Luchesa Cesar Antonio, Lopes Agnaldo José
Rehabilitation Sciences Post-Graduation Programme, Augusto Motta University Center (UNISUAM), Rio de Janeiro, Brazil.
Rehabilitation Center, University Center Fundação Assis Gurgacz (FAG), Cascavel, Brazil.
Rehabil Res Pract. 2022 Jun 2;2022:9138602. doi: 10.1155/2022/9138602. eCollection 2022.
Changes in lifestyle, a carbohydrate-rich diet, and decreased physical activity are part of the context that led to an obesity pandemic. Treating obesity is a task that requires multidisciplinary care; however, in many cases, conventional therapy has no effect, requiring surgical intervention. This, in turn, is not without risks and causes important changes in lung function. Therefore, the aim of this study is to evaluate the effect of electroanalgesia through conventional transcutaneous electrical nerve stimulation (TENS) on the pain and lung function in the postoperative period of bariatric surgery.
This is a controlled and blinded clinical trial with 66 subjects who underwent bariatric surgery. The participants were randomized into 2 groups as follows: an intervention group treated with TENS ( = 33) and a placebo group ( = 33). The participants underwent 4 TENS sessions, and the effect on pain was assessed using a visual analogue scale (VAS pain). Lung function was measured by spirometry.
There were no differences between the 2 groups regarding time of surgery and time of mechanical ventilation. Compared to placebo, TENS reduced pain in the intervention group ( = 0.001). Regarding the effect of electroanalgesia on pulmonary function, the spirometric parameters were similar between the groups. However, regarding muscle strength between the preoperative and postoperative periods, maximal inspiratory pressure (MIP) was maintained in the intervention group and decreased in the placebo group ( = 0.03). Compared with that in the intervention group, the respiratory rate in the placebo group increased during the application of TENS ( = 0.003).
Electroanalgesia reduces pain in patients who underwent bariatric surgery. Importantly, in these patients, the MIP is maintained between the preoperative and postoperative periods. However, electroanalgesia does not contribute to improvements in spirometric data. This trial is registered with NCT04800640.
生活方式的改变、富含碳水化合物的饮食以及体力活动的减少是导致肥胖大流行的部分因素。治疗肥胖是一项需要多学科护理的任务；然而，在许多情况下，传统疗法无效，需要手术干预。而手术干预并非没有风险，且会引起肺功能的重要变化。因此，本研究的目的是评估通过传统经皮电刺激神经疗法（TENS）进行电镇痛对减肥手术后疼痛和肺功能的影响。
这是一项针对66例接受减肥手术患者的对照双盲临床试验。参与者被随机分为两组：TENS治疗干预组（n = 33）和安慰剂组（n = 33）。参与者接受4次TENS治疗，使用视觉模拟量表（VAS疼痛）评估对疼痛的影响。通过肺活量测定法测量肺功能。
两组在手术时间和机械通气时间方面无差异。与安慰剂相比，TENS减轻了干预组的疼痛（P = 0.001）。关于电镇痛对肺功能的影响，两组的肺活量测定参数相似。然而，关于术前和术后的肌肉力量，干预组的最大吸气压力（MIP）保持不变，而安慰剂组则下降（P = 0.03）。与干预组相比，安慰剂组在TENS治疗期间呼吸频率增加（P = 0.003）。
电镇痛可减轻减肥手术患者的疼痛。重要的是，在这些患者中，术前和术后期间MIP保持不变。然而，电镇痛对肺活量测定数据的改善没有作用。本试验已在ClinicalTrials.gov上注册，注册号为NCT04800640。
