Solak Ozlem, Emmiler Mustafa, Ela Yüksel, Dündar Umit, Koçoiullari Cevdet Ugur, Eren Naim, Gökçe Iknur Yigit, Cekirdekçi Ahmet, Kavuncu Vural
Department of Physical Medicine and Rehabilitation, Afyon Kocatepe University, School of Medicine, Afyonkarahisar, Turkey.
Heart Surg Forum. 2009 Oct;12(5):E266-71. doi: 10.1532/HSF98.20081139.
We compared the effectiveness of continuous transcutaneous electrical nerve stimulation (TENS) and intermittent TENS in the management of pain after coronary artery bypass grafting (CABG).
We randomized 100 patients who had undergone median sternotomy for CABG into 4 groups with 25 patients each: (1) continuous TENS (CTENS) and pharmacologic analgesia, (2) intermittent TENS (ITENS) and pharmacologic analgesia, (3) placebo TENS (PTENS) and pharmacologic analgesia, and (4) pharmacologic analgesia alone (control). We studied these groups with regard to the relief of postoperative pain during the first 24 hours. For each patient we recorded the following: demographic characteristics; vital signs; intensity of pain with a visual analogue scale (VAS) before treatment (VAS(0)), at the 12th hour (VAS(12)), and at the 24th hour (VAS(24)); and analgesic intake.
The groups were comparable with respect to age, sex, and body mass index at baseline. Mean VAS scores decreased within each group; however, the mean VAS(12) and VAS(24) scores decreased significantly in the CTENS and ITENS groups, compared with PTENS and control groups (P < .05). We found no significant difference between the CTENS and ITENS groups with respect to decreasing VAS(12) and VAS(24) scores (P > .05). Narcotic intake was significantly less in the CTENS and ITENS groups than in the control and PTENS groups (P < .01). Furthermore, narcotic requirements were significantly lower in the CTENS group than in the ITENS group (P < .01).
CTENS and ITENS after median sternotomy for CABG decreased pain and reduced narcotic requirements more than in the PTENS and control treatments during first postoperative 24 hours. Neither CTENS nor ITENS is superior to the other in decreasing pain; however, CTENS leads to a greater reduction in the narcotic requirement than ITENS.
我们比较了持续经皮电神经刺激（TENS）和间歇性TENS在冠状动脉旁路移植术（CABG）后疼痛管理中的有效性。
我们将100例行正中开胸CABG的患者随机分为4组，每组25例：（1）持续TENS（CTENS）联合药物镇痛，（2）间歇性TENS（ITENS）联合药物镇痛，（3）安慰剂TENS（PTENS）联合药物镇痛，（4）单纯药物镇痛（对照组）。我们研究了这些组在前24小时内术后疼痛的缓解情况。对于每位患者，我们记录了以下内容：人口统计学特征；生命体征；治疗前（VAS(0)）、第12小时（VAS(12)）和第24小时（VAS(24)）使用视觉模拟量表（VAS）评估的疼痛强度；以及镇痛药物摄入量。
各组在基线时的年龄、性别和体重指数具有可比性。每组内的平均VAS评分均下降；然而，与PTENS组和对照组相比，CTENS组和ITENS组的平均VAS(12)和VAS(24)评分显著下降（P < 0.05）。我们发现CTENS组和ITENS组在降低VAS(12)和VAS(24)评分方面没有显著差异（P > 0.05）。CTENS组和ITENS组的麻醉药物摄入量显著低于对照组和PTENS组（P < 0.01）。此外，CTENS组的麻醉药物需求量显著低于ITENS组（P < 0.01）。
CABG正中开胸术后，CTENS和ITENS在术后第1个24小时内比PTENS和对照治疗更能减轻疼痛并降低麻醉药物需求量。在减轻疼痛方面，CTENS和ITENS均不优于对方；然而，CTENS比ITENS能更大程度地降低麻醉药物需求量。
