Sbruzzi Graciele, Silveira Scheila Azeredo, Silva Diego Vidaletti, Coronel Christian Correa, Plentz Rodrigo Della Méa
Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia, Porto Alegre, Brazil.
Rev Bras Cir Cardiovasc. 2012 Jan-Mar;27(1):75-87. doi: 10.5935/1678-9741.20120012.
To evaluate the effects of transcutaneous electric nerve stimulation (TENS) on pain and pulmonary function during the postoperative period after thoracic surgery by performing a systematic review and meta-analysis of randomized trials.
The search strategy included MEDLINE, PEDro, Cochrane CENTRAL, EMBASE and LILACS, besides a manual search, from inception to August, 2011. Randomized trials were included, comparing TENS associated or not with pharmacological analgesia vs. placebo TENS associated or not with pharmacological analgesia or vs. pharmacological analgesia alone to assess pain (visual analog scale - VAS) and/or pulmonary function represented by forced vital capacity (FVC) in postoperative thoracic surgery patients (pulmonary or cardiac with approach by thoracotomy or sternotomy).
Of the 2.489 articles identified, 11 studies were included. In the approach by thoracotomy, TENS associated with pharmacological analgesia reduced pain compared to the placebo TENS associated with pharmacological analgesia (VAS -1.29; CI95%: -1.94 to - 0.65). In the approach by sternotomy, TENS associated with pharmacological analgesia also reduced pain compared to the placebo TENS associated with pharmacological analgesia (VAS -1.33; 95%CI: -1.89 to 0.77) and compared to pharmacological analgesia alone (VAS -1.23; 95%CI: -1.79 to -0.67). There was no significant improvement in FVC (0.12 L; 95%CI: -0.27 to 0.51).
TENS associated with pharmacological analgesia provides pain relief compared to the placebo TENS in postoperative thoracic surgery patients both approached by thoracotomy and sternotomy. In the sternotomy it also provides more effective pain relief compared to pharmacological analgesia alone, but has no significant effect on pulmonary function.
通过对随机试验进行系统评价和荟萃分析，评估经皮电刺激神经疗法（TENS）对胸外科手术后疼痛及肺功能的影响。
检索策略包括MEDLINE、PEDro、Cochrane CENTRAL、EMBASE和LILACS数据库，此外还进行了手工检索，检索时间从建库至2011年8月。纳入随机试验，比较TENS联合或不联合药物镇痛与安慰剂TENS联合或不联合药物镇痛，或单独药物镇痛，以评估胸外科手术后患者（肺手术或心脏手术，采用开胸或胸骨切开术）的疼痛（视觉模拟评分法-VAS）和/或由用力肺活量（FVC）代表的肺功能。
在检索到的2489篇文章中，纳入了11项研究。在开胸手术中，与联合药物镇痛的安慰剂TENS相比，联合药物镇痛的TENS可减轻疼痛（VAS -1.29；95%CI：-1.94至-0.65）。在胸骨切开术中，与联合药物镇痛的安慰剂TENS相比，联合药物镇痛的TENS也可减轻疼痛（VAS -1.33；95%CI：-1.89至-0.77），与单独药物镇痛相比也减轻疼痛（VAS -1.23；95%CI：-1.79至-0.67）。FVC无显著改善（0.12L；95%CI：-0.27至0.51）。
与安慰剂TENS相比，联合药物镇痛的TENS可减轻胸外科手术后开胸和胸骨切开患者的疼痛。在胸骨切开术中，与单独药物镇痛相比，联合药物镇痛的TENS也能更有效地减轻疼痛，但对肺功能无显著影响。
