From the Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, China (J. Zhou, ZW, YZ, LL); West China School of Medicine, Sichuan University, Chengdu, China (J. Zhou, YD, YY, ML, J. Zhong, ZW); and Western China Collaborative Innovation Center for Early Diagnosis and Multidisciplinary Therapy of Lung Cancer, Sichuan University, Chengdu, China (LL).
Am J Phys Med Rehabil. 2020 Mar;99(3):241-249. doi: 10.1097/PHM.0000000000001312.
The aim of the study was to identify the analgesic efficacy and safety of transcutaneous electronic nerve stimulation in postoperative pain after pulmonary surgery.
Electronic databases (PubMed, Embase, Web of Science, and CENTRAL) were systematically searched from their inception to June 2019. The continuous variables were pooled as the weighted mean difference with correlated 95% confidence interval. Results were recognized as significant when a P value is less than 0.05. Subgroup analyses, sensitivity analyses, and quality assessment were performed.
Altogether, 10 studies were included. The pooled results indicated that transcutaneous electronic nerve stimulation group conferred lower pain intensity score on the first postoperative day (weighted mean difference = -0.93, 95% confidence interval = -1.56 to -0.30, P = 0.004), postoperative day 2 (weighted mean difference = -1.00, 95% confidence interval = -1.64 to -0.35, P = 0.002), postoperative day 3 (weighted mean difference = -0.92, 95% confidence interval = -1.76 to -0.09, P = 0.03), postoperative day 4 (weighted mean difference = -0.90, 95% confidence interval = -1.24 to -0.56, P < 0.001), and postoperative day 5 (weighted mean difference = -1.39, 95% confidence interval = -2.20 to -0.57, P < 0.001) compared with the placebo transcutaneous electronic nerve stimulation group. No publication bias was found. No significant discovery was obtained in sensitivity analyses.
Transcutaneous electronic nerve stimulation might be an effective supplementary analgesic regimen in multimodal analgesia to decrease pain intensity after pulmonary surgery.
本研究旨在确定经皮电神经刺激在肺手术后疼痛中的镇痛效果和安全性。
系统检索了从建库至 2019 年 6 月的电子数据库（PubMed、Embase、Web of Science 和 CENTRAL）。连续变量采用加权均数差及相关 95%置信区间进行汇总。当 P 值小于 0.05 时，结果被认为具有统计学意义。进行了亚组分析、敏感性分析和质量评估。
共纳入 10 项研究。汇总结果表明，经皮电神经刺激组在术后第 1 天（加权均数差=-0.93，95%置信区间=-1.56 至-0.30，P=0.004）、术后第 2 天（加权均数差=-1.00，95%置信区间=-1.64 至-0.35，P=0.002）、术后第 3 天（加权均数差=-0.92，95%置信区间=-1.76 至-0.09，P=0.03）、术后第 4 天（加权均数差=-0.90，95%置信区间=-1.24 至-0.56，P<0.001）和术后第 5 天（加权均数差=-1.39，95%置信区间=-2.20 至-0.57，P<0.001）时疼痛强度评分均低于安慰剂经皮电神经刺激组。未发现发表偏倚。敏感性分析未发现显著差异。
经皮电神经刺激可能是一种有效的多模式镇痛辅助治疗方案，可降低肺手术后的疼痛强度。
