Kasapoğlu Işıl, Kasapoğlu Aksoy Meliha, Çetinkaya Demir Bilge, Altan Lale
Department of Obstetrics and Gynecology, Uludağ University School of Medicine, Bursa, Turkey.
Department of Physical Medicine and Rehabilitation, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey.
Turk J Phys Med Rehabil. 2020 May 18;66(2):169-175. doi: 10.5606/tftrd.2020.3225. eCollection 2020 Jun.
This study aims to investigate the effects of transcutaneous electrical nerve stimulation (TENS) therapy on the intensity of pain associated with uterine contractions and abdominal incision in patients undergoing cesarean section (C-section) delivery.
This single-blind, prospective, randomized-controlled study included a total of 90 female patients (mean age 30.5 years; range, 25 to 36 years) who had a scheduled C-section delivery between November 2017 and April 2018. Forty-five postpartum patients were randomly assigned into the treatment group (Group 1) and TENS electrodes were placed below and above the abdominal incision. The control group (n=45) consisted of 45 patients who had a scheduled C-section (Group 2) (n=45) and received routine follow-up care. The Visual Numeric Scale (VNS) scores were obtained separately for abdominal, low back, and groin pain at baseline (within 1 h after C-section before the TENS replacement), at postpartum 2, 6, 24, and 48 h. In addition to instant scoring, the percentages of change in pain scores from baseline were also calculated for each time points.
Data of a total of 87 patients were analyzed. No statistically significant difference was found in the baseline VNS scores measured in any body regions between the groups (p>0.05). However, there was a statistically significant difference in the instant VNS scores for abdominal pain at 2, 6, 24, and 48 h in favor of Group 1 (p<0.05). No significant differences were found in the instant VNS scores for low back and groin pain (p>0.05). The comparison of changes in pain scores from baseline (% change) over time between the groups revealed a statistically significant difference in favor of Group 1 in all VNS scores for abdominal, low back, and groin pain at 2, 6, 24, and 48 h (p<0.05).
Our study results suggest that TENS is an effective and safe non-invasive, non-pharmacological treatment modality. It may be preferred as an alternative method in pain control in postpartum women after C-section delivery.
本研究旨在探讨经皮电刺激神经疗法（TENS）对剖宫产（C 剖宫产）产妇子宫收缩和腹部切口相关疼痛强度的影响。
本单盲、前瞻性、随机对照研究共纳入 90 名女性患者（平均年龄 30.5 岁；范围 25 至 36 岁），她们于 2017 年 11 月至 2018 年 4 月期间计划进行剖宫产。45 名产后患者被随机分配至治疗组（第 1 组），TENS 电极置于腹部切口上下。对照组（n = 45）由 45 名计划进行剖宫产的患者组成（第 2 组），并接受常规随访护理。在基线时（剖宫产术后 1 小时内，TENS 更换前）、产后 2、6、24 和 48 小时分别获取腹部、下背部和腹股沟疼痛的视觉数字评分（VNS）。除即时评分外，还计算了每个时间点疼痛评分相对于基线的变化百分比。
共分析了 87 名患者的数据。两组之间在任何身体部位测量的基线 VNS 评分均未发现统计学显著差异（p > 0.05）。然而，在 2、6、24 和 48 小时时，第 1 组腹部疼痛的即时 VNS 评分存在统计学显著差异（p < 0.05）。下背部和腹股沟疼痛的即时 VNS 评分未发现显著差异（p > 0.05）。两组之间疼痛评分相对于基线的变化（%变化）随时间的比较显示，在 2、6、24 和 48 小时时，第 1 组在腹部、下背部和腹股沟疼痛的所有 VNS 评分方面均存在统计学显著差异（p < 0.05）。
我们的研究结果表明，TENS 是一种有效且安全的非侵入性、非药物治疗方式。它可作为剖宫产术后产后女性疼痛控制的替代方法。
