (4 Hz) TENS, at strong, but comfortable sensory intensity, were applied for 20 minutes through 4 electrodes placed around the surgical incision immediately after surgery. Pain was assessed before and after application of TENS when patients were at postanesthesia care unit (PACU).
Both high and low frequency TENS significantly decreased postoperative pain intensity when compared with before administration of TENS using the numeric rating scale (P=0.001), pain rating index (P=0.001), and number of words chosen (P=0.001) compared with placebo TENS (P=0.001). TENS in combination with standard pharmacologic analgesic treatment was efficacious for postoperative pain relief after LS.
We recommend regular use of multimodal therapy with TENS and analgesic drugs after LS with placement of Yoon rings.
经皮电刺激神经疗法(TENS)是术后疼痛的一种有效辅助治疗方法;然而,不同刺激频率的效果尚未得到系统研究。腹腔镜绝育术(LS)在术后早期会引起显著疼痛,且需要大量术后药物治疗。因此,我们通过放置尹氏输卵管环,在前瞻性、随机、双盲和安慰剂对照研究中,研究了TENS对LS术后疼痛的影响。
64例行输卵管结扎术的LS患者被随机分配接受主动TENS或安慰剂TENS。使用标准的11点数字评分量表、麦吉尔疼痛问卷(MPQ)-疼痛评分指数和所选词汇数量评估术后疼痛。术后立即通过放置在手术切口周围的4个电极,以强烈但舒适的感觉强度,对高频(100Hz)和低频(4Hz)TENS各施加20分钟。当患者在麻醉后护理单元(PACU)时,在应用TENS前后评估疼痛。
与使用数字评分量表(P=0.001)、疼痛评分指数(P=0.001)和所选词汇数量(P=0.001)相比,高频和低频TENS与安慰剂TENS(P=0.001)相比,均显著降低了术后疼痛强度。TENS与标准药物镇痛治疗相结合对LS术后疼痛缓解有效。
我们建议在放置尹氏环的LS术后定期使用TENS和镇痛药的多模式治疗。