Smith Caroline M, Guralnick Melvin S, Gelfand Morrie M, Jeans Mary Ellen
School of Nursing, McGill University, Montreal, Que. H3A 2A7, Canada Department of Obstetrics and Gynecology, The Sir Mortimer B. Davis Jewish General Hospital, Montreal, Que. H3T 1E2 Canada.
Pain. 1986 Nov;27(2):181-193. doi: 10.1016/0304-3959(86)90209-5.
The purpose of this study was to examine the effect of continuous transcutaneous electrical nerve stimulation (TENS) near the incision site on post-cesarean pain and on analgesic intake during the early postoperative period. This investigation utilised a 2-group (TENS-treated and placebo TENS-treated), single-blind experimental design. Eighteen multiparous women, each having undergone an elective cesarean delivery, participated in the study. Nine patients received TENS and nine placebo stimulation. The treatment was continuous through to the third day following the day of surgery. The McGill Pain Questionnaire was used to estimate the three most frequent types of post-cesarean-associated pain, and records of the patients' analgesic intake were obtained from hospital charts. The results suggest that TENS was significantly more effective than placebo TENS in reducing cutaneous, movement-associated incisional pain. However, pain resulting from internal structures, i.e., deep pain, afterbirth pain (due to uterine contractions), and the somatic pain associated with decreased peristalsis (gas pains) were not amenable to TENS. No significant differences in analgesic intake were observed. The possible reasons for these findings are discussed.
本研究的目的是探讨在切口部位附近进行连续经皮电神经刺激(TENS)对剖宫产术后疼痛及术后早期镇痛药物摄入量的影响。本研究采用两组(TENS治疗组和安慰剂TENS治疗组)单盲实验设计。18名经产妇,均接受了择期剖宫产,参与了本研究。9例患者接受TENS治疗,9例接受安慰剂刺激。治疗持续至术后第三天。采用麦吉尔疼痛问卷评估剖宫产术后最常见的三种疼痛类型,并从医院病历中获取患者镇痛药物摄入记录。结果表明,在减轻皮肤性、与活动相关的切口疼痛方面,TENS比安慰剂TENS显著更有效。然而,由内部结构引起的疼痛,即深部疼痛、产后疼痛(由于子宫收缩)以及与蠕动减少相关的躯体疼痛(气痛),TENS对其无效。在镇痛药物摄入量方面未观察到显著差异。讨论了这些发现的可能原因。