Jahangirifard Alireza, Razavi Mohammadreza, Ahmadi Zargham Hosein, Forozeshfard Mohammad
Tracheal Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran; PhD Candidate in Nursing, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
Pain Manag Nurs. 2018 Aug;19(4):408-414. doi: 10.1016/j.pmn.2017.10.018. Epub 2018 Feb 1.
The aim of this study was to determine the effect of electrical nerve stimulation on pain intensity and pulmonary function in patients undergoing coronary artery bypass surgery.
In a randomized clinical trial, a total of 100 patients undergoing coronary artery bypass surgery at Masih Daneshvari Hospital, Tehran, Iran, from February to May 2014, were divided into two groups. In the intervention group (n = 50), patients received routine care along with transcutaneous electrical nerve stimulation (TENS) immediately after admission to the intensive care unit (ICU). In the placebo group (n = 50), patients only received routine care. The pain intensity was measured using a visual analog scale (VAS) every 6 hours for 72 hours after surgery in two conditions of rest and coughing. Pulmonary function was assessed through forced expiratory volume in 1 second (FEV1) and forced volume capacity (FVC) at 24, 48, and 72 hours after surgery. Age, gender, body mass index, narcotic consumption, ICU length of stay, and requests for chest radiographs were recorded. The statistical level of significance was set at p < .05.
There were no significant differences between the two groups in terms of age, gender, and body mass index (p > .05). Pain intensity was significantly lower in the TENS group than the placebo group in both resting and coughing condition (p < .05). FVC and FEV1 were significantly better and faster in the TENS group than in the placebo group at 24, 48, and 72 hours after surgery (p < .05). Patients in the TENS group had significantly lower narcotic use and requests for chest radiographs compared with placebo group.
TENS may reduce postoperative pain in resting and coughing conditions, improve pulmonary function, and reduce narcotic use in patients undergoing coronary artery bypass surgery.
本研究旨在确定电神经刺激对冠状动脉搭桥手术患者疼痛强度和肺功能的影响。
在一项随机临床试验中，2014年2月至5月期间，伊朗德黑兰马西赫·丹什瓦里医院共有100例接受冠状动脉搭桥手术的患者被分为两组。干预组（n = 50）患者在入住重症监护病房（ICU）后立即接受常规护理并进行经皮电神经刺激（TENS）。安慰剂组（n = 50）患者仅接受常规护理。术后72小时内，每6小时使用视觉模拟量表（VAS）在休息和咳嗽两种状态下测量疼痛强度。术后24、48和72小时通过第1秒用力呼气量（FEV1）和用力肺活量（FVC）评估肺功能。记录年龄、性别、体重指数、麻醉剂用量、ICU住院时间和胸部X光检查申请情况。统计学显著性水平设定为p <.05。
两组在年龄、性别和体重指数方面无显著差异（p >.05）。在休息和咳嗽状态下，TENS组的疼痛强度均显著低于安慰剂组（p <.05）。术后24、48和72小时，TENS组的FVC和FEV1显著优于且恢复速度快于安慰剂组（p <.05）。与安慰剂组相比，TENS组患者的麻醉剂使用量和胸部X光检查申请次数显著更低。
TENS可能减轻冠状动脉搭桥手术患者在休息和咳嗽状态下的术后疼痛，改善肺功能，并减少麻醉剂使用。
