Gupta Ruchi, Kaur Gaganjot, Kaur Jasleen, Chawla Sunil, Kaur Shubhdeep, Kullar Keerat K, Aujla S
Department of Anaesthesia, SGRD Institute of Medical Sciences and Research, Amritsar, Punjab, India.
Department of Anaesthesia, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India.
J Anaesthesiol Clin Pharmacol. 2020 Oct-Dec;36(4):500-505. doi: 10.4103/joacp.JOACP_286_19. Epub 2021 Jan 18.
Labor pain is one of the most severe pain that a woman experiences in her lifetime. Various methods are being used to relieve this pain and to achieve higher maternal satisfaction. One such technique is transcutaneous electrical nerve stimulation (TENS) that uses low-frequency electrotherapy. The aim of our study was to evaluate TENS by comparing it to an established labor analgesia technique, i.e., epidural analgesia in terms of maternal satisfaction.
This prospective study was conducted on 60 parturients in active stage of labor. The choice of analgesia was made by the parturient after informed consent. In group A (n = 30) TENS was used, while in group B (n = 30) epidural ropivacaine 0.125% + 2 μg/ml fentanyl was given. Continuous monitoring of maternal vitals, visual analogue score, and fetal heart rate (FHR) was done. Maternal satisfaction was scored considering pain relief, ability to move and experience of labor at the end of delivery and outcome was labeled as favorable and unfavorable.
TENS was found to be favorable in 90% of parturients as compared to 96.6% in epidural ( 0.301). The number of highly satisfied parturients was 4 (13.3%) in TENS group and 17 (56.6%) in the epidural group (= 0.000). Three patients in the epidural group had assisted delivery and two had cesarean section whereas all patients in TENS group delivered normally (= 0.065). No significant difference was found in the fetal outcome.
TENS is a good alternate choice for providing labor analgesia and may have a major role in future.
分娩疼痛是女性一生中经历的最剧烈的疼痛之一。人们正在使用各种方法来缓解这种疼痛并提高产妇满意度。经皮电刺激神经疗法（TENS）就是其中一种使用低频电疗法的技术。我们研究的目的是通过将TENS与一种既定的分娩镇痛技术（即硬膜外镇痛）在产妇满意度方面进行比较，来评估TENS。
这项前瞻性研究针对60名处于分娩活跃期的产妇进行。在获得知情同意后，由产妇选择镇痛方法。A组（n = 30）使用TENS，而B组（n = 30）给予0.125%罗哌卡因+2μg/ml芬太尼硬膜外麻醉。持续监测产妇生命体征、视觉模拟评分和胎儿心率（FHR）。根据分娩结束时的疼痛缓解情况、活动能力和分娩体验对产妇满意度进行评分，结果分为满意和不满意。
与硬膜外麻醉组的96.6%相比，TENS组90%的产妇结果满意（P = 0.301）。TENS组高度满意的产妇有4名（13.3%），硬膜外麻醉组有17名（56.6%）（P = 0.000）。硬膜外麻醉组有3名患者需要助产，2名患者进行了剖宫产，而TENS组所有患者均正常分娩（P = 0.065）。胎儿结局方面未发现显著差异。
TENS是提供分娩镇痛的一种良好替代选择，未来可能发挥重要作用。
