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冠状动脉搭桥术后经皮电神经刺激

Transcutaneous electrical nerve stimulation after coronary artery bypass graft surgery.

作者信息

Lima Paula Monique Barbosa, Farias Rebeca Taciana Fernandes de Brito, Carvalho Aline Carla Araújo, da Silva Patrícia Nobre Calheiros, Ferraz Filho Nailton Alves, de Brito Rosinete Fernandes

机构信息

Centro Universitário CESMAC, Maceió, AL, Brasil.

出版信息

Rev Bras Cir Cardiovasc. 2011 Oct-Dec;26(4):591-6. doi: 10.5935/1678-9741.20110049.

Abstract

INTRODUCTION

After cardiac surgery, patients have a limitation in respiratory muscle strength, which favors the appearing of pulmonary complications.

OBJECTIVE

To evaluate the effectiveness of transcutaneous electrical nerve stimulation (TENS) on the painful process and respiratory muscle strength in patients undergoing coronary artery bypass graft (CABG).

METHODS

The study included patients after on-pump CABG through sternotomy, general anesthesia, without being under the influence of neuromuscular blockade, with use of chest and mediastinal tubes, and extubation within 6 hours after the procedure and presenting index equal to or greater than three visual analog scale (VAS) of pain being on the first day after surgery. We recruited 20 patients divided into two groups with no predominance of sex: the control group (n = 10), who received more physiotherapy analgesic therapy, and TENS group received analgesic therapy, physiotherapy and TENS. The TENS was applied for 30 minutes, three times a day, a 3-hour period each application.

RESULTS

For the degree of pain, there was an average start and end, respectively, 7.0 / 1.0 for the TENS group and 7.0 / 8.0 for the control group. For inspiratory muscle strength, - 102.5 cmH2O / - 141.17 cm H2O to the TENS group and - 97.0 cmH2O / - 100.3 cm H2O for control. The expiratory muscle strength, 63cmH2O/125 cmH2O for the TENS group and 55.3 cmH2O/53, 2 cmH2O for the control group.

CONCLUSIONS

TENS has shown significant effectiveness in reducing pain, and the increase in respiratory muscle strength at first-day after CABG surgery.

摘要

引言

心脏手术后,患者呼吸肌力量受限,这有利于肺部并发症的出现。

目的

评估经皮电神经刺激(TENS)对冠状动脉旁路移植术(CABG)患者疼痛过程及呼吸肌力量的有效性。

方法

本研究纳入了通过胸骨切开术进行体外循环CABG的患者,采用全身麻醉,未受神经肌肉阻滞影响,使用胸部和纵隔引流管,术后6小时内拔管,且术后第一天疼痛视觉模拟量表(VAS)指数等于或大于3分。我们招募了20名患者,分为两组,无性别优势:对照组(n = 10),接受更多物理治疗镇痛疗法;TENS组接受镇痛疗法、物理治疗和TENS。TENS每次应用30分钟,每天3次,每次应用持续3小时。

结果

对于疼痛程度,TENS组平均起始和结束值分别为7.0 / 1.0,对照组为7.0 / 8.0。对于吸气肌力量,TENS组为- 102.5 cmH2O / - 141.17 cm H2O,对照组为- 97.0 cmH2O / - 100.3 cm H2O。呼气肌力量,TENS组为63cmH2O/125 cmH2O,对照组为55.3 cmH2O/53, 2 cmH2O。

结论

TENS在减轻CABG术后第一天的疼痛及增加呼吸肌力量方面显示出显著效果。

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