Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital/Östra, SE-416 85 Göteborg, Sweden Multidisciplinary Pain Center, Institution of Medicine, Sahlgrenska University Hospital/Östra, SE-416 85 Göteborg, Sweden Department of Obstetrics and Gynaecology, Sahlgrenska University Hospital/Östra, SE-416 85 Göteborg, Sweden.
Pain. 2010 Jan;148(1):114-119. doi: 10.1016/j.pain.2009.10.023. Epub 2009 Dec 2.
The aim of the study was to compare the pain-relieving effect and the time spent in the recovery ward after treatment with high-frequency, high-intensity transcutaneous electrical nerve stimulation (TENS) or intravenous (IV) conventional pharmacological treatment after surgical abortion. Two-hundred women who underwent surgical abortion and postoperatively reported a visual analogue scale (VAS) pain score3 were included. The patients were randomised to TENS or conventional pharmacological treatment for their postoperative pain. The TENS treatment was given with a stimulus intensity between 20 and 60 mA during 1 min and repeated once if insufficient pain relief (VAS3). In the conventional pharmacological treatment group, a maximum dose of 100 microg fentanyl was given IV. There was no difference between the groups with regard to pain relief according to the VAS pain score (TENS=VAS 1.3 vs. IV opioids=VAS 1.6; p=0.09) upon discharge from the recovery ward. However, the patients in the TENS group spent shorter time (44 min) in the recovery ward than the conventional pharmacological treatment group (62 min; p<0.0001). The number of patients who needed additional analgesics in the recovery ward was comparable in both groups, as was the reported VAS pain score upon leaving the hospital (TENS=2.0 vs. conventional pharmacological treatment=1.8, NS). These results suggest that the pain-relieving effect of TENS seems to be comparable to conventional pharmacological treatment with IV opioids. Hence, TENS may be a suitable alternative to conventional pain management with IV opioids after surgical abortion.
研究目的是比较高频高强度经皮神经电刺激(TENS)与静脉(IV)常规药物治疗在手术后流产后缓解疼痛的效果和在恢复病房停留的时间。共纳入 200 名接受手术流产且术后报告视觉模拟量表(VAS)疼痛评分≥3 的女性。将患者随机分为 TENS 或常规药物治疗组,以缓解术后疼痛。TENS 治疗的刺激强度为 20-60mA,持续 1 分钟,如果疼痛缓解不足(VAS3),则重复一次。在常规药物治疗组中,静脉给予最大剂量 100μg 芬太尼。从恢复病房出院时,根据 VAS 疼痛评分,两组之间的疼痛缓解程度无差异(TENS=VAS 1.3 对 IV 阿片类药物=VAS 1.6;p=0.09)。然而,TENS 组在恢复病房停留的时间(44 分钟)短于常规药物治疗组(62 分钟;p<0.0001)。两组在恢复病房需要额外镇痛药物的患者数量相当,出院时报告的 VAS 疼痛评分也相似(TENS=2.0 对常规药物治疗=1.8,NS)。这些结果表明,TENS 的镇痛效果似乎与 IV 阿片类药物的常规药物治疗相当。因此,TENS 可能是手术后流产后 IV 阿片类药物常规疼痛管理的一种合适替代方法。