经皮神经电刺激（TENS）治疗急诊科肾绞痛的随机、双盲、安慰剂对照试验。

Transcutaneous Electrical Nerve Stimulation (TENS) for the Treatment of Renal Colic in the ED: A Randomized, Double-Blind, Placebo-Controlled Trial.

机构信息

Department of Emergency Medicine, Adiyaman University Medical Faculty, Adiyaman, Turkey.

Department of Emergency Medicine, SBU Umraniye Training and Research Hospital, Istanbul, Turkey.

出版信息

Am J Emerg Med. 2022 Jun;56:127-132. doi: 10.1016/j.ajem.2022.02.044. Epub 2022 Mar 29.

DOI:10.1016/j.ajem.2022.02.044

PMID:35397352

Abstract

STUDY OBJECTIVE

To determine the analgesic efficacy of TENS treatment in patients with renal colic in the emergency department (ED).

METHODS

This double-blind, randomized controlled trial was conducted in a tertiary care ED. Patients with a definitive diagnosis of renal colic were assigned (1:1) as randomized to receive the real TENS with frequency 100 Hz, pulse width 200 microseconds, voltage 2 mA, or placebo with sham TENS. Pain intensity was measured using visual analog scales (VAS) at baseline, after 15 and 30th minutes.

RESULTS

A total of 100 patients were included in the final analysis: 50 patients treated with real TENS and 50 patients treated with sham TENS. VAS scores in both groups were similar at baseline. The mean reduction in VAS score at 15 min was 33.3 ± 17.6 (95% Confidence interval (CI): 28.3 to 38.3) for the real TENS group and 14.9 ± 11.6 (95% CI 11.6 to 18.2) for the sham TENS group (mean difference: 18.4 (95% CI: 12.5 to 24.4, P < 0.0001). The mean reduction in VAS score at 30 min was 63.7 ± 21.1 (95% CI: 57.7 to 69.7) for the real TENS group and 14.9 ± 16.2 (95% CI: 19.5 to 10.3) for the sham TENS group (mean difference: 48.8, 95% CI: 41.4 to 56.3, P < 0.0001). Four patients (8%) in the real TENS group and 24 patients (48%) in the sham TENS group required the rescue medication after 30th minutes.

CONCLUSIONS

TENS is effective for acute pain treatment in renal colic patients in the ED. TENS therapy could be a treatment option for renal colic.

摘要

研究目的

确定经皮神经电刺激（TENS）治疗急诊科（ED）肾绞痛患者的镇痛效果。

方法

这是一项在三级护理 ED 中进行的双盲、随机对照试验。将明确诊断为肾绞痛的患者（1:1）随机分配接受真 TENS 治疗，频率为 100 Hz、脉冲宽度为 200 微秒、电压为 2 mA，或接受假 TENS 治疗的安慰剂。在基线、第 15 分钟和第 30 分钟时使用视觉模拟量表（VAS）测量疼痛强度。

结果

共有 100 例患者纳入最终分析：50 例接受真 TENS 治疗，50 例接受假 TENS 治疗。两组患者的 VAS 评分在基线时相似。真 TENS 组 VAS 评分在 15 分钟时的平均降幅为 33.3 ± 17.6（95%置信区间：28.3 至 38.3），假 TENS 组为 14.9 ± 11.6（95%置信区间：11.6 至 18.2）（平均差值：18.4（95%置信区间：12.5 至 24.4，P<0.0001）。真 TENS 组 VAS 评分在 30 分钟时的平均降幅为 63.7 ± 21.1（95%置信区间：57.7 至 69.7），假 TENS 组为 14.9 ± 16.2（95%置信区间：19.5 至 10.3）（平均差值：48.8，95%置信区间：41.4 至 56.3，P<0.0001）。真 TENS 组有 4 例（8%）患者和假 TENS 组有 24 例（48%）患者在 30 分钟后需要使用解救药物。